Should health anxiety be carved at the joint? A look at the health anxiety construct using factor mixture modeling in a non-clinical sample

Asmundson, Gordon J.G.; Taylor, Steven; Nicholas Carleton, R.; Weeks, Justin W.; Hadjstavropoulos, Heather D.

doi:10.1016/j.janxdis.2011.11.009

Cited by 67Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychosomatic Disorders and Their TreatmentsPsychometric Methodologies and Testing

Should health anxiety be carved at the joint? A look at the health anxiety construct using factor mixture modeling in a non-clinical sample

Asmundson, Gordon J.G., Taylor, Steven, Nicholas Carleton, R., Weeks, Justin W., Hadjstavropoulos, Heather D.·2012·Journal of Anxiety Disorders

DOI 10.1016/j.janxdis.2011.11.009

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Abstract

Cognitive-behavioral models conceptualize health anxiety as a construct that varies in degree along a continuum rather than existing as nonpathological versus pathological classes or taxons. Only two studies have empirically evaluated the latent structure of health anxiety, both using taxometric statistical methods and both supporting its conceptualization as continuous (Ferguson, 2009; Longley et al., 2010). We sought to further evaluate the latent structure of health anxiety using factor mixture modeling (FMM), which involved a combination of exploratory factor analysis (EFA) and mixture modeling that allowed comparison of models comprising one or more latent classes. Health anxiety symptom data were obtained from the Illness Attitude Scales (IAS) administered to 1768 university undergraduate students. Indicators of health anxiety, derived from EFA of IAS item data, included disease worry, disease conviction, health-related safety behaviors, fear of death, somatic focus, interference due to symptoms, and treatment seeking. FMM of these indicators suggested that health anxiety consists of two classes: (a) an "anxious" class comprising 81.4% of the sample and characterized primarily by somatic focus and interference due to symptoms, and (b) a "nonanxious" class comprising 18.6% of the sample with low scores on all indicators. Contrary to current conceptualizations and taxometric findings, the FMM results indicate the latent structure of health anxiety to be taxonic rather than continuous. Implications for the measurement and conceptualization of health anxiety are discussed and future research directions are highlighted.

