Cognitive Therapy and Research

, Volume 37, Issue 5, pp 1027–1040 | Cite as

Negative Automatic Evaluation and Better Recognition of Bodily Symptom Words in College Students with Elevated Health Anxiety

  • Erika Schmidt
  • Michael Witthöft
  • Anna Kornadt
  • Fred Rist
  • Josef Bailer
Original Article


This study explored whether better recognition of symptom words is associated with stronger negative automatic evaluations of these words. We compared participants with health anxiety (HA; N = 27) to dysphoric (N = 29) and to non-health-anxious and non-dysphoric control participants (N = 28) in the Implicit Association Test (IAT) and in a word recognition task using health-threat-related, negative emotional, and neutral control words. Participants with HA made significantly more mistakes on the IAT than both other groups, in pairing the evaluation “harmless” with specific “symptoms” (p = .02, η2 = .10). Additionally, recognition performance was positively related to the IAT evaluation bias. The findings suggest that persons with HA automatically interpret symptoms as being more dangerous than the others saw them. This evaluation bias might explain the facilitation of access to symptom information in working memory that underlies cognitive biases observed in HA.


Health anxiety Hypochondriasis Automatic evaluation Implicit Association Test Memory bias 


Conflict of interest



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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Erika Schmidt
    • 1
  • Michael Witthöft
    • 2
  • Anna Kornadt
    • 3
  • Fred Rist
    • 4
  • Josef Bailer
    • 5
  1. 1.Department of Quality Management and Social MedicineUniversity Freiburg—Medical Center, Albert-Ludwigs-Universität/Universitätsklinikum FreiburgFreiburgGermany
  2. 2.Johannes Gutenberg-UniversitätMainzGermany
  3. 3.Friedrich-Schiller-UniversitätJenaGermany
  4. 4.Westfälische Wilhelms-UniversitätMünsterGermany
  5. 5.Zentralinstitut für Seelische GesundheitMannheimGermany

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