Abstract
Severe health anxiety is the preoccupation that one has or will acquire a severe medical disease and impairs individual’s functioning in the psychological, social, professional, and other domains of daily life. This chapter briefly describes this category of symptomatology in terms of epidemiology, predispositional factors, and impact, and it focuses on reviewing the mechanisms that were linked to the maintenance of health anxiety, which stem from the cognitive-behavioral conceptualization and existing empirical evidence. In addition, this chapter introduces a mechanism that potentially buffers the impact of health anxiety on individual’s functioning and provides an overview of behavioral and cognitive approaches in therapy. Directions for future research in areas that warrant further investigation are also provided.
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References
Abramowitz, J. S., & Moore, E. L. (2007). An experimental analysis of hypochondriasis. Behaviour Research and Therapy, 45(3), 413–424. https://doi.org/10.1016/j.brat.2006.04.005
Alberts, N. M., & Hadjistavropoulos, H. D. (2014). Parental illness, attachment dimensions, and health beliefs: Testing the cognitive-behavioural and interpersonal models of health anxiety. Anxiety, Stress, and Coping, 27(2), 216–228. https://doi.org/10.1080/10615806.2013.835401
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5) (5th ed.). Washington, DC: American Psychiatric Publishing. https://doi.org/10.1080/09515070801936578
Asmundson, G., Taylor, S., & Cox, B. (2001). Health anxiety: Clinical and research perspectives on hypochondriasis and related conditions. New York: Wiley. https://doi.org/10.1348/014466502760379181
Asmundson, G. J. G., Abramowitz, J. S., Richter, A. A., & Whedon, M. (2010). Health anxiety: Current perspectives and future directions. Current Psychiatry Reports, 12(4), 306–312. https://doi.org/10.1007/s11920-010-0123-9
Bailey, R., & Wells, A. (2015). Metacognitive beliefs moderate the relationship between catastrophic misinterpretation and health anxiety. Journal of Anxiety Disorders, 34, 8–14. https://doi.org/10.1016/j.janxdis.2015.05.005
Bailey, R., & Wells, A. (2016). Is metacognition a causal moderator of the relationship between catastrophic misinterpretation and health anxiety? A prospective study. Behaviour Research and Therapy, 78, 43–50. https://doi.org/10.1016/j.brat.2016.01.002
Bardeen, J. R., & Fergus, T. A. (2014). An examination of the incremental contribution of emotion regulation difficulties to health anxiety beyond specific emotion regulation strategies. Journal of Anxiety Disorders, 28(4), 394–401. https://doi.org/10.1016/j.janxdis.2014.03.002
Barsky, A. J., Frank, C. B., Cleary, P. D., Wyshak, G., & Klerman, G. L. (1991). The relation between hypochondriasis and age. The American Journal of Psychiatry, 148(7), 923–928.
Barsky, A. J., Orav, E. J., & Bates, D. W. (2005). Somatization increases medical utilization and costs independent of psychiatric and medical comorbidity. Archives of General Psychiatry, 62(8), 903. https://doi.org/10.1001/archpsyc.62.8.903
Barsky, A. J., & Wyshak, G. (1990). Hypochondriasis and somatosensory amplification. British Journal of Psychiatry, 157(3), 404–409. https://doi.org/10.1192/bjp.157.3.404
Barsky, A. J., Wyshak, G., Klerman, G. L., & Latham, K. S. (1990). The prevalence of hypochondriasis in medical outpatients. Social Psychiatry and Psychiatric Epidemiology, 25(2), 89–94. https://doi.org/10.1007/BF00794988
Bogaerts, K., Notebaert, K., Van Diest, I., Devriese, S., De Peuter, S., & Van Den Bergh, O. (2005). Accuracy of respiratory symptom perception in different affective contexts. Journal of Psychosomatic Research, 58(6), 537–543. https://doi.org/10.1016/j.jpsychores.2004.12.005
Bonanno, G. A., Papa, A., Lalande, K., Westphal, M., & Coifman, K. (2004). The importance of being flexible: The ability to both enhance and suppress emotional expression predicts long-term adjustment. Psychological Science, 15(7), 482–487. https://doi.org/10.1111/j.0956-7976.2004.00705.x
Brady, R. E., & Lohr, J. M. (2014). A behavioral test of contamination fear in excessive health anxiety. Journal of Behavior Therapy and Experimental Psychiatry, 45(1), 122–127. https://doi.org/10.1016/j.jbtep.2013.09.011
Bravo, I. M., & Silverman, W. K. (2001). Anxiety sensitivity, anxiety, and depression in older patients and their relation to hypochondriacal concerns and medical illnesses. Aging & Mental Health, 5(4), 349–357. https://doi.org/10.1080/13607860120080305
Brownlee, S., Leventhal, H., & Balaban, M. (1992). Autonomic correlates of illness imagery. Psychophysiology, 29(2), 142–153. https://doi.org/10.1111/j.1469-8986.1992.tb01677.x
Burton, C. (2003). Beyond somatisation: A review of the understanding and treatment of medically unexplained physical symptoms (MUPS). British Journal of General Practice, 53(488), 231–239.