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Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,841 · see citing works
Diagnostic and Statistical Manual of Mental Disorders.
Widiger, T. A. (2000) · Oxford University Press eBooks · doi:10.1037/10518-009 · Cited by 19,767 · see citing works
Deciding on the Number of Classes in Latent Class Analysis and Growth Mixture Modeling: A Monte Carlo Simulation Study
Nylund, K. L., Asparouhov, T., & Muthén, B. O. (2007) · Structural Equation Modeling: A Multidisciplinary Journal · doi:10.1080/10705510701575396 · Cited by 11,415 · see citing works
SPSS and SAS programs for determining the number of components using parallel analysis and Velicer’s MAP test
O’connor, B. P. (2000) · Behavior Research Methods, Instruments, & Computers · doi:10.3758/bf03200807 · Cited by 4,116 · see citing works
Dimensions of Hypochondriasis
Pilowsky, I. (1967) · British Journal of Psychiatry · doi:10.1192/bjp.113.494.89 · Cited by 865 · see citing works
Overview: hypochondriasis, bodily complaints, and somatic styles
BARSKY, A. J., & Klerman, G. L. (1983) · American Journal of Psychiatry · doi:10.1176/ajp.140.3.273 · Cited by 605 · see citing works
Hypochondriasis
Warwick, H. M. C., & Salkovskis, P. M. (1990) · Behaviour Research and Therapy · doi:10.1016/0005-7967(90)90023-c · Cited by 587 · cited 1× · see citing works
“…reserved. doi:10.1016/j.janxdis.2011.11.009 Reassurance seeking and recurrent checking behaviors, while providing transient relief to distress (Haenen, de Jong, Schmidt, Steven, & Visser, 2000), perpetuate dysfunctional beliefs and are detrimental in the long term (Warwick & Salkovskis, 1990).”
BackgroundInfluential
Multivariate Taxometric Procedures: Distinguishing Types from Continua
Waller, N. G., & Meehl, P. E. (1997) · Cited by 540 · see citing works
Morbid preoccupations, health anxiety and reassurance: a cognitive-behavioural approach to hypochondriasis
Salkovskis, P. M., & Warwick, H. M. C. (1986) · Behaviour Research and Therapy · doi:10.1016/0005-7967(86)90041-0 · Cited by 475 · cited 1× · see citing works
“…can vary over time for a given individual, and levels can vary across people; consequently, contemporary cognitivebehavioral models conceptualize it along a continuum ranging from minimal to severe (Abramowitz, Schwartz, & Whiteside, 2002; Salkovskis & Warwick, 1986; Taylor & Asmundson, 2004).”
Background
Taxometric analysis. I: Detecting taxonicity with two quantitative indicators using means above and below a sliding cut (MAMBAC procedure)
Meehl, P. E., & Yonce, L. J. (1994) · Psychological Reports · Cited by 357 · see citing works
Epidemiology of somatoform disorders: a community survey in Florence
Faravelli, C., Salvatori, S., Galassi, F., Aiazzi, L., Drei, C., & Cabras, P. L. (1997) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/bf00800664 · Cited by 332 · see citing works
Health Anxiety: Current Perspectives and Future Directions
Asmundson, G. J. G., Abramowitz, J. S., Richter, A. A., & Whedon, M. (2010) · Current Psychiatry Reports · doi:10.1007/s11920-010-0123-9 · Cited by 309 · cited 1× · see citing works
“People with high levels of health anxiety are often diagnosed with hypochondriasis, a DSM-IV somatoform disorder characterized by presentations of core features of health anxiety (Asmundson et al., 2010).”
Background
A validation study of the Whitely Index, the Illness Attitude Scales, and the Somatosensory Amplification Scale in general medical and general practice patients
Speckens, A. E. M., Spinhoven, P., Sloekers, P. P. A., Bolk, J. H., & van Hemert, A. M. (1996) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(95)00561-7 · Cited by 303 · see citing works
Somatization and Hypochondriasis
Kellner, R. (1985) · Medical Entomology and Zoology · Cited by 295 · see citing works
Introduction to the Taxometric Method: A Practical Guide
Ruscio, J., Haslam, N., & Ruscio, A. M. (2006) · Medical Entomology and Zoology · Cited by 290 · see citing works
Untitled work
(2004) · Cited by 261 · see citing works
Fears, Beliefs, and Attitudes in DSM-III Hypochondriasis
KELLNER, R., ABBOTT, P., WINSLOW, W. W., & PATHAK, D. (1987) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-198701000-00004 · Cited by 258 · see citing works
Social anxiety and fear of negative evaluation: Construct validity of the BFNE-II
Carleton, R. N., Collimore, K. C., & Asmundson, G. J. G. (2006) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2006.03.010 · Cited by 219 · see citing works
A taxometric analysis of health anxiety
Ferguson, E. (2009) · Psychological Medicine · doi:10.1017/s0033291708003322 · Cited by 183 · see citing works
Refining and validating the Social Interaction Anxiety Scale and the Social Phobia Scale
Carleton, R. N., Collimore, K. C., Asmundson, G. J. G., McCabe, R. E., Rowa, K., & Antony, M. M. (2009) · Depression and Anxiety · doi:10.1002/da.20480 · Cited by 177 · see citing works
Somatization and Hypochondriasis
Fava, G. A. (1986) · Psychosomatics · doi:10.1016/s0033-3182(86)72593-0 · Cited by 168 · see citing works
Handbook of Research Methods in Abnormal and Clinical Psychology
Guha, M. (2008) · Reference Reviews · doi:10.1108/09504120810914349 · Cited by 153 · see citing works
Assessment of the Hypochondriasis Domain: The Multidimensional Inventory of Hypochondriacal Traits (MIHT).
Longley, S. L., Watson, D., & Noyes, R. (2005) · Psychological Assessment · doi:10.1037/1040-3590.17.1.3 · Cited by 153 · see citing works
Cognitive and behavioral responses to illness information: the role of health anxiety.
Hadjistavropoulos, H., Craig, K., & Hadjistavropoulos, T. (1998) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(98)00014-x · Cited by 150 · see citing works
