Predictors of health anxiety among older and young adults
Open accessAbstract
BACKGROUND: Many older adults have at least one chronic disease and experience greater health problems than young adults. However, little is known about factors other than health that account for health anxiety (HA) among older adults. The overall objective of the present study was to develop a better understanding of HA among older and young adults. METHODS: We examined how anxiety-related constructs (anxiety sensitivity, intolerance of uncertainty, anxiety control, and emotion regulation) predict two core components of HA described in the cognitive-behavioral model of HA (illness likelihood and negative consequences) in older and young adults. We also examined the extent to which the predictor variables differentially account for HA in both age groups. Older and young adult participants completed several self-report surveys. RESULTS: Young adults reported higher levels of HA than older adults. Anxiety sensitivity and reappraisal predicted illness likelihood for older and young adults. Intolerance of uncertainty predicted negative consequences in both age groups. Anxiety sensitivity predicted negative consequences for older adults only. Anxiety control did not predict illness likelihood or negative consequences for either age group. CONCLUSIONS: Results suggest that anxiety sensitivity and intolerance of uncertainty may predispose older and young adults to HA, which is influenced by reappraisal. Implications for the cognitive-behavioral model of HA in both age groups are discussed.
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Compared with older adults, younger adults tend to report higher levels of AS along with greater levels of health anxiety.
“Furthermore, compared with older adults, younger adults tend to report higher levels of AS along with greater levels of health anxiety (Gerolimatos & Edelstein, 2012).”
From Anxiety Sensitivity, Experiential Avoidance, and Mindfulness Among Younger and Older Adults: Age Differences in Risk Factors for Anxiety Symptoms (2015) · cites this paper as Gerolimatos & Edelstein, 2012
The age difference on the physical concerns subscale supports findings that younger adults reported higher levels of health anxiety and its associated consequences.
“A significant age difference was also found on the physical concerns subscale of the ASI-3 with younger adults scoring higher than older adults, supporting the findings of Gerolimatos and Edelstein (2012) that younger adults reported higher levels of health anxiety and its associated consequences.”
From Anxiety Sensitivity, Experiential Avoidance, and Mindfulness Among Younger and Older Adults: Age Differences in Risk Factors for Anxiety Symptoms (2015) · cites this paper as Gerolimatos and Edelstein (2012)
The cognitive behavioral model of severe health anxiety posits four central maintaining mechanisms: perceived risk of disease, perceived negative consequences of disease, attention to bodily sensations, and intolerance of uncertainty.
“According to the cognitive behavioral model of severe health anxiety (hypochondriasis) four central maintaining mechanisms are how the individual perceives the risk of disease and how negative its consequences would be, attention to bodily sensations, and intolerance of uncertainty.”
From Mediators in Internet-Based Cognitive Behavior Therapy for Severe Health Anxiety (2013) · cites this paper as [20]
Intolerance of uncertainty is associated with health anxiety and with outcome in CBT for generalized anxiety disorder.
“The fourth putative mechanism is intolerance of uncertainty, which has been shown to be associated with health anxiety and with outcome in CBT for generalized anxiety disorder [19,20].”
From Mediators in Internet-Based Cognitive Behavior Therapy for Severe Health Anxiety (2013) · cites this paper as [20]
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The Role of Emotion Reactivity in Health Anxiety
O’Bryan, E. M., McLeish, A. C., & Johnson, A. L. (2017) · Behavior Modification · doi:10.1177/0145445517719398 · Cited by 20 · see citing works
“Gender and age were chosen as covariates on an a priori basis due to associations with emotion reactivity and health anxiety (e.g., Gerolimatos & Edelstein, 2012; MacSwain et al., 2009; Nock et al., 2008).”
MethodBredemeier, K., Church, L. D., Bounoua, N., Feler, B., & Spielberg, J. M. (2023) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2022.102660 · Cited by 18 · see citing works
“…with health anxiety in the literature are intolerance of uncertainty and anxiety sensitivity (e.g., Fergus & Bardeen, 2013; Fetzner et al., 2014; Gerolimatos & Edelstein, 2012; Horenstein, Rogers, Bakhshaie, Zvolensky, & Heimberg, 2019; Norr, Albanese, Oglesby, Allan, & Schmidt, 2015; Wright,…”
Anxiety sensitivity and fear of exercise in patients attending cardiac rehabilitation
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Dattilo, T. M., Roberts, C. M., Fisher, R. S., Traino, K. A., Edwards, C. S., Pepper-Davis, M., Chaney, J. M., & Mullins, L. L. (2021) · Journal of Pediatric Nursing · doi:10.1016/j.pedn.2021.04.006 · Cited by 18 · see citing works
Pifer, M., & Segal, D. (2020) · Clinical Gerontologist · doi:10.1080/07317115.2020.1725793 · Cited by 18 · see citing works
“This could be problematic in LTC because older adults may be more likely to endorse somatic anxiety symptoms rather than worry symptoms (Gerolimatos & Edelstein, 2012).”