Buss, K. A., & Kiel, E. J. (2013). Temperamental risk factors for pediatric anxiety disorders. In R. A. Vasa & A. Krain Roy (Eds.), Pediatric anxiety disorders: A clinical guide (pp. 47–68). New York: Springer. https://doi.org/10.1007/978-1-4614-6599-7_3
Cameron, O. G. (2002). Visceral sensory neuroscience: Interoception. New York: Oxford University Press.
Chaturvedi, S. K., Desai, G., & Shaligram, D. (2006). Somatoform disorders, somatization and abnormal illness behaviour. International Review of Psychiatry, 18(1), 75–80. https://doi.org/10.1080/09540260500467087
Cisler, J. M., & Koster, E. H. W. (2010). Mechanisms of attentional biases towards threat in anxiety disorders: An integrative review. Clinical Psychology Review, 30(2), 203–216. https://doi.org/10.1016/j.cpr.2009.11.003
Constantinou, E. (2014). Affective processing of interoceptive information in persons with medically unexplained symptoms. Leuven: KU Leuven.
Craig, A. D., & Craig, A. D. (2002). How do you feel? Interoception: The sense of the physiological condition of the body. Nature Reviews. Neuroscience, 3(8), 655–666. https://doi.org/10.1038/nrn894
Creed, F., & Barsky, A. (2004). A systematic review of the epidemiology of somatisation disorder and hypochondriasis. Journal of Psychosomatic Research, 56(4), 391–408. https://doi.org/10.1016/S0022-3999(03)00622-6
Damasio, A. R. (1994). Descartes’ error: Emotion, reason and the human brain. New York: Grosset/Putman.
Damasio, A. R. (1999). The feeling of what happens: Body and emotion in the making of consciousness. New York: Harcourt Brace.
Derakshan, N., Eysenck, M. W., & Myers, L. B. (2007). Emotional information processing in repressors: The vigilance-avoidance theory. Cognition & Emotion, 21(8), 1585–1614. https://doi.org/10.1080/02699930701499857
Duddu, V., Chaturvedi, S. K., & Isaac, M. K. (2003). Amplification and attribution styles in somatoform and depressive disorders: A study from Bangalore, India. Psychopathology, 36(2), 98–103. https://doi.org/10.1159/000070365
Eftekhari, A., Zoellner, L. A., & Vigil, S. A. (2009). Patterns of emotion regulation and psychopathology. Anxiety, Stress & Coping, 22(5), 571–586. https://doi.org/10.1080/10615800802179860
Eilenberg, T., Kronstrand, L., Fink, P., & Frostholm, L. (2013). Acceptance and commitment group therapy for health anxiety: Results from a pilot study. Journal of Anxiety Disorders, 27(5), 461–468. https://doi.org/10.1016/j.janxdis.2013.06.001
Fairclough, S. H., & Goodwin, L. (2007). The effect of psychological stress and relaxation on interoceptive accuracy: Implications for symptom perception. Journal of Psychosomatic Research, 62(3), 289–295. https://doi.org/10.1016/j.jpsychores.2006.10.017
Fergus, T. A., & Valentiner, D. P. (2010). Disease phobia and disease conviction are separate dimensions underlying hypochondriasis. Journal of Behavior Therapy and Experimental Psychiatry, 41(4), 438–444. https://doi.org/10.1016/j.jbtep.2010.05.002
Ferguson, E., Moghaddam, N. G., & Bibby, P. A. (2007). Memory bias in health anxiety is related to the emotional valence of health-related words. Journal of Psychosomatic Research, 62(3), 263–274. https://doi.org/10.1016/j.jpsychores.2007.01.015
Frazier, L. D., & Waid, L. D. (1999). Influences on anxiety in later life: The role of health status, health perceptions, and health locus of control. Aging & Mental Health, 3(3), 213–220. https://doi.org/10.1080/13607869956163
Fulton, J. J., Marcus, D. K., & Merkey, T. (2011). Irrational health beliefs and health anxiety. Journal of Clinical Psychology, 67(6), 527–538. https://doi.org/10.1002/jclp.20769
Goetz, A. R., Lee, H.-J., & Cougle, J. R. (2012). The association between health anxiety and disgust reactions in a contamination-based behavioral approach task. Anxiety, Stress & Coping, 26(4), 1–16. https://doi.org/10.1080/10615806.2012.684241
Görgen, S. M., Hiller, W., & Witthöft, M. (2014). Health anxiety, cognitive coping, and emotion regulation: A latent variable approach. International Journal of Behavioral Medicine, 21(2), 364–374. https://doi.org/10.1007/s12529-013-9297-y
Grabe, H. J., Baumeister, S. E., John, U., Freyberger, H. J., & Völzke, H. (2009). Association of mental distress with health care utilization and costs: A 5-year observation in a general population. Social Psychiatry and Psychiatric Epidemiology, 44(10), 835–844. https://doi.org/10.1007/s00127-009-0005-9
Gramling, S. E., Clawson, E. P., & McDonald, M. K. (1996). Perceptual and cognitive abnormality model of hypochondriasis: Amplification and physiological reactivity in women. Psychosomatic Medicine, 58(5), 423–431. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/8902894.