A contemporary conceptual model of hypochondriasis
Abramowitz, J. S., Schwartz, S. A., & Whiteside, S. P. (2002) · Mayo Clinic Proceedings · doi:10.4065/77.12.1323 · Cited by 139 · see citing works
Hypochondriacal concerns in a community population
Looper, K. J., & Kirmayer, L. J. (2001) · Psychological Medicine · doi:10.1017/s0033291701003737 · Cited by 135 · see citing works
Hypochondriasis and health anxiety in the German population
Bleichhardt, G. M., & Hiller, W. F. A. (2007) · British Journal of Health Psychology · doi:10.1348/135910706x146034 · Cited by 133 · see citing works
The Illness Attitude Scales
Sirri, L., Grandi, S., & Fava, G. A. (2008) · Psychotherapy and Psychosomatics · doi:10.1159/000151387 · Cited by 131 · see citing works
Anxiety sensitivity mediates the relationships between childhood learning experiences and elevated hypochondriacal concerns in young adulthood
Watt, M. C., & Stewart, S. H. (2000) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(00)00097-0 · Cited by 129 · see citing works
Attentional Bias Toward Illness Threat in Individuals with Elevated Health Anxiety
Owens, K. M. B., Asmundson, G. J. G., Hadjistavropoulos, T., & Owens, T. J. (2004) · Cognitive Therapy and Research · doi:10.1023/b:cotr.0000016930.85884.29 · Cited by 107 · see citing works
A Taxometric Study of Hypochondriasis Symptoms
Longley, S. L., Broman-Fulks, J. J., Calamari, J. E., Noyes, R., Wade, M., & Orlando, C. M. (2010) · Behavior Therapy · doi:10.1016/j.beth.2010.02.002 · Cited by 103 · see citing works
Interpretation of bodily symptoms in hypochondriasis
Hitchcock, P. B., & Mathews, A. (1992) · Behaviour Research and Therapy · doi:10.1016/0005-7967(92)90068-r · Cited by 100 · see citing works
Hypochondriacal concerns, anxiety sensitivity, and panic disorder
Otto, M. W., Pollack, M. H., Sachs, G. S., & Rosenbaum, J. F. (1992) · Journal of Anxiety Disorders · doi:10.1016/0887-6185(92)90008-u · Cited by 96 · see citing works
Hypochondriacs' estimation of negative outcomes: domain-specificity and responsiveness to reassuring and alarming information
Haenen, M.-A., de Jong, P. J., Schmidt, A. J. M., Stevens, S., & Visser, L. (2000) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(99)00128-x · Cited by 79 · see citing works
Illness Attitudes Scale dimensions and their associations with anxiety-related constructs in a nonclinical sample
Stewart, S. H., & Watt, M. C. (2000) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(98)00207-1 · Cited by 78 · see citing works
The Illness Attitudes Scale (IAS): A psychometric evaluation on a non-clinical population
Ferguson, E., & Daniel, E. R. (1995) · Personality and Individual Differences · doi:10.1016/0191-8869(94)00186-v · Cited by 68 · see citing works
Exploratory and confirmatory factor analytic investigations of the Illness Attitudes Scale in a nonclinical sample
Hadjistavropoulos, H. D., Frombach, I. K., & Asmundson, G. J. G. (1999) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(98)00159-4 · Cited by 67 · see citing works
Dimensional, categorical, or dimensional-categories: testing the latent structure of anxiety sensitivity among adults using factor-mixture modeling.
Bernstein, A., Stickle, T. R., Zvolensky, M. J., Taylor, S., Abramowitz, J., & Stewart, S. (2010) · The Behavior Therapist · doi:10.1016/j.beth.2010.02.003 · Cited by 67 · see citing works
Additional Findings on the Association Between Anxiety Sensitivity and Hypochondriacal Concerns
Otto, M. W., Demopulos, C. M., McLean, N. E., Pollack, M. H., & D, M. F. M. (1998) · Journal of Anxiety Disorders · doi:10.1016/s0887-6185(98)00011-5 · Cited by 61 · see citing works
Dimensions of hypochondriasis and the five-factor model of personality
Cox, B. J., Borger, S. C., Asmundson, G. J. G., & Taylor, S. J. (2000) · Personality and Individual Differences · doi:10.1016/s0191-8869(99)00180-4 · Cited by 60 · see citing works
Measures of anxiety: is there a difference in their ability to predict functioning at three‐month follow‐up among pain patients?
Hadjistavropoulos, H. D., Asmundson, G. J. G., & Kowalyk, K. M. (2003) · European Journal of Pain · doi:10.1016/s1090-3801(03)00059-4 · Cited by 52 · see citing works
Does anxiety about health influence eating patterns and shape-related body checking among females?
Hadjistavropoulos, H. D., & Lawrence, B. (2007) · Personality and Individual Differences · doi:10.1016/j.paid.2006.11.021 · Cited by 37 · see citing works
Asymptotic robustness of standard errors in multilevel structural equation models
Yuan, K., & Bentler, P. M. (2005) · Journal of Multivariate Analysis · doi:10.1016/j.jmva.2005.06.003 · Cited by 35 · see citing works
Factor analytic investigation of the Illness Attitudes Scale in a chronic pain safmple
Hadjistavropoulos, H. D., & Asmundson, G. J. G. (1998) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(98)00077-1 · Cited by 31 · see citing works
Comment on Otto et al. (1992): Hypochondriacal concerns, anxiety sensitivity, and panic disorder
Taylor, S. (1994) · Journal of Anxiety Disorders · doi:10.1016/0887-6185(94)90026-4 · Cited by 25 · see citing works
Analogue Research
Tull, M. T., Bornovalova, M., Patterson, R., Hopko, D. R., & Lejuez, C. W. (2008) · Digital Commons - University of South Florida (University of South Florida) · Cited by 18 · see citing works
The factor structure and reliability of the Illness Attitude Scales in a student and a patient sample
Crössmann, A., & Pauli, P. (2006) · BMC Psychiatry · doi:10.1186/1471-244x-6-46 · Cited by 15 · see citing works
Panic disorder and hypochondriacal concerns: Reply to Otto and Pollack (1994)
Taylor, S. J. (1995) · Journal of Anxiety Disorders · doi:10.1016/0887-6185(94)00030-e · Cited by 12 · see citing works

