Cognitive Biases in Pathological Health Anxiety: The Contribution of Attention, Memory, and Evaluation Processes
Abstract
Pathological health anxiety refers to the medically unfounded fear of suffering from a severe illness. Differences in cognitive processes related to attention, memory, and evaluation of health threat have been hypothesized to underlie pathological health anxiety. In no study, however, have researchers systematically and simultaneously assessed different cognitive biases. On the basis of the idea that multiple cognitive biases simultaneously contribute to psychopathology (the combined-cognitive-bias hypothesis), we compared 88 patients with pathological health anxiety, 52 patients with depressive disorder, and 52 healthy participants on their performance in several cognitive tasks involving health-threatening content. Individuals with pathological health anxiety showed a stronger attentional bias to health-threat-related information, more negative explicit (but not implicit) evaluations of health threat, and biased response behavior in light of health threat. The results suggest that stronger bindings between feelings of arousal and health-threatening information in working memory might be crucial for the higher salience of health-threatening contents in pathological health anxiety.
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Illness-related bias occurs in highly health-anxious individuals and patients with pathological HA, and describes the tendency to focus on information that confirms health worries and to ignore contradictory information.
“It was found to occur in highly health-anxious individuals [97,98], as well as in patients with pathological HA [99-101] and describes the tendency to focus on information that confirms their health worries and to ignore information that is contradictory [58].”
From Conceptualizations of cyberchondria and relations to the anxiety spectrum: Systematic review and meta-analysis (2021) · cites this paper as [101]
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Optimierung von Expositionstherapie bei pathologischen Krankheitsängsten
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Blume, C., & Vorster, A. P. A. (2026) · Journal of Sleep Research · doi:10.1111/jsr.70319
- Authors
- Witthöft, M., Kerstner, T., Ofer, J., Mier, D., Rist, F., Diener, C., & Bailer, J.
- Affiliations
- Johannes Gutenberg University Mainz (DE)
- Heidelberg University (DE)
- University of Münster (DE)
- SRH University of Applied Sciences Heidelberg (DE)
- Corresponding author
- Witthöft, Michael
- Venue
- Clinical Psychological Science
- Publisher
- SAGE Publications
- Published
- 2015-08-11
- Volume
- 4
- Issue
- 3
- Pages
- 464-479
- ISSN
- 2167-7026 (ISSN-L)
- 2167-7034
- OpenAlex
- W2257800394
- Cited by
- 49
- References
- 79
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 5 · 2023: 5 · 2022: 11 · 2021: 3 · 2020: 7 · 2019: 3 · 2018: 4 · 2017: 4 · 2016: 2 · 2015: 2
- FWCI
- 6.03
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Psychological Science (publishedVersion)
- KOPS (University of Konstanz) (submittedVersion)
- Funders
- Deutsche Forschungsgemeinschaft (DFG, BA 1597/5, BA 1597/5-1,2)
- 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
- cognitive biases, attentional bias, working memory, arousal, depressive disorders
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