Health Anxiety: A Cognitive-Behavioral Framework

Abstract

Health anxiety (HA) is characterized by a preoccupation with the inaccurate belief that one has, or is in danger of developing, a serious medical illness. With the most recent Diagnostic and Statistical Manual of Mental Disorders, clinically interfering HA symptoms have been classified into two distinct diagnoses: illness anxiety disorder and somatic symptom disorder. Somatic symptom disorder is similar to an illness anxiety disorder, but with elevated levels of bodily complaints. Cognitive-behavioral therapy (CBT) for HA (also hypochondriasis) involves psychoeducation, exposure and response prevention, and stress management. Initial investigations using CBT for hypochondriasis have produced encouraging results. Meta-analyses have shown that CBT is effective in reducing HA/hypochondriasis symptoms. The treatment becomes significantly more complicated when the patient currently has a comorbid medical illness such as cancer, diabetes, pain, and chronic obstructive pulmonary disease. Ultimately, a primary goal of HA treatment is to guide a patient to challenge their own dysfunctional beliefs about illness and physical symptoms through exposing themselves to the very thoughts that trigger and maintain their anxiety. This enables the patient to act in a manner consistent with their values and goals, rather than one that is dictated by their anxieties and compulsive pursuit of safety signals. (PsycINFO Database Record (c) 2019 APA, all rights reserved)