BackgroundWolf, J. P., Freisthler, B., & McCarthy, K. S. (2021) · Social Science & Medicine · doi:10.1016/j.socscimed.2021.113887 · Cited by 18 · see citing works
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Covid-19 Pandemi Sürecinde Bireylerin Sağlık Kaygılarının Siberkondri Üzerindeki Etkisi
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Blackman, G., Cherfi, Y., Morrin, H., Ellis, C. M., Bashford, J., Ruths, F. A., & David, A. S. (2019) · Psychosomatics · doi:10.1016/j.psym.2019.04.001 · Cited by 12 · see citing works
İNTERNET BAĞIMLILIĞI VE SAĞLIK ANKSİYETESİNİN SİBERKONDRİ DAVRANIŞLARI ÜZERİNE ETKİSİ
Doğan, S., Acar, F., & Doğan, T. (2021) · Erciyes Üniversitesi Sosyal Bilimler Enstitüsü Dergisi · doi:10.48070/erusosbilder.859102 · Cited by 14 · see citing works
Shiloh, S., Peleg, S., & Nudelman, G. (2022) · Psychology Health & Medicine · doi:10.1080/13548506.2022.2030480 · Cited by 12 · see citing works
“It has been associated with anxiety and panic disorder (Capobianco et al., 2018), health anxiety (Gerolimatos & Edelstein, 2012), worry (Gentes & Ruscio, 2011), and perceived stress (Bardeen et al., 2017).”
BackgroundPositive and Detached Reappraisal of Threatening Music in Younger and Older Adults
Vieillard, S., Pinabiaux, C., & Bigand, E. (2020) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2020.00216 · Cited by 11 · see citing works
“, 2014), some other studies report greater preference for cognitive reappraisal over other emotion-regulation modalities for older adults compared with their younger counterparts (John and Gross, 2004; Urry and Gross, 2010; Gerolimatos and Edelstein, 2012).”
BackgroundCommons, D., Greenwood, K. M., & Anderson, R. (2015) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465815000454 · Cited by 11 · see citing works
Andreeva, M. T., & Караваева, Т. А. (2020) · V M BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY · doi:10.31363/2313-7053-2019-4-2-19-28 · Cited by 11 · see citing works
Department of Psychology, F. O. E. A. P., Elhamiasl, M., Dehghani, M., Department of Psychology, F. O. E. A. P., Heidari, M., Department of Psychology, F. O. E. A. P., Khatibi, A., & Interdisciplinary Program in Neuroscience, B. U. (2020) · Basic and Clinical Neuroscience Journal · doi:10.32598/bcn.9.10.240 · Cited by 9 · see citing works
“However, another study reported that none of these strategies were related to IAD (Gerolimatos & Edelstein, 2012).”
Emotion-regulation strategies in older people: a systematic review
Ramírez‐Ruiz, B., Quinn, K. M., & Ferreira, N. B. (2019) · Working with Older People · doi:10.1108/wwop-09-2019-0026 · Cited by 9 · see citing works
Yu, M. H. M., Cao, Y., Fung, S. S. Y., Kwan, G. S. Y., Tse, Z. C. K., & Shum, D. H. K. (2025) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2025.102975 · Cited by 8 · see citing works
Yu, Y., Ouyang, G., Li, J., & Cao, D. (2025) · Neuroscience · doi:10.1016/j.neuroscience.2025.06.022 · Cited by 8 · see citing works
Bräscher, A., Brähler, E., Häuser, W., & Witthöft, M. (2023) · Assessment · doi:10.1177/10731911231219802 · Cited by 8 · see citing works
“Since health anxiety has been shown to vary with age (Bleichhardt & Hiller, 2007; Gerolimatos & Edelstein, 2012), education (Bleichhardt & Hiller, 2007; Boston & Merrick, 2010), and gender (Bleichhardt & Hiller, 2007), investigating representative samples can help to gain an unbiased understanding…”
Niu, T., Cao, S., Cheng, J., Zhang, Y., Zhang, Z., Xue, R., Ma, J., Ran, Q., & Xian, X. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1451703 · Cited by 7 · see citing works
Akariya, O., Anholt, G. E., & Shahar, G. (2021) · International Journal of Cognitive Therapy · doi:10.1007/s41811-021-00121-x · Cited by 7 · see citing works
“This age group reports higher levels of health anxiety than older adults (Bourgault-Fagnou & Hadjistavropoulos, 2009; Gerolimatos & Edelstein, 2012).”
