| Summary: | 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.
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