The DOI matches its Crossref record; 65 of the 66 references it cites were found in a registry or an index.
Hypochondriasis
Abstract
Hypochondriasis and other syndromes in which health anxiety is prominent are frequently seen in clinical practice and often pose problems of management. In contrast with other anxiety problems, the conceptualization and treatment of health anxiety has developed very little in recent years. Behavioural approaches to treatment have only recently been applied. In the present paper, current theoretical models are critically evaluated and a cognitive-behavioural approach is proposed to account for the development and maintenance of hypochondriacal problems. Principles of cognitive-behavioural treatment based on this approach are outlined, together with some suggestions for research.
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“SSD, in turn, is very much in line with mainstream theoretical approaches to chronic pain and medically unexplained symptoms, notable examples being the fearavoidance theory of pain 3 and the cognitive behavioral model of health anxiety.33”
From Symptom Preoccupation in Fibromyalgia: Prevalence and Correlates of Somatic Symptom Disorder in a Self-Recruited Sample (2020) · cites this paper as [33]
In the citing paper
“The cognitive-behavioral model of HA and hypochondriasis by Warwick and Salkovskis [58] postulates that the perception of normal bodily symptoms and their misinterpretation as harmful and as a sign of a serious illness as well as the mechanism of somatosensory amplification [59] lead to negative affect (eg, anxiety and worry).”
From Conceptualizations of cyberchondria and relations to the anxiety spectrum: Systematic review and meta-analysis (2021) · cites this paper as [58]
In the citing paper
“Third, past research has shown iCBT reduces maladaptive cognitions and beliefs, but no studies have examined the impact of iCBT on other key cognitive (e.g., intolerance of uncertainty, body hypervigilance) and behavioural (e.g., safety behaviours and avoidance) processes thought to perpetuate health anxiety ( Warwick & Salkovskis, 1990 ).”
From Internet-Based Cognitive Behavioral Therapy Versus Psychoeducation Control for Illness Anxiety Disorder and Somatic Symptom Disorder: A Randomized Controlled Trial (2018) · cites this paper as Warwick & Salkovskis, 1990
In the citing paper
“The program followed the protocol for MBCT for recurrent depression as outlined by Segal et al. (2002) but was modified for HA in that it was informed by Warwick and Salkovskis' (1990) cognitive model of HA.”
From Mindfulness-based cognitive therapy for severe health anxiety (hypochondriasis): An interpretative phenomenological analysis of patients' experiences (2011) · cites this paper as Warwick and Salkovskis, 1990
In the citing paper
“Third, cognitive-behavioural conceptualizations of HA have emphasized the role of heightened bodily focused attention in the maintenance of the disorder (e.g., Warwick & Salkovskis, 1990).”
From Mindfulness-based cognitive therapy for severe health anxiety (hypochondriasis): An interpretative phenomenological analysis of patients' experiences (2011) · cites this paper as Warwick & Salkovskis, 1990
In the citing paper
“However, for HA sufferers there may be less desire to alter one's life in order to cultivate a sense of mastery over their HA, since HA individuals' concerns are often about seeking and gaining medical attention and intervention (Warwick & Salkovskis, 1990).”
From Mindfulness-based cognitive therapy for severe health anxiety (hypochondriasis): An interpretative phenomenological analysis of patients' experiences (2011) · cites this paper as Warwick & Salkovskis, 1990
In the citing paper
“Disorder-specific cognitive-behavioural conceptual models of anxiety disorders have facilitated the understanding and treatment of anxiety in adults (Salkovskis, 1999;Warwick & Salkovskis, 1990;Wells, 1995).”
From Applicability of the intolerance of uncertainty model to Generalized Anxiety Disorder symptoms in young people (2021) · cites this paper as Warwick & Salkovskis, 1990
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“Of particular relevance here is the cognitive model of HA (Salkovskis and Warwick, 1986; Warwick and Salkovskis, 1990).”
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“Another important factor which could contribute to a less active way of life is avoidance behavior (Warwick and Salkovskis, 1990).”