Gropalis, M., Bleichhardt, G., Hiller, W., & Witthöft, M. (2012). Specificity and modifiability of cognitive biases in hypochondriasis. Journal of Consulting and Clinical Psychology, 81(3), 558–565. https://doi.org/10.1037/a0028493
Gureje, O., Üstun, T. B., & Simon, G. E. (1997). The syndrome of hypochondriasis: A cross-national study in primary care. Psychological Medicine, 27(5), 1001–1010.
Hadjistavropoulos, H. D., Janzen, J. A., Kehler, M. D., Leclerc, J. A., Sharpe, D., & Bourgault-Fagnou, M. D. (2012). Core cognitions related to health anxiety in self-reported medical and non-medical samples. Journal of Behavioral Medicine, 35(2), 167–178. https://doi.org/10.1007/s10865-011-9339-3
Haga, S. M., Kraft, P., & Corby, E.-K. (2009). Emotion regulation: Antecedents and well-being outcomes of cognitive reappraisal and expressive suppression in cross-cultural samples. Journal of Happiness Studies, 10(3), 271–291. https://doi.org/10.1007/s10902-007-9080-3
Hager, A. D., & Runtz, M. G. (2012). Physical and psychological maltreatment in childhood and later health problems in women: An exploratory investigation of the roles of perceived stress and coping strategies. Child Abuse & Neglect, 36(5), 393–403. https://doi.org/10.1016/j.chiabu.2012.02.002
Hayes, S. C., Strosahl, K., Wilson, K. G., Bissett, R. T., Pistorello, J., Toarmino, D., … McCurry, S. M. (2004). Measuring experiential avoidance: A preliminary test of a working model. The Psychological Record, 54(4), 553–578.
Hedman, E., Andersson, G., Andersson, E., Ljótsson, B., Rück, C., Asmundson, G. J. G., & Lindefors, N. (2011). Internet-based cognitive-behavioural therapy for severe health anxiety: Randomised controlled trial. British Journal of Psychiatry, 198(3), 230–236. https://doi.org/10.1192/bjp.bp.110.086843
Hitchcock, P. B., & Mathews, A. (1992). Interpretation of bodily symptoms in hypochondriasis. Behaviour Research and Therapy, 30(3), 223–234. https://doi.org/10.1016/0005-7967(92)90068-R
Hu, T., Zhang, D., Wang, J., Mistry, R., Ran, G., & Wang, X. (2014). Relation between emotion regulation and mental health: A meta-analysis review. Psychological Reports: Measures & Statistics, 114(2), 341–362. https://doi.org/10.2466/03.20.PR0.114k22w4
Hyphantis, T., Tomenson, B., Paika, V., Almyroudi, A., Pappa, C., Tsifetaki, N., … Creed, F. (2009). Somatization is associated with physical health-related quality of life independent of anxiety and depression in cancer, glaucoma and rheumatological disorders. Quality of Life Research, 18(8), 1029–1042. https://doi.org/10.1007/s11136-009-9527-6
James, W. (1984). What is emotion? Mind, 9, 188–205.