BackgroundAttitudes to aging mediate the reciprocal effects of health anxiety and physical functioning
Bodner, E., Shrira, A., & Palgi, Y. (2021) · Psychology and Health · doi:10.1080/08870446.2021.1956496 · Cited by 6 · see citing works
“In this regard, studies have shown that older adults with chronic medical conditions (e.g. Kim et al., 2001), and older adults in general (El-Gabalawy et al., 2011, 2013; Gerolimatos & Edelstein, 2012; Kim et al., 2001; van Balkom et al., 2000) demonstrate a higher risk for anxiety disorders.”
BackgroundAssessment of Anxiety in Long-Term Care Residents: Issues and Strategies
Pifer, M., Segal, D., Jester, D. J., & Molinari, V. (2020) · The International Journal of Aging & Human Development · doi:10.1177/0091415020943321 · Cited by 6 · see citing works
“One leading reason for this lack of detection and lack of subsequent intervention is that there are insufficient screening and assessment instruments for anxiety specifically designed and validated for older adults in diverse LTC settings (Gerolimatos & Edelstein, 2012).”
BackgroundFitzgerald, H. E., Parsons, E. M., Indriolo, T., Taghian, N. R., Gold, A. K., Hoyt, D. L., Milligan, M. A., Zvolensky, M. J., & Otto, M. (2022) · Cognitive Therapy and Research · doi:10.1007/s10608-022-10321-0 · Cited by 6 · see citing works
“Such findings parallel research showing IU to relate to health anxiety (e.g., Deacon & Abramowitz 2008; Boelen & Carleton, 2012; Gerolimatos & Edelstein, 2012), and suggests that this relationship extends to COVID-19 emotional responses.”
BackgroundPedroso‐Chaparro, M. D. S., Cabrera, I., Fernándes-Pires, J., Márquez‐González, M., & Losada‐Baltar, A. (2023) · Aging & Mental Health · doi:10.1080/13607863.2023.2262947 · Cited by 5 · see citing works
“…people from several age ranges (e.g. Dunkley et al., 2020; Hovenkamp-Hermelink et al., 2019) and samples specifically composed of older adults (e.g. Gerolimatos & Edelstein, 2012; Xiao et al., 2019), a significant and negative association was found between higher perceived control and lower…”
BackgroundMental health disorder in chronic liver disease: a questionnaire survey
Long, J., Xiong, P., Jiang, W., Wang, X., Wu, D., Tang, X., & Zhou, T. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1469372 · Cited by 5 · see citing works
“Anxiety sensitivity and an intolerance of uncertainty may make both older and younger individuals more prone to anxiety (24).”
BackgroundNorbye, A. D., Abelsen, B., Førde, O. H., & Ringberg, U. (2022) · BMC Family Practice · doi:10.1186/s12875-022-01749-0 · Cited by 5 · see citing works
“Possible cohort effect Older age is associated with lower HA [40], and as physical diseases are more prevalent in older individuals, we hypothesised that the association between HA and disease may differ by age.”
BackgroundMohsenabadi, H., Pirmoradi, M., Tajrishi, K. Z., & Gharraee, B. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1478442 · Cited by 12 · see citing works
Demirtepe-Saygılı, D., Eşiyok, E., & Turancı, E. (2021) · Türkiye İletişim Araştırmaları Dergisi · doi:10.17829/turcom.862102 · Cited by 4 · see citing works
Exercise and Health Anxiety in Older Women: Exploring the Mediating Role of Anxiety Sensitivity
Nah, K., & Olthuis, J. V. (2023) · Journal of Aging and Physical Activity · doi:10.1123/japa.2022-0204 · Cited by 4 · see citing works
Age differences in the influence of self-esteem and emotional regulation on memory
Doron, Y., & Anaki, D. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1346693 · Cited by 2 · see citing works
“In contrast, other studies (e.g., Gerolimatos and Edelstein, 2012) showed a higher preference for reappraisal.”
