The Validity and Reliability Study of the Turkish Version of Cognitive Complaints in Bipolar Disorder Rating Assessment

Abstract

Objectives: The Cognitive Complaints Rating Scale in Bipolar Disorder (COBRA) is a brief self-report measure designed to capture Subjective Cognitive Complaints (SCC) experienced by patients with Bipolar Disorder (BD). This study aimed to translate the 16-item COBRA into Turkish (COBRA-TR) and comprehensively assess its psychometric properties. Methods: We recruited 160 participants, consisting of 80 BD patients in remission and 80 controls. The psychometric evaluation included confirmatory factor analysis (CFA), calculation of internal consistency, and examination of divergent and convergent validity through Pearson's correlations with related scales. Statistical analyses were performed using the SPSSv29 and the Jamovi software of R Statistical Package. Results: The COBRA-TR showed excellent internal consistency (Cronbach α = 0.898) and robust convergent validity, strongly correlating with the Cognitive Failures Questionnaire (r = 0.784, p < 0.001). It demonstrated moderate-to-high correlations with cognitive (r = 0.574, p < 0.001) and global functioning (r = 0.624, p < 0.001), as assessed by the Functioning Assessment Short Test. CFA provided strong support for a unidimensional factor structure. Furthermore, the COBRA-TR successfully differentiated patients from controls. Clinical variables minimally influenced the scale, though it showed weak correlations with subclinical depressive symptoms (r = 0.325, p = 0.003) and working memory performance (r = −0.250, p = 0.002). Conclusion: Our findings highlight that the COBRA-TR is a highly reliable and valid tool, effectively capturing SCC among BD patients. Its brevity, ease of administration, and strong psychometric properties suggest its potential utility as a valuable instrument in both clinical practice and research settings. © 2025 Elsevier B.V., All rights reserved.