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Řiháček, T., & Čevelíček, M. (2019) · Psychotherapy Research · doi:10.1080/10503307.2019.1645370 · Cited by 15
“While some categories may simply acknowledge the presence of symptoms, others, such as hypochondriasis or health anxiety, emphasize patients’ attitude towards these symptoms (Warwick & Salkovskis, 1990).”
BackgroundIMPACT OF INTERNET ADDICTION ON HEALTH ANXIETY IN MALAYSIAN YOUTH DURING COVID-19 PANDEMIC
Khodabakhsh, S., Ramasamy, S., Teng, T. Y., & Chan, S. L. (2021) · Malaysian Journal of Medical Research · doi:10.31674/mjmr.2021.v05i02.003 · Cited by 17
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“The cognitive behavioral model postulates that certain cognitive variables help develop and maintain health anxiety (Salkovskis and Warwick, 1986, 2001; Warwick and Salkovskis, 1990).”
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Suppression May Improve Adaptation to Worry When Facing Uncertainty: Studying COVID-19 Pandemic
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Health anxiety amplifies fearful responses to illness-related imagery
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“Salkovskis & Warwick (1986) reported two cases of hypo chondriasis successfully treated with CBT, and went on to describe a comprehensive cognitivebehavioural formulation of hypochondriasis (Salkovskis, 1989; Warwick & Salkovskis, 1990: described below).”
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BEHAVIORAL, COGNITIVE, AND FAMILY THERAPY FOR OBSESSIVE-COMPULSIVE AND RELATED DISORDERS
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“In an effort to reduce the anxiety and gain certainty about health status, these individuals engage in safety-seeking behaviors, such as visiting medical providers, obsessively checking their body, or searching health information on the internet (Abramowitz et al., 2002; Warwick & Salkovskis, 1990).”
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“Taken together, the existing self-report instruments fail to cover all aspects (affective, behavioral, cognitive, and perceptual) of health anxiety as proposed by the cognitivebehavioral model (e.g., Warwick & Salkovskis, 1990).”
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“…stress and arousal, perceive and interpret the function of their heart in a phobic manner, and engage in a number of ruminations and avoidance behaviours that appear to be similar to those of persons with extreme health anxieties or illness phobias (Rachman, 1974; Warwick & Salkovskis, 1990).”
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“…perspective of health anxiety Hypochondriasis may be better categorised as an anxiety disorder (health anxiety) than a somatoform disorder as it has much in common with both obsessive–compulsive disorder (OCD) and panic disorder (Salkovskis & Warwick, 1986; Warwick & Salkovskis, 1990).”
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“Attention to bodily symptoms has been proposed as a pathogenetic mechanism in psychosomatic disorders (Warwick & Salkovskis, 1990), and it has even been postulated that: ‘‘anything that directs a person’s attention to his or her body and physiological processes will increase the perceived intensity…”
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“An enhanced attentional bias toward potential health threats is presumed to be a central and causal mechanism for the exacerbation and maintenance of health anxiety, according to the prominent cognitive behavioural model by Warwick and Salkovskis (1990).”
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“The pioneering formulation of health anxiety (Salkovskis and Warwick, 1986; Warwick and Salkovskis, 1990) posited that patients with hypochondriasis or severe health anxiety might experience intrusive distressing thoughts about the possible causes of their symptoms and/or somatic sensations.”
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“This is in accordance with the suggestion of Warwick and Salkovskis (1990) that avoidance behaviours such as reassurance seeking and avoidance of illness-related situations could be important maintaining factors in hypochondriasis.”
ResultObsessive-compulsive spectrum disorders
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Recommendations for the Treatment of Hypochondriac Patients
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“In all of them, the interaction between various behaviors and the way they mutually affect each other have been emphasized (see Warwick & Salkovskis, 1990; Williams, 2004).”
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Self-citationSelective Attention and Health Anxiety: Ill-Health Stimuli are Distracting for Everyone
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Panic Disorder and Agoraphobia
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“Os procedimentos terapêuticos usados foram uma adaptação do programa desenvolvido por Salkovskis and Warwick (Salkovskis, 1989; Salkovskis & Warwick, 1986; Warwick, 1989; Warwick & Salkovskis, 1989, 1990).”
