Health anxiety, rumination, and negative affect: A mediational analysis
Abstract
Objective A ruminative cognitive style has been associated with a variety of mood and anxiety disorders. This study examined whether a ruminative cognitive style is associated with health anxiety, even when controlling for negative affect. Method College students (N=198) completed measures of health anxiety, rumination, and negative affect and estimated the likelihood that ambiguous symptoms were indicative of catastrophic illnesses. These data were analyzed using structural equation modeling. Results A ruminative cognitive style was both indirectly associated with health anxiety via its strong relationship with negative affect and was also directly associated with health anxiety. Furthermore, catastrophizing ambiguous symptoms was also directly related to health anxiety. Conclusion High health anxiety individuals not only hold dysfunctional beliefs about health and illness but they also think about their distress in a ruminative manner. A more complete cognitive-behavioral model of health anxiety should include not only cognitive contents ("what") but also cognitive style ("how").
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Rumination has been shown to be central to the maintenance of health anxiety.
“Second, rumination has been shown to be central to the maintenance of HA (Marcus, Hughes, & Arnau, 2008)”
From Mindfulness-based cognitive therapy for severe health anxiety (hypochondriasis): An interpretative phenomenological analysis of patients' experiences (2011) · cites this paper as Marcus, Hughes, & Arnau, 2008
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- Authors
- Marcus, D. K., Hughes, K. T., & Arnau, R. C.
- Affiliations
- University of Southern Mississippi (US)
- Corresponding author
- Marcus, David K.
- ORCID
- Marcus, David K.
- Venue
- Journal of Psychosomatic Research
- Publisher
- Elsevier BV
- Published
- 2008-05
- Volume
- 64
- Issue
- 5
- Pages
- 495-501
- ISSN
- 0022-3999 (ISSN-L)
- OpenAlex
- W1982809109
- Cited by
- 99
- References
- 13
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 4 · 2023: 3 · 2022: 9 · 2021: 7 · 2020: 5 · 2019: 4 · 2018: 8 · 2017: 5 · 2016: 6 · 2015: 7 · 2014: 9 · 2013: 7 · 2012: 6
- FWCI
- 5.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Psychosomatic Research (publishedVersion)
- PubMed (publishedVersion)
- Aquila Digital Community (University of Southern Mississippi) (submittedVersion)
- 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 › COVID-19 and Mental Health
- Keywords
- health anxiety, rumination, negative affect, catastrophizing, cognitive style, cognitive-behavioral model, university students, illness beliefs
- MeSH terms
- Adult, Affect, Anxiety Disorders, Attitude to Health, Female, Health Status, Humans, Male, Surveys and Questionnaires, Severity of Illness Index
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