Core cognitions related to health anxiety in self-reported medical and non-medical samples

Abstract

The cognitive-behavioural model of health anxiety hypothesizes that the degree of health threat experienced by an individual is a function of the perceived: (1) likelihood of illness; (2) awfulness of illness; (3) difficulty coping with illness; and (4) inadequacy of medical services. While research has examined cognitions in health anxiety, it is not known whether these cognitions predict health anxiety in individuals who do or do not report medical conditions and whether these cognitions are uniquely related to health anxiety. After developing the Health Cognitions Questionnaire to assess these specific cognitions, we examined the extent to which the cognitions predicted health anxiety and poor response to reassurance in a healthy community sample (n = 273) and a sample who self-reported various medical conditions (n = 208). Supporting the cognitive-behavioural model, these cognitions predicted health anxiety and poor response to reassurance in both samples, with some differences observed between those who did or did not report medical conditions. The cognitions were uniquely related to health anxiety even after controlling for depression and general anxiety. Clinical and theoretical implications are discussed. Overall, the Health Cognitions Questionnaire has potential to facilitate further research on the development, maintenance, and treatment of health anxiety.

Rumination and self-defining memories in the context of health concerns

“…A total scale cut-off score of 18 is used to determine clinically significant health anxiety (Castellano et al, 2013;Rode, Salkovskis, Dowd, & Hanna, 2006). To examine both health anxiety, and catastrophic cognitions around future illness, this study included both the SHAI-total score (14-item main scale score, as used in Hadjistavropoulos et al, 2012) and the SHAI-NC supplementary subscale separately across analyses. Depression, Anxiety, Stress Scales-Short Form (DASS-21; Lovibond & Lovibond, 1995).…”

Is metacognition a causal moderator of the relationship between catastrophic misinterpretation and health anxiety? A prospective study

“…A number of cross sectional studies have demonstrated that these dysfunctional beliefs are specific to health anxiety and strongly associated and predictive of this disorder (e.g. Hadjistavropoulos et al, 2012;Fergus, 2014).…”

Psychometric properties of Internet-administered measures of health anxiety: An investigation of the Health Anxiety Inventory, the Illness Attitude Scales, and the Whiteley Index

“…Although the Internet has been used to administer measures of health anxiety and estimates of internal consistency have been reported [16][17][18][19][20][21], there is to our knowledge no previous study that has rigorously investigated the psychometric properties, including testretest reliability, of the Internet-administered HAI, IAS and WI using participants diagnosed with severe health anxiety. This is a major limitation as it cannot be taken for granted that reliability and validity estimates are the same when going from paper-and-pencil format to the Internet.…”