Jasper, F., & Witthoft, M. (2011). Health anxiety and attentional bias: The time course of vigilance and avoidance in light of pictorial illness information. Journal of Anxiety Disorders, 25(8), 1131–1138. https://doi.org/10.1016/j.janxdis.2011.08.004
Jasper, F., & Witthöft, M. (2013). Automatic evaluative processes in health anxiety and their relations to emotion regulation. Cognitive Therapy and Research, 37(3), 521–533. https://doi.org/10.1007/s10608-012-9484-1
Karademas, E. C., Christopoulou, S., Dimostheni, A., & Pavlu, F. (2008). Health anxiety and cognitive interference: Evidence from the application of a modified Stroop task in two studies. Personality and Individual Differences, 44(5), 1138–1150. https://doi.org/10.1016/j.paid.2007.11.007
Karekla, M., & Panayiotou, G. (2011). Coping and experiential avoidance: Unique or overlapping constructs? Journal of Behavior Therapy and Experimental Psychiatry, 42(2), 163–170. https://doi.org/10.1016/j.jbtep.2010.10.002
Kashdan, T. B., Barrios, V., Forsyth, J. P., & Steger, M. F. (2006). Experiential avoidance as a generalized psychological vulnerability: Comparisons with coping and emotion regulation strategies. Behaviour Research and Therapy, 44(9), 1301–1320. https://doi.org/10.1016/j.brat.2005.10.003
Katzer, A., Oberfeld, D., Hiller, W., & Witthöft, M. (2011). Tactile perceptual processes and their relationship to medically unexplained symptoms and health anxiety. Journal of Psychosomatic Research, 71(5), 335–341. https://doi.org/10.1016/j.jpsychores.2011.03.009
Kellner, R. (1986). Somatization and hypochondriasis. Santa Barbara, CA: Praeger.
Kim, J., & Cicchetti, D. (2009). Longitudinal pathways linking child maltreatment, emotion regulation, peer relations, and psychopathology. Journal of Child Psychology and Psychiatry, 51(6), 706–716. https://doi.org/10.1111/j.1469-7610.2009.02202.x
Kim, S., Kim, K., & Lee, J.-H. (2014). Effects of dispositional coping strategy and level of health anxiety on attention bias. Social Behavior & Personality: An International Journal, 42(7), 1183–1190. https://doi.org/10.2224/sbp.2014.42.7.1183
Kim, S., & Lee, J. H. (2014). Time course of attentional bias for health-related information in individuals with health anxiety. Journal of Health Psychology, 21(8), 1527–1535. https://doi.org/10.1177/1359105314557976
Köteles, F., & Simor, P. (2014). Modern health worries, somatosensory amplification, health anxiety, and well-being: A cross-sectional study. European Journal of Mental Health, 9(1), 20–33. https://doi.org/10.5708/EJMH.9.2014.1.2
Köteles, F., Szemerszky, R., Freyler, A., & Bárdos, G. (2011). Somatosensory amplification as a possible source of subjective symptoms behind modern health worries. Scandinavian Journal of Psychology, 52(2), 174–178. https://doi.org/10.1111/j.1467-9450.2010.00846.x
Krautwurst, S., Gerlach, A. L., Gomille, L., Hiller, W., & Witthöft, M. (2014). Health anxiety: An indicator of higher interoceptive sensitivity? Journal of Behavior Therapy and Experimental Psychiatry, 45(2), 303–309. https://doi.org/10.1016/j.jbtep.2014.02.001
Krautwurst, S., Gerlach, A. L., & Witthöft, M. (2016). Interoception in pathological health anxiety. Journal of Abnormal Psychology, 125(8), 1179–1184. https://doi.org/10.1037/abn0000210
Kroenke, K. (2003). Patients presenting with somatic complaints: Epidemiology, psychiatric co-morbidity and management. International Journal of Methods in Psychiatric Research, 12(1), 34–43. https://doi.org/10.1002/mpr.140
Lee, H., Turkel, J. E., Cotter, S. P., Milliken, J. M., Cougle, J., Goetz, A. R., & Lesnick, A. M. (2013). Attentional bias toward personally relevant health-threat words. Anxiety, Stress & Coping, 26(5), 493–507. https://doi.org/10.1080/10615806.2012.713474
Lee, H. J., Goetz, A. R., Turkel, J. E., & Siwiec, S. G. (2015). Computerized attention retraining for individuals with elevated health anxiety. Anxiety, Stress, and Coping, 28(2), 226–237. https://doi.org/10.1080/10615806.2014.918964
Leibbrand, R., Hiller, W., & Fichter, M. M. (2000). Hypochondriasis and somatization: Two distinct aspects of somatoform disorders? Journal of Clinical Psychology, 56(1), 63–72. https://doi.org/10.1002/(SICI)1097-4679(200001)56:1<63::AID-JCLP6>3.0.CO;2-O
Leonidou, C., & Panayiotou, G. (2016). Assessing health anxiety with the Greek SHAI and identifying correlates and predictors. In Oral presentation at the 30th Annual Conference of the European Health Psychology Society, Aberdeen, Scotland.
Leonidou, C., Panayiotou, G., Bati, A., & Karekla, M. (2014a). Correlates and predictors of severe health anxiety. In Poster presented at the 4th Annual Conference of the Centre of Applied Neuroscience, Nicosia, Cyprus.