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Self-citation
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Lebel, S., Mutsaers, B., Tomei, C., Leclair, C. S., Jones, G., Petricone‐Westwood, D., Rutkowski, N. A., Ta, V., Trudel, G., Laflamme, S. Z., et al. (2020) · PLoS ONE · doi:10.1371/journal.pone.0234124 · Cited by 211 · see citing works
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Reiser, S. J., McMillan, K. A., Wright, K. D., & Asmundson, G. J. G. (2013) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2013.08.007 · Cited by 90 · see citing works
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Petricone‐Westwood, D., Jones, G., Mutsaers, B., Leclair, C. S., Tomei, C., Trudel, G., Dinkel, A., & Lebel, S. (2018) · International Journal of Behavioral Medicine · doi:10.1007/s12529-018-9748-6 · Cited by 27 · see citing works
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Zoltek, M., Andersson, T., Axelsson, E., Hedman, C., & Lundgren, C. I. (2022) · Cancers · doi:10.3390/cancers14102349 · Cited by 6 · see citing works
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Yap, A. U., Zheng, Y., Liu, T., Li, Y., Liu, Y., Zhou, X., Wang, J., & Xiong, X. (2025) · Journal of Oral Rehabilitation · doi:10.1111/joor.14023 · Cited by 5 · see citing works
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Hedman‐Lagerlöf, E., Björkander, D., Andersson, E., & Axelsson, E. (2024) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465824000377 · Cited by 5 · see citing works
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Taylor, S. J., & Asmundson, G. J. (2011) · International Journal of Genetics and Gene Therapy journal · doi:10.5348/ijggt-2012-2-oa-1 · Cited by 5 · see citing works
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Demirtepe-Saygılı, D., Eşiyok, E., & Turancı, E. (2021) · Türkiye İletişim Araştırmaları Dergisi · doi:10.17829/turcom.862102 · Cited by 4 · see citing works
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Axelsson, E., Österman, S., & Hedman‐Lagerlöf, E. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-05151-7 · Cited by 5 · see citing works
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Csibi, S., Csibi, M., & Bognár, J. (2023) · International Journal of Mental Health Promotion · doi:10.32604/ijmhp.2023.029390 · Cited by 3 · see citing works
Evaluation of Health Anxiety in Healthcare Workers During Coronavirus Disease 2019 (COVID-19) Pandemic
Ardakani, M. B., Aghamolaei, T., Azad, M. H., Soleimani-Ahmadi, M., Zare, F., Khademian, M., Zare, M. R., Kakhaki, H. E. S., Madani, A., & Zare, M. (2021) · Disease and Diagnosis · doi:10.34172/ddj.2021.11 · Cited by 3 · see citing works
Frequency of Illness Anxiety (Hypochondriasis) by Proxy Encountered by Doctors in Parents towards their Children
El‐Gabry, D. A., Aziz, K. A., Al-Hosani, M. H., Aljneibi, M. K., Shouma, A., Zeid, D. A., Stip, É., & Elkholy, H. A. (2022) · Annals of Clinical Psychiatry · doi:10.12788/acp.0083 · Cited by 3 · see citing works
The positive effects of warning labels: Evidence from healthy food consumption
Li, H., Zhang, S., Liu, X., & Zhao, H. P. (2025) · Journal of Retailing and Consumer Services · doi:10.1016/j.jretconser.2025.104614 · Cited by 2 · see citing works
Worry and Other Mental Health Problems
Jansson‐Fröjmark, M., Bilevicius, E., El-Gabalawy, R. M., & Asmundson, G. J. G. (2020) · Wiley eBooks · doi:10.1002/9781119189909.ch5 · Cited by 3 · see citing works
Persian version of the Short Health Anxiety Inventory (SHAI) for patients with cancer: Evaluation of psychometric properties, factor structure, and association with related constructs
Poshtan, M. M., Aflakseir, A., Witthöft, M., Cherry, M. G., & Ramzi, M. (2024) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2024.111958 · Cited by 1 · see citing works
Acil Servise Başvuran Hastaların Sağlık Anksiyetesinin Belirlenmesi
Özlü, İ., Kılınç, T., & Özlü, Z. K. (2021) · Genel Tıp Dergisi · doi:10.54005/geneltip.996839 · Cited by 1 · see citing works
Evaluation of a brief psychosocial intervention for health anxiety delivered by medical assistants in primary care: Study protocol for a pilot hybrid trial
Brady, R. E., Hegel, M. T., Curran, G. M., Asmundson, G. J. G., Xie, H., & BRUCE, M. L. (2021) · Contemporary Clinical Trials · doi:10.1016/j.cct.2021.106574 · Cited by 1 · see citing works
Protective behaviors during COVID-19 confinement measures in Greece: the role of anxiety, perceived risk and risky-choice framing
Koulierakis, G., Dermatis, A., Zavras, D., & Pavi, E. (2023) · AIMS Public Health · doi:10.3934/publichealth.2023021 · Cited by 1 · see citing works
Hypochondriasis
Asmundson, G. J. G., Peluso, D. L., Thibodeau, M. A., & Taylor, S. J. (2013) · Wiley eBooks · doi:10.1002/9781118528563.wbcbt21 · Cited by 1 · see citing works
Being a medical pathology expert in the COVID-19 pandemic
Erdem, H., & Çelik, M. A. (2020) · Medicine Science | International Medical Journal · doi:10.5455/medscience.2020.09.181
Health Anxiety
Axelsson, E., & Hedman‐Lagerlöf, E. (2021) · Comprehensive Clinical Psychology · doi:10.1016/b978-0-12-818697-8.00231-4
Creando conciencia: la experiencia del Servicio Universitario del Trabajo en Santiago de Compostela
Pazos, F. M. (2022) · Hispania-revista Espanola De Historia · doi:10.3989/hispania.2022.021
Main Manifestations of the Psychological and Behavioural Impacts of the COVID-19 Pandemic on Populations
Saga, M., Rkhaila, A., & Ounine, K. (2022) · Advances in public policy and administration (APPA) book series · doi:10.4018/978-1-6684-6496-0.ch003 · Cited by 1 · see citing works
COVID-19 aşısı olma niyetini anlamak: Maddi kayıp yaşama, aşılar hakkında algılanan bilgi düzeyi ve sağlık kaygısının yordayıcı rolü
LEBLEBİCİ, E., AYÖZCAN, M. N., & İkizer, G. (2023) · Klinik Psikoloji Dergisi · doi:10.57127/kpd.26024438.1274631
Additional file 2 of Joint factor analysis and approximate equipercentile linking of common trait health anxiety measures: a cross-sectional study of the 14-, 18- and 64-item health anxiety inventory, the illness attitude scale, and the 14-item Whiteley Index
Axelsson, E., Österman, S., & Hedman-Lagerlöf, E. (2023) · Figshare · doi:10.6084/m9.figshare.24098310
Additional file 3 of Joint factor analysis and approximate equipercentile linking of common trait health anxiety measures: a cross-sectional study of the 14-, 18- and 64-item health anxiety inventory, the illness attitude scale, and the 14-item Whiteley Index
Axelsson, E., Österman, S., & Hedman-Lagerlöf, E. (2023) · Figshare · doi:10.6084/m9.figshare.24098313
Additional file 1 of Joint factor analysis and approximate equipercentile linking of common trait health anxiety measures: a cross-sectional study of the 14-, 18- and 64-item health anxiety inventory, the illness attitude scale, and the 14-item Whiteley Index
Axelsson, E., Österman, S., & Hedman-Lagerlöf, E. (2023) · Figshare · doi:10.6084/m9.figshare.24098307
The Relationship between Health Literacy, Health Perception, and Health Anxiety
Murt, E., GÜMÜŞ, M., & DAŞLI, Y. (2026) · Cyprus Turkish Journal of Psychiatry and Psychology · doi:10.35365/ctjpp.26.2.05
When Uncertainty Varies by Language – Psychometric Findings of the Intolerance of Uncertainty Scale (IUS) in Oncology
Poshtan, M. M., Aflakseir, A., & Ramzi, M. (2026) · International Perspectives in Psychology · doi:10.1027/2157-3891/a000162
Rethinking the nature of mental disorder : a latent structure approach to data from three national psychiatric morbidity surveys
McCrea, R. L. (2013) · UCL Discovery (University College London)

