Attentional bias toward health-threat in health anxiety: a systematic review and three-level meta-analysis
Abstract
Attentional bias toward health-threat may theoretically contribute to the development and maintenance of health anxiety, but the empirical findings have been controversial. This study aimed to synthesize and explore the heterogeneity in a health-threat related attentional bias of health-anxious individuals, and to determine the theoretical model that better represents the pattern of attentional bias in health anxiety. Four databases (Web of Science, PubMed, PsycINFO, and Scopus) were searched for relevant studies, with 17 articles (N = 1546) included for a qualitative review and 16 articles (18 studies) for a three-level meta-analysis (N = 1490). The meta-analytic results indicated that the health anxiety group, compared to the control group, showed significantly greater attentional bias toward health-threat (g = 0.256). Further analyses revealed that attentional bias type, paradigm, and stimuli type were significant moderators. Additionally, compared to the controls, health-anxious individuals displayed significantly greater attention maintenance (g = 0.327) but nonsignificant attention vigilance to health-threat (g = −0.116). Our results provide evidence for the attention maintenance model in health-anxious individuals. The implications for further research and treatment of elevated health anxiety in the context of coronavirus disease-2019 (COVID-19) were also discussed.
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Attentional bias towards health-threat related stimuli is strongly associated with health anxiety in a recent systematic review and meta-analysis.
“A key contribution to this misinterpretation is an attentional bias towards health-threat related stimuli, which has shown to be strongly associated with health anxiety in a recent systematic review and meta-analysis [46].”
From Illness Anxiety Disorder: A Review of the Current Research and Future Directions (2024) · cites this paper as [46]
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Illness Anxiety Disorder: A Review of the Current Research and Future Directions
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“A key contribution to this misinterpretation is an attentional bias towards health-threat related stimuli, which has shown to be strongly associated with health anxiety in a recent systematic review and meta-analysis [46].”
BackgroundInterpretation bias in health anxiety: a systematic review and meta-analysis
Du, X., Witthöft, M., Zhang, T., Shi, C., & Ren, Z. (2023) · Psychological Medicine · doi:10.1017/s0033291722003427 · Cited by 30 · see citing works
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- Authors
- Shi, C., Taylor, S., Witthöft, M., Du, X., Zhang, T., Lu, S., & Ren, Z.
- Affiliations
- Central China Normal University (CN)
- University of British Columbia (CA)
- Johannes Gutenberg University Mainz (DE)
- Corresponding author
- Ren, Zhihong
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2022-01-10
- Volume
- 52
- Issue
- 4
- Pages
- 604-613
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W4205977150
- Cited by
- 32
- References
- 68
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 12 · 2023: 5 · 2022: 3
- FWCI
- 1.02
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Key Program of Institute of Wuhan Studies of Jianghan University (IWHS20201007)
- 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, attentional bias, health hazards, sustained attention, COVID-19 pandemic, anxiety maintenance
- MeSH terms
- Attentional Bias, COVID-19, Anxiety, Anxiety Disorders, Humans
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