Leonidou, C., Panayiotou, G., Bati, A., & Karekla, M. (2014b). Factors associated with the clinical levels of somatization and hypochondriasis: The role of anxiety and panic symptoms. In Poster presented at the EABCT Congress (p. 19). Hague, Netherlands: Psychomed.
Leonidou, C., Panayiotou, G., Karekla, M., & Bati, A. (2016). Coping with psychosomatic symptoms: The buffering role of psychological flexibility and impact on quality of life. Journal of Health Psychology. https://doi.org/10.1177/1359105316666657
Lovas, D. A., & Barsky, A. J. (2010). Mindfulness-based cognitive therapy for hypochondriasis, or severe health anxiety: A pilot study. Journal of Anxiety Disorders, 24(8), 931–935. https://doi.org/10.1016/j.janxdis.2010.06.019
MacLeod, A. K., Haynes, C., & Sensky, T. (1998). Attributions about common bodily sensations: Their associations with hypochondriasis and anxiety. Psychological Medicine, 28(1), 225–228. https://doi.org/10.1017/S0033291797005849
MacSwain, K. L. H., Sherry, S. B., Stewart, S. H., Watt, M. C., Hadjistavropoulos, H. D., & Graham, A. R. (2009). Gender differences in health anxiety: An investigation of the interpersonal model of health anxiety. Personality and Individual Differences, 47(8), 938–943. https://doi.org/10.1016/j.paid.2009.07.020
Magariños, M., Zafar, U., Nissenson, K., & Blanco, C. (2002). Epidemiology and treatment of hypochondriasis. CNS Drugs, 16(1), 9–22. https://doi.org/10.2165/00023210-200216010-00002
Mailloux, J., & Brener, J. (2002). Somatosensory amplification and its relationship to heartbeat detection ability. Psychosomatic Medicine, 64(2), 353–357. https://doi.org/10.1097/00006842-200203000-00020
Marcus, D. K., Gurley, J. R., Marchi, M. M., & Bauer, C. (2007). Cognitive and perceptual variables in hypochondriasis and health anxiety: A systematic review. Clinical Psychology Review, 27(2), 127–139. https://doi.org/10.1016/j.cpr.2006.09.003
Marcus, D. K., Hughes, K. T., Arnau, R. C., Salkovskis, P., Warwick, H., Salkovskis, P., … Baer, R. (2008). Health anxiety, rumination, and negative affect: A mediational analysis. Journal of Psychosomatic Research, 64(5), 495–501. https://doi.org/10.1016/j.jpsychores.2008.02.004
Martin, A., Buech, A., Schwenk, C., & Rief, W. (2007). Memory bias for health-related information in somatoform disorders. Journal of Psychosomatic Research, 63(6), 663–671. https://doi.org/10.1016/j.jpsychores.2007.05.005
Masuda, A., & Tully, E. C. (2012). The role of mindfulness and psychological flexibility in somatization, depression, anxiety, and general psychological distress in a nonclinical college sample. Journal of Evidence-Based Complementary & Alternative Medicine, 17(1), 66–71. https://doi.org/10.1177/2156587211423400
McManus, F., Muse, K., Surawy, C., Hackmann, A., & Williams, J. M. G. (2015). Relating differently to intrusive images: The impact of mindfulness-based cognitive therapy (MBCT) on intrusive images in patients with severe health anxiety (hypochondriasis). Mindfulness, 6(4), 788–796. https://doi.org/10.1007/s12671-014-0318-y
Muse, K., McManus, F., Hackmann, A., Williams, M., & Williams, M. (2010). Intrusive imagery in severe health anxiety: Prevalence, nature and links with memories and maintenance cycles. Behaviour Research and Therapy, 48(8), 792–798. https://doi.org/10.1016/j.brat.2010.05.008
Neng, J. M. B., & Weck, F. (2015). Attribution of somatic symptoms in hypochondriasis. Clinical Psychology and Psychotherapy, 22(2), 116–124. https://doi.org/10.1002/cpp.1871
Noyes, R., Stuart, S., Langbehn, D. R., Happel, R. L., Longley, S. L., Yagla, S. J., … Goldberg, S. (2002). Childhood antecedents of hypochondriasis. Psychosomatics, 43(4), 282–289. https://doi.org/10.1176/appi.psy.43.4.282
Noyes, R., Stuart, S. P., Langbehn, D. R., Happel, R. L., Longley, S. L., Muller, B. A., & Yagla, S. J. (2003). Test of an interpersonal model of hypochondriasis. Psychosomatic Medicine, 65(2), 292–300. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12651997.