Panic disorder and hypochondriacal concerns: Reply to Otto and Pollack (1994)
Taylor, S. J. (1995) · Journal of Anxiety Disorders · doi:10.1016/0887-6185(94)00030-e · Cited by 12 · see citing works
A taxometric analysis of health anxiety
Ferguson, E. (2009) · Psychological Medicine · doi:10.1017/s0033291708003322 · Cited by 183 · see citing works
Health Anxiety: Latent Structure and Associations with Anxiety-related Psychological Processes in a Student Sample
Wheaton, M. G., Berman, N. C., Franklin, J. C., & Abramowitz, J. S. (2010) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-010-9179-4 · Cited by 77 · see citing works
Further Evidence for a Dimensional Latent Structure of Health Anxiety: Taxometric Analyses of the Whiteley Index Based on Two German Representative Samples
Bräscher, A., Brähler, E., Häuser, W., & Witthöft, M. (2023) · Assessment · doi:10.1177/10731911231219802 · Cited by 8 · see citing works
Comparison of Unitary and Multidimensional Models of the Whiteley Index in a Nonclinical Sample: Implications for Understanding and Assessing Health Anxiety
Asmundson, G. J. G., Carleton, R. N., Bovell, C. V., & Taylor, S. J. (2008) · Journal of Cognitive Psychotherapy · doi:10.1891/0889-8391.22.2.87 · Cited by 41 · see citing works

