Health anxiety in a disease-avoidance framework: Investigation of anxiety, disgust and disease perception in response to sickness cues.
Abstract
Severe health anxiety is characterized by a debilitating fear of somatic illness, and avoidance of disease-related stimuli plays a key role in the maintenance of the disorder. The aim of this study was to investigate severe health anxiety within an evolutionary disease-avoidance framework. We hypothesized that, compared to healthy controls, participants with severe health anxiety would perceive others as sicker, more contagious, and less attractive. We also expected individuals with severe health anxiety to be more prone to avoid interaction with persons who appeared sick, as well as to respond with more health-related worry, more disgust, and more anxiety when confronting such individuals. In addition, this sensitivity was expected to be larger if people showed manifest sickness symptoms. Participants with and without severe health anxiety (N = 224) were exposed to facial photos with a varying degree of apparent sickness. Patients with severe health anxiety, compared to controls, rated apparently healthy people as being less healthy and less attractive. There were significant interaction effects showing that that the increase in disgust, anxiety, perceived contagiousness, and worry over one's own health as a function of how sick the person in the photo appeared, was significantly larger in the clinical sample compared to the healthy control sample (ps < .047). Results from regression analyses using health anxiety as a dimensional predictor also supported our hypotheses. We suggest that disgust and cognitive biases relating to the disease-avoidance model are significant features of severe health anxiety. (PsycINFO Database Record
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Health anxiety drives the avoidance of people and environments that an individual perceives as threatening, leading to reduced help-seeking.
“Health anxiety drives the avoidance of people and environments that an individual perceives as threatening, leading to reduced help-seeking.”
From A Cognitive Behavioral Therapy Chatbot (Otis) for Health Anxiety Management: Mixed Methods Pilot Study (2022) · cites this paper as [7]
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- Authors
- Hedman, E., Lekander, M., Karshikoff, B., Ljótsson, B., Axelsson, E., & Axelsson, J.
- Affiliations
- Karolinska Institutet (SE)
- Venue
- Journal of Abnormal Psychology
- Published
- 2016-10
- Volume
- 125
- Issue
- 7
- Pages
- 868-878
- ISSN
- 0021-843X (ISSN-L)
- 1939-1846
- OpenAlex
- W2531240972
- Cited by
- 30
- References
- 40
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 2 · 2022: 8 · 2021: 4 · 2020: 5 · 2019: 3 · 2018: 4
- FWCI
- 3.31
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Abnormal Psychology (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 › Body Image and Dysmorphia Studies
- Keywords
- health anxiety, disgust, illness perception, facial attractiveness, social avoidance, evolutionary psychology, cognitive biases
- MeSH terms
- Adult, Affect, Anxiety, Attitude to Health, Avoidance Learning, Female, Humans, Male, Social Perception, Illness Behavior
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