BackgroundMethodInfluentialO’Bryan, E. M., McLeish, A. C., Norr, A. M., Ely, S., Bass, Z., Davies, C. D., Capron, D. W., Schmidt, N. B., & Mano, K. E. J. (2021) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2021.102425 · Cited by 8
The psychometric properties of the Italian adaptation of the Health Orientation Scale (HOS)
Masiero, M. A., Oliveri, S., Cutica, I., Monzani, D., Faccio, F., Mazzocco, K., & Pravettoni, G. (2020) · Health and Quality of Life Outcomes · doi:10.1186/s12955-020-01298-z · Cited by 8
Encoding and retrieval biases for health-related scenes in patients with severe health anxiety
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“The negatively evaluated health-related information might trigger anxiety, which likely increases physiological arousal, and brings normal bodily variations to awareness that would otherwise go unnoticed (Salkovskis & Warwick, 2001; Warwick & Salkovskis, 1990).”
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Cough Is Dangerous: Neural Correlates of Implicit Body Symptoms Associations
Mier, D. U., Witthöft, M., Bailer, J., Ofer, J., Kerstner, T., Rist, F., & Diener, C. (2016) · Frontiers in Psychology · doi:10.3389/fpsyg.2016.00247 · Cited by 8
“Cognitive-behavioral (Warwick and Salkovskis, 1990) and cognitive-developmental (Williams, 2004) as well as interpersonal models (Noyes et al., 2003) of HA stress the importance of illness-related schemata in memory that developed in childhood and adolescence and may become triggered by current…”
BackgroundRask, C. U., Gehrt, T. B., Rimvall, M. K., & Frostholm, L. (2020) · Zeitschrift für Psychologie · doi:10.1027/2151-2604/a000407 · Cited by 8
Sobre o transtorno de pânico e a hipocondria: uma revisão
Torres, A. R., & Crepaldi, A. L. (2002) · Revista Brasileira de Psiquiatria · doi:10.1590/s1516-44462002000300009 · Cited by 14
Song, Y., & Min, D. (2024) · Journal of the Association for Information Science and Technology · doi:10.1002/asi.24946 · Cited by 7
Severe health anxiety: Why it persists and how to treat it
Abramowitz, J. S., & Deacon, B. J. (2004) · Comprehensive Therapy · doi:10.1007/s12019-004-0023-1 · Cited by 7
Gong, H., Deng, S., Wang, H., & Cao, G. (2023) · Digital Health · doi:10.1177/20552076231208559 · Cited by 10
Hybelius, J., Gustavsson, A., Hammarberg, S. A. W., Toth-Pal, E., Johansson, R., Ljótsson, B., & Axelsson, E. (2022) · Pilot and Feasibility Studies · doi:10.1186/s40814-022-01105-0 · Cited by 7
Jordan, K. D., Williams, P., & Smith, T. W. (2015) · Journal of Social and Clinical Psychology · doi:10.1521/jscp.2015.34.6.459 · Cited by 8
“…reassurance seeking may be maintained more by a negative reinforcement cycle, such that instances of seeking reassurance or medical attention may serve to temporarily alleviate anxiety, much like the compulsions of individuals with obsessivecompulsive disorder (Warwick & Salkovskis, 1990).”
BackgroundUsing behavioral experiments in the treatment of cardiophobia: A case study
Eifert, G. H., & Lau, A. W. (2001) · Cognitive and Behavioral Practice · doi:10.1016/s1077-7229(01)80003-1 · Cited by 7
Tobben met hypochondere en somatiserende patiënten
Visser, S., & Bouman, T. K. (1994) · Directieve therapie · doi:10.1007/bf03060088 · Cited by 7
Everyday worry in adolescents with and without chronic pain: A diary study
Fisher, E., Keogh, E., & Eccleston, C. (2017) · Psychology, Health & Medicine · doi:10.1080/13548506.2017.1280175 · Cited by 6
“Anxiety is common during childhood (Costello, Mustillo, Erkanli, Keeler, & Angold, 2003) and is composed of cognitive, behavioural, and physiological responses to a perceived or anticipated threat (Warwick & Salkovskis, 1990).”