Authors: Asmundson, G. J. G., Taylor, S., Nicholas Carleton, R., Weeks, J. W., & Hadjstavropoulos, H. D.
Affiliations: University of Regina (CA)
University of British Columbia (CA)
Ohio University (US)
Corresponding author: Asmundson, Gordon J.G.
ORCID: Asmundson, Gordon J.G.
Taylor, Steven
Weeks, Justin W.
Venue: Journal of Anxiety Disorders
Publisher: Elsevier BV
Published: 2012-01
Volume: 26
Issue: 1
Pages: 246-251
ISSN: 0887-6185 (ISSN-L)
DOI: 10.1016/j.janxdis.2011.11.009
OpenAlex: W2001585924
Cited by: 67
References: 48
Citations by year: 2026: 2 · 2025: 5 · 2024: 3 · 2023: 9 · 2022: 8 · 2021: 5 · 2020: 11 · 2019: 1 · 2018: 2 · 2017: 2 · 2016: 1 · 2015: 3 · 2014: 5 · 2013: 8 · 2012: 1
FWCI: 6.20
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Journal of Anxiety Disorders (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 › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
Keywords: health anxiety, fear of illness, taxometric analysis, factor mixture modeling, latent structure, disease conviction, somatic focus, symptom interference, fear of death, cognitive-behavioral model, non-clinical sample
MeSH terms: Adolescent, Adult, Anxiety, Attitude to Health, Female, Humans, Hypochondriasis, Male, Middle Aged, Models, Psychological, Psychiatric Status Rating Scales, Psychometrics, Surveys and Questionnaires

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Should health anxiety be carved at the joint? A look at the health anxiety construct using factor mixture modeling in a non-clinical sample

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