Health anxiety, hypochondriasis, and the anxiety disorders

Although clinical observations suggest that health-related anxiety is present, to some extent, in a number of anxiety disorders, this relationship has not been examined empirically. The present study therefore utilized the Short Health Anxiety Inventory (SHAI) to elucidate the structure of such symptoms among patients with anxiety disorders and to empirically investigate the presence of health anxiety in various anxiety disorders. Confirmatory factor analysis yielded equivalent support for either a 2-factor or 3-factor model of the SHAI's latent structure. The measure demonstrated good reliability, convergent validity, and discriminant validity. Comparison of SHAI scores across groups of patients with various anxiety disorders revealed elevated levels of health anxiety among patients with hypochondriasis and panic disorder relative to those with other anxiety disorders. Receiver operating characteristic analyses supported the utility of the SHAI as a diagnostic tool for screening patients with hypochondriasis utilizing empirically derived cut scores. Findings are discussed in terms of cognitive-behavioral models of anxiety disorders.     

Psychopathy,anxiety and malingering

Psychopathy is commonly measured as a low score on an Anxiety scale or as a high score on the MMPI Pd scale. The Pd scale, the Spielberger et al. Trait Anxiety scale and a short Achievement Motivation scale were administered to a random postal sample of 115 Australians. It was found that there was a high positive correlation between the Pd and Anxiety scales. This strongly supports Eysenck's theory that psychopaths are neurotic extraverts. A possible alternative explanation of the findings, however, is that the Pd scale may measure not psychopathy but malingering.     

Perfectionism, self-consciousness and anxiety

The relation between perfectionism, anxiety, and self-consciousness was studied in a normal sample. The perfectionism dimensions of Concern over Mistakes, Doubts about Action, and Socially Prescribed Perfectionism showed a pattern of correlations not only with measures of social anxiety, but also with measures of agoraphobic fears, and fears of bodily injury, death and illness. Public self-consciousness also correlated with various measures of anxiety, but these correlations disappeared when the relevant dimensions of perfectionism were controlled for. It is concluded that perfectionism is a more relevant construct in the study of anxiety than is public self-consciousness. The results are discussed in terms of possible causal relationships between perfectionism and anxiety.     

Hypnotizability, imaginative involvement, and anxiety

Forty-five undergraduate students were investigated to determine the relationship between hypnotizability, imaginative involvement (absorption), and anxiety responses. Hypnotizability was measured independently with the Creative Imagination Scale (CIS), and imaginative involvement was measured with the Absorption Scale (ABS). The results indicated moderate significant correlations between CIS, ABS, and several of the anxiety measures. In particular self-reported physiological aspects of anxiety/activation were associated with the CIS and the ABS. Three of the subjects reported having panic attacks. These subjects also exhibited high hypnotic responsiveness, and their scores on the ABS and several of the anxiety scales were considerably elevated as compared with the group mean level.     

Death anxiety, dissent, and competence

A total of 64 male undergraduates were administered a multistage interview which was structured to assess (a) their level of overtly expressed death anxiety, (b) covert (GSR) arousal to death stimuli (c) self-perceived competence, and (d) agreement with or dissent from life threatening national policies. The analyses that followed were concerned with examining the relationships among these variables. In previous studies of this kind it had been typically found that (1) self-perceived competence and magnitude of expressed death concern are inversely related and (2) overt expressions of death concern and covert physiological arousal to death cues are inversely related. Psychodynamic formulations centering on the ego-defensive nature of inhibited expressions of death anxiety have been cited to explain these past data. The current investigation proposed that the magnitude of expressed death concern would bear an inverse relationship to both felt competence and covert death arousal only when the level of overt concern was not contingent upon the individual's attitudes concerning the imminence of real life threatening circumstances in the environment. The rationale behind these predictions inheres in the notion that the neurotic components of strongly expressed death anxiety derive from its lack of anchoring in "real" external threats. Conversely, the expression of low death fear can only be regarded as "defensive" when real threats are perceived and acknowledged. The obtained results strongly support this rationale and the discussion centers on the impact of social conditions on psychodynamic processes.     

Health anxiety, anxiety sensitivity, and attentional biases for pictorial and linguistic health-threat cues

The study investigated attentional biases for pictorial and linguistic health-threat stimuli in high and low health anxious individuals, who were selected from the upper and lower quartile ranges of a normal sample using a screening measure of health anxiety. Attentional bias was assessed using a visual probe task which presented health-threat and neutral pictures and words at two exposure durations, 500 ms and 1250 ms. The prediction that the high health anxious group would show a greater attentional bias for health-threat cues than the low health anxious group was not supported despite the groups being well-differentiated on a general measure of health anxiety, the Illness Attitudes Scale (IAS). Instead, the results indicated that individuals with high levels of anxiety sensitivity showed a significantly greater initial attentional bias for threat pictures compared with those with low anxiety sensitivity, as assessed by the Anxiety Sensitivity Index (ASI).     

Temperament, anxiety, and attentional control

To regulate attention has been a significant component of individual differences in temperament, and other research supported a relation between measures of attentional control and anxiety, i.e., high scores on trait anxiety were correlated with inability to regulate attention in response to the environment, so enhanced attentional control may interact with dimensions of temperament to modify the effects of generalized anxiety. To test this hypothesis, 69 undergraduates completed the Revised Dimensions of Temperament Survey, the Burns Anxiety Scale, and the Derryberry and Reed measure of Attentional Control. Analysis suggested attentional control may be a significant factor in modifying reported anxiety. Further research is warranted, given the present small sample tested with numerous measures.     

Risk-taking, death anxiety, and dreaming

Dream characteristics of 29 women from a graduate program were correlated with scores on the Sensation-Seeking and Death Anxiety scales. Significant positive correlations were obtained between Sensation Seeking and dream frequency (.38), meaningful dreams (.38), and Openness and depth of dreaming (.39) as well as between Thrill-seeking and dream frequency (.41) and meaningful dreams (.41). Death Anxiety scores positively related to the occurrence of nightmares (.37), representations of death in dreams (.55), and recurring nightmares (.38), but no support was found for a relationship between death anxiety and Sensation Seeking.