ResultAssessment of intolerance of uncertainty: Validation of a modified anagram task
O’Bryan, E. M., Beadel, J. R., McLeish, A. C., & Teachman, B. A. (2021) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2021.101671 · Cited by 4 · see citing works
Pasay-an, E. A., Alalawi, R. H., Shanmugam, S. R., Alshammari, S. A., Alreshidi, M. S., Alkubati, S. A., Alrashidi, N. A., Pangket, P. P., Benjamin, L. S., Gonzales, F., et al. (2025) · PLoS ONE · doi:10.1371/journal.pone.0325791 · Cited by 3 · see citing works
“In fact, it has been found that individuals with high levels of health anxiety frequently misinterpret their physical symptoms as indications of serious illnesses [16], with young adults reporting higher levels of health anxiety than older individuals [17].”
Aprodita, N. P. (2022) · Jurnal Psikologi · doi:10.24014/jp.v18i2.16654 · Cited by 3 · see citing works
Hill, S., & Watts, D. (2024) · Clinical Case Reports · doi:10.1002/ccr3.9316 · Cited by 3 · see citing works
Health anxiety and related factors among the rural population: A cross-sectional study in China
Jiang, Z. C., Cao, G., Suomi, R., & Zha, D. (2024) · Journal of Health Psychology · doi:10.1177/13591053241301201 · Cited by 3 · see citing works
“Anxiety sensitivity predisposes both older and younger adults to health anxiety and predicts the likelihood of its occurrence in these age groups (Gerolimatos and Edelstein, 2012).”
Hew, A., Lloyd, M., Rayner, G., Matson, A., Rychkova, M., Ali, R., Winton‐Brown, T., Perucca, P., Kwan, P., O'Brien, T. J., et al. (2021) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2021.107987 · Cited by 3 · see citing works
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
Correlating Cyberchondria and Health Anxiety: Demographic Insights from Stable Asthma Patients
Durak, B., & Kaya, A. E. (2024) · European Journal of Therapeutics · doi:10.58600/eurjther2026 · Cited by 3 · see citing works
Effect of cognitive therapy training in groups on health anxiety among nursing students
Shali, E. M., Alipor, A., & Pashang, S. H. (2013) · Pars of Jahrom University of Medical Sciences · doi:10.29252/jmj.11.2.8 · Cited by 3 · see citing works
“Results of studies by Juroly Mathus and Edelstein also showed young adults had higher rates of reported health anxiety than older people (9).”
ResultMental Health and Treatment Considerations for Older Adults
Edelstein, B. A., Spalding, R., & Katz, E. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-818697-8.00137-0 · Cited by 3 · see citing works
Dalawi, I., Isa, M. R., Malik, K. A., Hatta, F. H. M., & Rahmat, M. F. (2022) · Journal of Mental Health and Social Behaviour · doi:10.33790/jmhsb1100163 · Cited by 2 · see citing works
The effect of cyberchondria on anxiety and surgical fear levels in surgical oncology patients
Polat, H., Kapıkıran, G., & Kartal, M. (2025) · Current Psychology · doi:10.1007/s12144-025-07639-9 · Cited by 2 · see citing works
“According to previous research, young adults exhibit greater levels of health anxiety compared to older individuals (Gerolimatos & Edelstein, 2012).”
Lu, Y., Jiang, M., Cui, C., Xia, B., Skitmore, M., & Liu, Y. (2025) · Energy Strategy Reviews · doi:10.1016/j.esr.2025.101741 · Cited by 2 · see citing works
Llewelyn-Williams, J., Oliver, A. M., Wright, K. D., Runalls, S., Lahti, D. S., Bradley, T. J., Kakadekar, A. P., Pharis, S., Pockett, C. R., ERLANDSON, M. C., et al. (2022) · Journal of Child Health Care · doi:10.1177/13674935221075896 · Cited by 2 · see citing works
“An example of anxiety sensitivity could be experiencing fear due to increased heart rate and the evaluation that the change in heart rate could have deleterious effects for one’s health (Gerolimatos and Edelstein, 2012; Taylor et al., 2007).”