Olatunji, B. O., Deacon, B. J., & Abramowitz, J. S. (2009). Is hypochondriasis an anxiety disorder? British Journal of Psychiatry, 194(6), 481–482. https://doi.org/10.1192/bjp.bp.108.061085
Olatunji, B. O., Deacon, B. J., Abramowitz, J. S., & Valentiner, D. P. (2007). Body vigilance in nonclinical and anxiety disorder samples: Structure, correlates, and prediction of health concerns. Behavior Therapy, 38(4), 392–401. https://doi.org/10.1016/j.beth.2006.09.002
Olatunji, B. O., Etzel, E. N., Tomarken, A. J., Ciesielski, B. G., & Deacon, B. (2011). The effects of safety behaviors on health anxiety: An experimental investigation. Behaviour Research and Therapy, 49(11), 719–728. https://doi.org/10.1016/j.brat.2011.07.008
Olatunji, B. O., Kauffman, B. Y., Meltzer, S., Davis, M. L., Smits, J. A. J. J., & Powers, M. B. (2014). Cognitive-behavioral therapy for hypochondriasis/health anxiety: A meta-analysis of treatment outcome and moderators. Behaviour Research and Therapy, 58, 65–74. https://doi.org/10.1016/j.brat.2014.05.002
Otto, M. W., Pollack, M. H., Sachs, G. S., & Rosenbaum, J. F. (1992). Hypochondriacal concerns, anxiety sensitivity, and panic disorder. Journal of Anxiety Disorders, 6(2), 93–104. https://doi.org/10.1016/0887-6185(92)90008-U
Owens, K., Asmundson, G., Hadjistavropoulos, T., & Owens, T. (2004). Attentional bias toward illness threat cues in individuals with health anxiety. Cognitive Therapy and Research, 28(1), 57–66. https://doi.org/10.1023/B:COTR.0000016930.85884.29
Panayiotou, G., Karekla, M., & Mete, I. (2014). Dispositional coping in individuals with anxiety disorder symptomatology: Avoidance predicts distress. Journal of Contextual Behavioral Science, 3(4), 314–321. https://doi.org/10.1016/j.jcbs.2014.07.001
Papageorgiou, C., & Wells, A. (1998). Effects of attention training on hypochondriasis: A brief case series. Psychological Medicineedicine, 28(1), 193–200. https://doi.org/10.1017/S0033291797005825
Parker, J. D. A., Bagby, R. M., & Taylor, G. J. (1989). Toronto alexithymia scale, EPQ and self-report measures of somatic complaints. Personality and Individual Differences, 10(6), 599–604. https://doi.org/10.1016/0191-8869(89)90219-5
Pauli, P., & Alpers, G. W. (2002). Memory bias in patients with hypochondriasis and somatoform pain disorder. Journal of Psychosomatic Research, 52(1), 45–53. https://doi.org/10.1016/S0022-3999(01)00295-1
Pollatos, O., Matthias, E., & Schandry, R. (2007). Heartbeat perception and P300 amplitude in a visual oddball paradigm. Clinical Neurophysiology, 118(10), 2248–2253. https://doi.org/10.1016/j.clinph.2007.06.057
Rachman, S. (2012). Health anxiety disorders: A cognitive construal. Behaviour Research and Therapy, 50(7–8), 502–512. https://doi.org/10.1016/j.brat.2012.05.001
Rachman, S., Radomsky, A. S., & Shafran, R. (2008). Safety behaviour: A reconsideration. Behaviour Research and Therapy, 46(2), 163–173. https://doi.org/10.1016/j.brat.2007.11.008
Rief, W., & Broadbent, E. (2007). Explaining medically unexplained symptoms: Models and mechanisms. Clinical Psychology Review, 27(7), 821–841. https://doi.org/10.1016/j.cpr.2007.07.005
Rief, W., & Hiller, W. (1998). Cognitive aspects of hypochondriasis and the somatization syndrome. Journal of Abnormal Psychology, 107(4), 587–595. https://doi.org/10.1037/0021-843X.107.4.587
Rodic, D., Meyer, A. H., Lieb, R., & Meinlschmidt, G. (2016). The association of sensory responsiveness with somatic symptoms and illness anxiety. International Journal of Behavioral Medicine, 23(1), 39–48. https://doi.org/10.1007/s12529-015-9483-1
Salkovskis, P. M. (1991). The importance of behaviour in the maintenance of anxiety and panic: A cognitive account. Behavioural and Cognitive Psychotherapy, 19(1), 6–19.
