Metacognitive beliefs as a predictor of health anxiety in a self‐reporting Italian clinical sample

Abstract

Research has supported the specific role that anxiety sensitivity, health-related dysfunctional beliefs, and metacognitive beliefs may play in the development and maintenance of health anxiety symptoms. However, the role of metacognitive beliefs in health anxiety has only been explored in analogue samples. The aim of this study was to explore for the first time the association between metacognitive beliefs and health anxiety symptoms in a sample of participants who reported having received a diagnosis of severe health anxiety (hypochondriasis) or illness anxiety disorder and test whether these beliefs are significant predictors of health anxiety after controlling for anxiety, depression, anxiety sensitivity, and dysfunctional beliefs. A series of dimensional self-report measures were administered to a large Italian sample (N = 458). At a bivariate level, Beliefs that Thoughts are Uncontrollable had a stronger association with health anxiety than any of the dysfunctional beliefs and anxiety sensitivity subscales. Results from hierarchical multiple regression analysis indicated that Beliefs that Thoughts are Uncontrollable predicted health anxiety symptoms over-and-above depression, general anxiety, anxiety sensitivity, and health-related dysfunctional beliefs. Despite many important limitations, this study supported the hypothesis that metacognition may have an important role in health anxiety in clinical samples.

Exploring metacognitions in health anxiety and chronic pain: a cross-sectional survey

“…Results of the current study support previous findings that metacognitions are an important consideration in both HA [15][16][17][18][19] and chronic pain [10,[20][21][22], and extend this to the application of metacognitions about health in co-occurring HA and chronic pain. Specifically, results indicate that metacognitions about health may independently influence HA and pain-related outcomes, and suggest that both HA and pain-related disability may share an underlying etiological factor, namely metacognitions about biased thinking.…”

“…Research in HA indicates that metacognitions predict HA alongside, and often beyond, more specific cognitive factors, such as attentional bias towards health-related information and catastrophizing [7,[15][16][17][18][19]. In pain research, there has been a focus on how metacognitions are associated with pain catastrophizing, and how both constructs influence pain outcomes [11,[20][21][22].…”

Neural Correlates of Cognitive-Attentional Syndrome: An fMRI Study on Repetitive Negative Thinking Induction and Resting State Functional Connectivity

“…The discrepancy between lack of difference in number of physical illnesses and concerns in SCID-I and large difference in self-reported levels of pain symptoms may be due to self-focused attention and threat monitoring in people with high levels of CAS, resulting in fixation of attention on bodily sensations that would otherwise go unnoticed. Such a mechanism would be consistent with an understanding of health anxiety based on the metacognitive model (Melli et al, 2018).…”

Dysfunctional beliefs as mediators between illness-related intrusive thoughts and health anxiety symptoms

“…Regarding hypochondriasis, some authors have suggested that experiencing intrusive images about illness and death could increase the estimation of the likelihood of these events occurring (Muse et al, 2010). More recently, studies have proposed that a relevant belief associated with hypochondriasis is the belief that having thoughts about illness can cause illness (Bailey and Wells, 2015, 2016a, 2016bMelli et al, 2018), and Fergus (2015) found that cognitive fusion (CF) is associated with the cognitive and affective dimensions of health anxiety in non-clinical participants. These proposals are close to the meaning of the TAF-L belief.…”