BackgroundResultInfluentialClinical Assessment of Late-Life Anxiety
Gould, C. E., Kok, B. C., Ma, V. K., & Edelstein, B. A. (2021) · Cambridge University Press eBooks · doi:10.1017/9781139087469.006 · Cited by 2 · see citing works
A Comparative Study on Emotion Regulation of Older and Younger Adults
Saeidi, N., Lotfi, M., Akbarian, M., Saeidi, A. R., & Salehi, A. (2021) · Salmand · doi:10.32598/sija.2021.16.3.3153.1 · Cited by 2 · see citing works
Autenrieth, L. K., Benke, C., Asselmann, E., & Pané‐Farré, C. A. (2023) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2023.100491 · Cited by 2 · see citing works
Changes in emotion regulation across the life span
Meier, T., Stephens, J. E., & Haase, C. M. (2024) · Elsevier eBooks · doi:10.1016/b978-0-323-95604-8.00011-3 · Cited by 5 · see citing works
Changes in Emotion Regulation across the Life SpanPreprint
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Factors influencing health anxiety
Hylan, J. (2023) · BPS Branch Awards · doi:10.53841/bpsba.2023.1.1.15 · Cited by 1 · see citing works
Maternal threats and college student mental health: The role of perceived anxiety control
Trent, E. S., Hylton, R. M., & Viana, A. (2022) · Journal of American College Health · doi:10.1080/07448481.2022.2140291 · Cited by 1 · see citing works
“6,8 Our findings also align with past reports of significant associations between lower levels of perceived anxiety con-trol and mental health problems among young adults (anxiety, health anxiety, sleep problems 39,40 ) and in college students in particular (anxiety, depression, adjustment 17,41 ).”
Orok, E. N., Okuoru, W., Oni, O. I., Ojo, T. F., Oluwadare, T., Bamitale, T., Jaiyesimi, B., Akinjisola, A., & Apara, T. (2023) · Research Square · doi:10.21203/rs.3.rs-3542029/v1 · Cited by 1 · see citing works
A comparative investigation of emotion regulation patterns in different decades of age
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“34 The Cronbach alpha for the conscientiousness subscale was 0.59.”
BackgroundInfluentialCOVID-19 Pandemi Sürecinde Göreve Başlayan Sağlık Personelinde Anksiyete ve Sağlık Kaygısı
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Pengembangan Aplikasi Deteksi Kecemasan Kesehatan dan Intervensi
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Diverging influences of punishment motivation and negative affect on cognitive control
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“However, our sample average is consistent with other undergraduate young adult samples (Gerolimatos & Edelstein, 2012: M = 63.55, SD = 22.06; Kraemer et al., 2015: M = 66.53, SD = 20.32), although neither study screened for nor excluded participants with a diagnosed anxiety disorder.”
InfluentialBailey, R., Carmichael, T. D., & Penney, A. M. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1766275
Poshtan, M. M., Aflakseir, A., & Ramzi, M. (2026) · International Perspectives in Psychology · doi:10.1027/2157-3891/a000162
- Authors
- Gerolimatos, L. A., & Edelstein, B. A.
- Affiliations
- West Virginia University (US)
- Corresponding author
- Gerolimatos, Lindsay A.
- ORCID
- Edelstein, Barry A.
- Venue
- International Psychogeriatrics
- Publisher
- Elsevier BV
- Published
- 2012-12
- Volume
- 24
- Issue
- 12
- Pages
- 1998-2008
- ISSN
- 1041-6102 (ISSN-L)
- OpenAlex
- W2321379831
- Cited by
- 99
- References
- 40
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 11 · 2023: 11 · 2022: 17 · 2021: 15 · 2020: 5 · 2019: 5 · 2018: 5 · 2017: 7 · 2016: 1 · 2015: 5 · 2014: 3 · 2013: 3
- FWCI
- 4.71
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Psychogeriatrics (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- West Virginia University
- 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, older adults, young adults, age differences, anxiety sensitivity, intolerance of uncertainty, anxiety control, emotion regulation, cognitive reappraisal, negative consequences
- MeSH terms
- Adaptation, Psychological, Adult, Age Factors, Aged, Aged, 80 and over, Anxiety, Attitude to Health, Chronic Disease, Female, Humans, Middle Aged, Models, Psychological, Surveys and Questionnaires, Risk Factors, Uncertainty, Illness Behavior, Young Adult, Self Report
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