Salkovskis, P. M. (2003). Cognitive-behavioral treatment for severe and persistent health anxiety (hypochondriasis). Brief Treatment and Crisis Intervention, 3(3), 353–368. https://doi.org/10.1093/brief-treatment/mhg026
Salkovskis, P. M., & Warwick, H. M. C. (2001). Meaning, misinterpretations, and medicine: A cognitive-behavioral approach to understanding health anxiety and hypochondriasis. In D. R. Starcevic & V. Lipsitt (Eds.), Hypochondriasis: Modern perspectives on an ancient malady (pp. 202–222). New York: Oxford University Press.
Sansom-Daly, U. M., Bryant, R. A., Cohn, R. J., & Wakefield, C. E. (2014). Imagining the future in health anxiety: The impact of rumination on the specificity of illness-related memory and future thinking. Anxiety, Stress, and Coping, 27(5), 587–600. https://doi.org/10.1080/10615806.2014.880111
Schachter, S., & Singer, J. E. (1962). Cognitive, social and psychological determinants of emotional state. Psychological Review, 69(5), 379–399.
Schmidt, E., Witthöft, M., Kornadt, A., Rist, F., & Bailer, J. (2013). Negative automatic evaluation and better recognition of bodily symptom words in college students with elevated health anxiety. Cognitive Therapy and Research, 37(5), 1027–1040. https://doi.org/10.1007/s10608-013-9540-5
Schreiber, F., Neng, J. M. B., Heimlich, C., Witthöft, M., & Weck, F. (2014). Implicit affective evaluation bias in hypochondriasis: Findings from the affect misattribution Procedure. Journal of Anxiety Disorders, 28(7), 671–678. https://doi.org/10.1016/j.janxdis.2014.07.004
Sempertegui, G. A., Karreman, A., van Hout, G. C., & Bekker, M. H. (2016). Functional status in patients with medically unexplained physical symptoms: Coping styles and their relationship with depression and anxiety. Journal of Health Psychology. https://doi.org/10.1177/1359105316638548
Sherry, D. L., Sherry, S. B., Vincent, N. A., Stewart, S. H., Hadjistavropoulos, H. D., Doucette, S., & Hartling, N. (2014). Anxious attachment and emotional instability interact to predict health anxiety: An extension of the interpersonal model of health anxiety. Personality and Individual Differences, 56, 89–94. https://doi.org/10.1016/j.paid.2013.08.025
Stuart, S., & Noyes, R. (1999). Attachment and interpersonal communication in somatization. Psychosomatics, 40(1), 34–43. https://doi.org/10.1016/S0033-3182(99)71269-7
Surawy, C., McManus, F., Muse, K., & Williams, J. M. G. (2015). Mindfulness-based cognitive therapy (MBCT) for health anxiety (hypochondriasis): Rationale, implementation and case illustration. Mindfulness, 6(2), 382–392. https://doi.org/10.1007/s12671-013-0271-1
Tang, N. K. Y., Salkovskis, P. M., Poplavskaya, E., Wright, K. J., Hanna, M., & Hester, J. (2007). Increased use of safety-seeking behaviors in chronic back pain patients with high health anxiety. Behaviour Research and Therapy, 45(12), 2821–2835. https://doi.org/10.1016/j.brat.2007.05.004
Taylor, G. J., Bagby, R. M., & Parker, J. D. A. (1997). Disorders of affect regulation: Alexithymia in medical and psychiatric illness (Vol. 7). Cambridge: Cambridge University Press. https://doi.org/10.1002/1099-0879(200007)7:3<240::AID-CPP245>3.0.CO;2-7
Taylor, S., & Asmundson, G. J. G. (2004). What is health anxiety? In Treating health anxiety: A cognitive-behavioral approach (pp. 1–18). New York: Guilford.
Terluin, B., van Rhenen, W., Anema, J. R., & Taris, T. W. (2011). Psychological symptoms and subsequent sickness absence. International Archives of Occupational and Environmental Health, 84(7), 825–837. https://doi.org/10.1007/s00420-011-0637-4
Thastum, M., Watson, M., Kienbacher, C., Piha, J., Steck, B., Zachariae, R., … Romer, G. (2009). Prevalence and predictors of emotional and behavioural functioning of children where a parent has cancer. Cancer, 115(17), 4030–4039. https://doi.org/10.1002/cncr.24449
Thompson, R. A. (1994). Emotion regulation: A theme in search of definition. Monographs of the Society for Research in Child Development, 59(2–3), 25–52. https://doi.org/10.1111/j.1540-5834.1994.tb01276.x
Tull, M. T., Gratz, K. L., Salters, K., & Roemer, L. (2004). The role of experiential avoidance in posttraumatic stress symptoms and symptoms of depression, anxiety, and somatization. The Journal of Nervous and Mental Disease, 192(11), 754–761. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/15505519.
