Illness‐related intrusive thoughts and illness anxiety disorder
Open accessAbstract
Introduction: Intrusive thoughts about health threats (illness‐ITs) are a potential cognitive risk factor for the development and maintenance of illness anxiety disorder (IAD). This study analyzes the dimensionality of illness‐ITs from normalcy to psychopathology, and it evaluates whether the appraisals instigated by the Its mediate between these thoughts and IAD symptoms. Methods: Two groups of individuals participated in the study and completed the Illness Intrusive Thoughts Inventory and the Whiteley Index. The first group was composed of 446 non‐clinical community participants. Of them, 264 individuals (68.6% women; M age = 30.03 [ SD = 13.83]) reported having experienced an upsetting illness‐IT in the past three months and were then included in the main analyses. The second group included 31 patients with a current main diagnosis of IAD based on DSM‐5 criteria (51.6% women; M age = 32.74 [ SD = 9.69]). Their severity was assessed with the Hypochondriasis Yale‐Brown Obsessive‐Compulsive Scale ‐Modified version, with scores ranging from 15 to 58 ( M = 46.12, SD = 9.41). Results: Illness‐ITs are common in both non‐clinical individuals and in patients with IAD, and they instigate dysfunctional emotional, cognitive, and behavioral consequences, although with greater intensity in patients than in non‐clinical individuals. The relationship between illness‐ITs and IAD is mediated by overestimation of threat and thought‐action fusion‐probability appraisals. Conclusion: Illness‐ITs are a dimensional cognitive experience. The way they are appraised facilitates their escalation into symptoms of IAD. Practitioner points: Provides support for the cognitive explanatory model of IAD and its usefulness in clinical practice. Indicates that the way people interpret and react to naturally occurring intrusive thoughts about illness seems to be a vulnerability marker for developing an illness anxiety disorder. Emphasizes that the meaning that patients with IAD ascribe to their intrusive thoughts about illnesses must be a main target in the cognitive‐behavioral treatment of IAD. Suggests that the importance of intrusive thoughts in IAD does not lie in the frequency with which they are experienced, but in the way, they are appraised/interpreted, which is what determines whether they become a clinically significant symptom. Indicates that the relationship between illness intrusive thoughts and IAD symptoms in non‐clinical individuals is based on: overestimating the negative consequences of experiencing an illness intrusive thought; and the appraisal that having such a thought would increase its likelihood of coming true. Shows that the frequency of illness‐related intrusive cognitions is associated with worse cognitive and behavioral consequences.
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Health-anxious individuals experience more frequent and intense illness-related intrusive thoughts and demonstrate a selective negative interpretation bias of these thoughts or sensations.
“Health-anxious individuals have also been shown to experience more frequent and intense illness-related intrusive thoughts [47, 48], and to demonstrate a selective negative interpretation bias of these thoughts or sensations [49].”
From Illness Anxiety Disorder: A Review of the Current Research and Future Directions (2024) · cites this paper as [47]
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- Authors
- Arnáez, S., García‐Soriano, G., López‐Santiago, J., & Belloch, A.
- Affiliations
- Universitat de València (ES)
- Mental Health Unit University Hospital of Albacete Spain
- Corresponding author
- García‐Soriano, Gemma
- Venue
- Psychology and Psychotherapy: Theory, Research and Practice
- Publisher
- Wiley
- Published
- 2020-01-20
- Volume
- 94
- Issue
- 1
- Pages
- 63-80
- ISSN
- 1476-0835 (ISSN-L)
- 2044-8341
- OpenAlex
- W3000047017
- Cited by
- 30
- References
- 60
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 8 · 2023: 4 · 2022: 3 · 2021: 3
- FWCI
- 1.81
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- Psychology and Psychotherapy Theory Research and Practice (publishedVersion)
- PubMed (publishedVersion)
- Repository of Digital Objects for Teaching Research and Culture (University of Valencia) (submittedVersion, cc-by-nc)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Keywords
- health anxiety, thought-action fusion, cognitive appraisal, vulnerability indicators, cognitive behavioral therapy, Whiteley Index
- MeSH terms
- Adult, Anxiety Disorders, Mental Disorders, Cognition, Female, Humans, Hypochondriasis, Male, Cognitive Behavioral Therapy
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