BackgroundHosseinchi, P., Ghalibaf, E., Dehghani, A., & Khatibi, A. (2022) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2022.103808 · Cited by 6
Haenen, M.-A., Schmidt, A. J. M., Schoenmakers, M., & van den Hout, M. A. (1997) · Psychosomatics · doi:10.1016/s0033-3182(97)71399-9 · Cited by 8
Schreiber, F., Witthöft, M., Neng, J. M. B., & Weck, F. (2015) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2015.07.005 · Cited by 7
“Introduction Cognitive models of hypochondriasis (HYP) and health anxiety (e.g., Rachman, 2012; Warwick & Salkovskis, 1990) emphasize the importance of cognitive and affective misinterpretations of essentially harmless body sensations as severe signs of a physical illness and highlight the…”
BackgroundHealth anxiety and attentional control interact to predict uncertainty-related attentional biases
Rogers, T. A., Daniel, T. A., & Bardeen, J. R. (2021) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2021.101697 · Cited by 7
Astasie-abasie : causes psychogènes et non psychogènes
Vercueil, L. (2009) · Revue Neurologique · doi:10.1016/j.neurol.2009.08.004 · Cited by 6
Reliability and Validity of the Korean Version of Health Anxiety Questionnaire
Hwang, K.-S., Jang, S.-H., Lee, H.-J., & Lee, S.-Y. (2018) · Psychiatry Investigation · doi:10.30773/pi.2018.07.25 · Cited by 6
Morales, A., Reis, S., Espada, J. P., & Orgilés, M. (2016) · Journal of Health Psychology · doi:10.1177/1359105316669859 · Cited by 8
“Based on the cognitivebehavioral model of HA (Salkovskis et al., 2002; Warwick and Salkovskis, 1990), SHAI measures fear of illness and fear of negative consequences of an illness using a twofactor structure.”
MethodCognitive and Behavioral Mechanisms of Health Anxiety
Fergus, T. A., & Asmundson, G. J. G. (2019) · The Clinician's Guide to Treating Health Anxiety · doi:10.1016/b978-0-12-811806-1.00004-4 · Cited by 5
Yeom, C., Ha, H., Hahm, B., Lee, S. H., Kim, N. J., & Shim, E. (2024) · Journal of Health Psychology · doi:10.1177/13591053231224177 · Cited by 6
Do metacognitions contribute to pathological health anxiety? A systematic review and meta-analysis
Ivan, L., Foerster, P., Bermpohl, F., Gerlach, A., & Pohl, A. (2025) · PLoS ONE · doi:10.1371/journal.pone.0325563 · Cited by 2
“Currently, in both research and practice, the cognitive behavioral model [18] predominates the field, and most treatment approaches are based on this model.”
Metadata
- Authors
- Warwick, H. M. C., & Salkovskis, P. M.
- Affiliations
- Warneford Hospital (GB)
- ORCID
- Salkovskis, Paul M.
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 1990
- Volume
- 28
- Issue
- 2
- Pages
- 105-117
- ISSN
- 0005-7967 (ISSN-L)
- OpenAlex
- W2911986200
- Semantic Scholar
- 23ea1c589ed8ff10851ee82876c1d45b5db0abcb
- Cited by
- 587
- References
- 66
- Citations by year
- 2026: 14 · 2025: 18 · 2024: 13 · 2023: 20 · 2022: 24 · 2021: 32 · 2020: 29 · 2019: 26 · 2018: 18 · 2017: 22 · 2016: 20 · 2015: 18 · 2014: 24 · 2013: 29 · 2012: 23
- FWCI
- 3.03
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- health anxiety, cognitive-behavioral intervention, cognitive-behavioral model, behavioral interventions, anxiety disorders
- MeSH terms
- Behavior Therapy, Humans, Hypochondriasis, Sick Role
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