Tyrer, P., Cooper, S., Salkovskis, P., Tyrer, H., Crawford, M., Byford, S., … Barrett, B. (2014). Clinical and cost-effectiveness of cognitive behaviour therapy for health anxiety in medical patients: A multicentre randomised controlled trial. The Lancet, 383(9913), 219–225. https://doi.org/10.1016/S0140-6736(13)61905-4
Van Den Heuvel, O. A., Veltman, D. J., Groenewegen, D. J., Witter, M. P., Merkelbach, J., Cath, D. C., … Van Dyck, R. (2005). Disorder-specific neuroanatomical correlates of attentional bias in obsessive-compulsive disorder. Panic Disorder, and Hypochondriasis, 62(8), 922–933.
Waldinger, R. J., Schulz, M. S., Barsky, A. J., & Ahern, D. K. (2006). Mapping the road from childhood trauma to adult somatization: The role of attachment. Psychosomatic Medicine, 68(1), 129–135. https://doi.org/10.1097/01.psy.0000195834.37094.a4
Warwick, H., & Salkovskis, P. (1990). Hypochondriasis. Behaviour Research and Therapy, 28(2), 105–117. Retrieved from http://www.sciencedirect.com/science/article/pii/000579679090023C.
Warwick, H. M., Clark, D. M., Cobb, A. M., & Salkovskis, P. M. (1996). A controlled trial of cognitive-behavioural treatment of hypochondriasis. The British Journal of Psychiatry, 169(2), 189–195.
Watt, M. C., O’Connor, R. M., Stewart, S. H., Moon, E. C., & Terry, L. (2008). Specificity of childhood learning experiences in relation to anxiety sensitivity and illness/injury sensitivity: Implications for health anxiety and pain. Journal of Cognitive Psychotherapy, 22(2), 128–142. https://doi.org/10.1891/0889-8391.22.2.128
Watt, M. C., Stewart, S. H., Asmundson, G., Norton, G., Asmundson, G., Taylor, S., … Costa, P. (2000). Anxiety sensitivity mediates the relationships between childhood learning experiences and elevated hypochondriacal concerns in young adulthood. Journal of Psychosomatic Research, 49(2), 107–118. https://doi.org/10.1016/S0022-3999(00)00097-0
Weck, F., Neng, J. M. B., Göller, K., Müller-Marbach, A. M., Witthöft, M., Hiller, W., … Craig, T. K. (2010). Previous experiences with illness and traumatic experiences: A specific risk factor for hypochondriasis? Psychosomatics, 55(4), 362–371. https://doi.org/10.1016/j.psym.2013.10.005
Williams, M. J., McManus, F., Muse, K., & Williams, J. M. G. (2011). Mindfulness-based cognitive therapy for severe health anxiety (hypochondriasis): An interpretative phenomenological analysis of patients’ experiences. British Journal of Clinical Psychology, 50(4), 379–397. https://doi.org/10.1111/j.2044-8260.2010.02000.x
Witthoft, M., Kerstner, T., Ofer, J., Mier, D., Rist, F., Diener, C., … Witthöft, M. (2016). Cognitive biases in pathological health anxiety: The contribution of attention, memory, and evaluation processes. Clinical Psychological Science, 4(3), 464–479. https://doi.org/10.1177/2167702615593474
Witthöft, M., Mier, D., Ofer, J., Müller, T., Rist, F., Kirsch, P., … Diener, C. (2013). Neuronal and behavioral correlates of health anxiety: Results of an illness-related emotional Stroop task. Neuropsychobiology, 67(2), 93–102. https://doi.org/10.1159/000345545
Witthöft, M., Rist, F., & Bailer, J. (2008). Enhanced early emotional intrusion effects and proportional habituation of threat response for symptom and illness words in college students with elevated health anxiety. Cognitive Therapy and Research, 32(6), 818–842. https://doi.org/10.1007/s10608-007-9159-5
Zincir, S. B., Sunbul, M., Sunbul, E. A., Dalkilic, B., Cengiz, F., Kivrak, T., & Durmus, E. (2016). Evaluation of alexithymia, somatosensory sensitivity, and health anxiety levels in patients with noncardiac chest pain health anxiety levels in patients with noncardiac chest pain. Biomedical Research International, 2014, 1–6. https://doi.org/10.1155/2014/896183
Zvolensky, M. J., & Forsyth, J. P. (2002). Anxiety sensitivity dimensions in the prediction of body vigilance and emotional avoidance. Cognitive Therapy and Research, 26(4), 449–460. https://doi.org/10.1023/A:1016223716132
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Leonidou, C., Panayiotou, G. (2018). Maintaining Mechanisms of Health Anxiety: Current State of Knowledge. In: Charis, C., Panayiotou, G. (eds) Somatoform and Other Psychosomatic Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-89360-0_1
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