Cognitive and behavioural responses to illness information in health anxiety

A cognitive-behavioural theory (CBT) has been put forth to explain hypochondriasis and less extreme forms of health anxiety (Warwick & Salkovskis, 1990). The extent to which less extreme forms of health anxiety are relevant for understanding illness behaviour remains unclear, however. Further, the independence of health anxiety from a more general construct of negative affectivity, as well as response styles is not known. The CBT of health anxiety predicts that in response to illness information health anxious individuals will show a characteristic cognitive (e.g., attend to and misinterpret information) and behavioural (e.g., avoidance and reassurance seeking) response. Although the predictions are supported by clinical observations, rigorous and systematic contrasts of health anxious and non-health anxious individuals to the same objective health related information have not yet been carried out. Further, there are a number of additional issues that need to be clarified with respect to the theory, including: (a) Are there additional cognitive and behavioural responses involved in health anxiety not predicted by the CBT?; (b) Are health anxious individuals deficient in there use of certain adaptive responses to illness information?; and (c) Are the cognitive and behavioural responses shown by health anxious individuals moderated under certain circumstances? In the present study, students scoring either within normal or nonclinically high ranges on a measure of health anxiety underwent a physiological test ostensibly examining risk for medical complications and were randomly assigned to receive positive, negative, or ambiguous test results. They then underwent a cold pressor task ostensibly to examine physiological activity and were asked questions tapping their responses to the diagnostic information and painful procedure. They were also judged for facial expressiveness. Unmistakable support was found for a dysfunctional cognitive (e.g., negative interpretational focus) and behavioural (e.g., reassurance seeking) response style among health anxious individuals. Little support was found for either cognitive or behavioural avoidance in health anxiety. Not anticipated by the CBT, as time went on health anxious individuals became more expressive of their pain; this may have important implications, since increased expressiveness could result in an increase in the felt emotional experience. Adding to the CBT, evidence was found to suggest that health anxious individuals may have a deficit or be deficient in their use of a positive concrete somatic monitoring strategy. Finally, the results suggested that there are statistically and clinically significant differences among nonclinically health anxious individuals and normals that can not be accounted for by differences in negative affectivity or response styles.Arts, Faculty ofPsychology, Department ofGraduat