The Short Health Anxiety Inventory: Psychometric Properties and Construct Validity in a Non-clinical Sample
Open accessAbstract
Contemporary conceptualizations of hypochondriasis (HC) as severe health anxiety have led to the development of cognitive-behavioral approaches to understanding, assessing, and treating this problem. The Short Health Anxiety Inventory (SHAI) is a new instrument that measures cognitive factors associated with HC. In the present study, we examined the psychometric properties and factor structure of the SHAI in a large sample of medically healthy university students. We also examined the scale's convergent, divergent, and predictive validity. Results indicated that the SHAI has good psychometric properties and contains three factors that assess the perceived likelihood and perceived severity of becoming ill, and body vigilance. Facets of health anxiety uniquely predicted increased safety-seeking behavior and medical utilization, behaviors that are commonly observed in HC. Results are discussed in terms of the cognitive-behavioral model of HC.
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The sample's medical care utilization and safety behaviour scores were higher than in comparison studies.
“Utilization of medical resources as measured by part 2 of the MUQ were significantly higher in the present sample (M = 7.75, SD = 5.56) as compared to Abramowitz et al.’s (2007) non-clinical sample: M = 0.55 (0.47), t(897) = 29.90, 95% CI [7.17, 8.22), p < .000, and to Fergus and Valentiner’s (2010) non-clinical sample: M = 6.46 (5.37), t(958) = 3.66, 95% CI [0.60, 1.98], p < 0.01.”
From Anxiety Sensitivity Mediates Relations Between Mental Distress Symptoms and Medical Care Utilization During COVID-19 Pandemic. (2021) · cites this paper as Abramowitz et al. (2007)
The Results (Preliminary analyses) report 0.55 (SD = 0.47) as the mean for MUQ safety-seeking behaviors, not medical-resource utilization. They report a separate mean of 4.27 medical/health-service visits (SD = 4.84). Thus the citing sentence uses a safety-behavior score as its medical-utilization comparator. (LLM, conf=0.89)
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Experimental — accuracy not yet measuredMedical care utilization as measured by part 2 of the MUQ was significantly higher in the present sample than in two non-clinical samples.
“Utilization of medical resources as measured by part 2 of the MUQ were significantly higher in the present sample (M = 7.75, SD = 5.56) as compared to Abramowitz et al.’s (2007) non-clinical sample”
From Anxiety Sensitivity Mediates Relations Between Mental Distress Symptoms and Medical Care Utilization During COVID-19 Pandemic. (2021) · cites this paper as Abramowitz et al.’s (2007)
The Methods (Measures; page not provided) describe the MUQ as measuring medical-service visits in its first domain and safety-seeking behaviors in its second. The Results (Preliminary analyses; page not provided) report a mean of 4.27 visits in this non-clinical sample, which is below the citing paper’s stated mean of 7.75. The source does not establish whether the difference between samples is statistically significant, and it does not support calling medical utilization 'part 2' of the MUQ. (LLM, conf=0.88)
Experimental — accuracy not yet measuredA score of 27 and greater on the SHAI-18 differentiated health anxiety from other anxiety disorders.
“a previous study concluded that a score of 27 and greater differentiated health anxiety from other anxiety disorders [2].”
From A Cognitive Behavioral Therapy Chatbot (Otis) for Health Anxiety Management: Mixed Methods Pilot Study (2022) · cites this paper as [2]
The Discussion reports that the SHAI differentiated people with health anxiety from people with other anxiety problems, citing Salkovskis et al. (2002). It does not give a score of 27 or conclude that this threshold makes the distinction; a search for that score found no supporting passage. Page numbers are not available in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredSHAI has demonstrated adequate internal consistency (Cronbach's alpha = 0.83) and good convergent and divergent validity.
“The instrument has demonstrated adequate internal consistency (Cronbach's alpha = 0.83) and god convergent and divergent validity (Abramowitz, Deacon & Valentiner, 2007).”
From Exposure‐based cognitive behavior therapy for anxiety related to asthma: A feasibility study with multivariate baseline design. (2020) · cites this paper as Abramowitz, Deacon & Valentiner, 2007
The Results (Preliminary analyses; page unavailable) describe the SHAI’s internal consistency as adequate, but report α = .86, not .83. The Results (Correlations with related measures; page unavailable) support good convergent and divergent validity. (LLM, conf=0.94)
Experimental — accuracy not yet measuredThe SHAI has good psychometric properties when used in non-clinical samples (α = .86).
“It has commonly been used to assess health anxiety among adolescents and has good psychometric properties when used in non-clinical samples (α = .86) [49].”
From Effectiveness of a mindfulness and acceptance-based intervention for improving the mental health of adolescents with HIV in Uganda: An open-label trial (2024) · cites this paper as [49]
The SHAI-18 has demonstrated comparable validity and reliability (Cronbach ɑ=.86) to its initial 64-item counterpart.
“It has demonstrated comparable validity and reliability (Cronbach ɑ=.86) to its initial 64-item counterpart, the Health Anxiety Inventory [2].”
From A Cognitive Behavioral Therapy Chatbot (Otis) for Health Anxiety Management: Mixed Methods Pilot Study (2022) · cites this paper as [2]
The SHAI has shown sound psychometric properties including good reliability and validity in clinical and non-clinical populations.
“The SHAI has shown sound psychometric properties including good reliability and validity in clinical and non-clinical populations (Salkovskis et al., 2002; Abramowitz et al., 2007; Alberts et al., 2013).”
From Health Anxiety and Mental Health Outcome During COVID-19 Lockdown in Italy: The Mediating and Moderating Roles of Psychological Flexibility (2020) · cites this paper as Abramowitz et al., 2007
Only 5 participants met the cut-off score (25) for health anxiety, which supports a floor effect in the remainder of the sample.
“Furthermore, only 5 participants in the study met the cut-off score (25) for health anxiety [2], which further supports the supposition of a floor effect in the remainder of the sample.”
From A Cognitive Behavioral Therapy Chatbot (Otis) for Health Anxiety Management: Mixed Methods Pilot Study (2022) · cites this paper as [2]
The citation is attached to the health-anxiety cut-off of 25; the count of five participants and the proposed floor effect concern the citing study. The cited paper’s Method > Measures describes the SHAI, and Results > Preliminary analyses reports its mean score, but neither gives a cut-off of 25. Searches for that cut-off, a clinical threshold, and a floor effect found no supporting passage in our copy. (LLM, conf=0.77)
Experimental — accuracy not yet measured
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References 26 · Cited by 308
Research works printed but not linked: 1
- Nunnally J. Bernstein I. Psychometric theory 1994 New York McGraw-Hill
- Authors
- Abramowitz, J. S., Deacon, B. J., & Valentiner, D. P.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- University of Wyoming (US)
- Northern Illinois University (US)
- Corresponding author
- Abramowitz, Jonathan S.
- Venue
- Cognitive Therapy and Research
- Published
- 2007-02-15
- Volume
- 31
- Issue
- 6
- Pages
- 871-883
- ISSN
- 0147-5916 (ISSN-L)
- 1573-2819
- PMC
- PMC7088052
- OpenAlex
- W1999882126
- Cited by
- 308
- References
- 26
- Citations by year
- 2026: 15 · 2025: 12 · 2024: 19 · 2023: 38 · 2022: 31 · 2021: 43 · 2020: 28 · 2019: 17 · 2018: 11 · 2017: 11 · 2016: 13 · 2015: 15 · 2014: 19 · 2013: 8 · 2012: 7
- FWCI
- 2.22
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Cognitive Therapy and Research (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Keywords
- Short Health Anxiety Inventory, health anxiety, psychometric properties, factor structure, construct validity, convergent validity, discriminant validity, predictive validity, perceived illness severity, body vigilance, safety-seeking behavior, medical utilization, cognitive-behavioral model, university students
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