In an era where health information is constantly at our fingertips, many of us have experienced that moment of panic after noticing an unusual bodily sensation or reading about a disease with symptoms similar to our own. While concern about our health is normal, for some people, these worries can spiral into persistent anxiety that significantly impacts their quality of life.
A groundbreaking study by Dr. Brett Deacon and colleagues provides valuable insights into how we process health concerns and why some people develop health anxiety (formerly known as hypochondriasis). Their research validates a useful tool for measuring health anxiety and reveals important psychological factors that contribute to this increasingly common problem.
The Cognitive Framework of Health Anxiety
The researchers begin with a compelling cognitive-behavioral model that explains how health anxiety develops and persists. According to this model, health anxiety stems from dysfunctional beliefs about bodily symptoms and illness. These might include assumptions that symptoms always indicate something seriously wrong (the “hurt equals harm” belief) or exaggerated notions about the likelihood and severity of serious illness.
Once these beliefs are in place, a person might catastrophically misinterpret normal bodily sensations. For example, someone who believes they’re at high risk for a brain tumor might become anxious about mild dizziness, immediately jumping to the worst-case scenario.
Most importantly, the research shows that health anxiety is maintained by the very behaviors people use to cope with their fears. These safety-seeking behaviors—like excessive medical visits, body checking, or researching symptoms online—actually reinforce anxiety in the long run.
Three Key Components of Health Anxiety
Dr. Deacon’s team validated the Short Health Anxiety Inventory (SHAI), a brief questionnaire that measures health anxiety. Their analysis revealed three core components:
- Perceived Illness Likelihood: The belief that you’re likely to have or develop a serious illness
- Perceived Illness Severity: Catastrophic thoughts about how terrible it would be if you were seriously ill
- Body Vigilance: Heightened attention to bodily sensations and changes
Interestingly, the research found that these components relate differently to behavior. Perceived illness likelihood and body vigilance were the strongest predictors of safety-seeking behaviors like checking symptoms online or repeatedly examining one’s body. Meanwhile, perceived illness severity was most strongly linked to “intolerance of uncertainty”—difficulty coping with the unknown.
How This Research Can Help You
Understanding the psychological mechanisms behind health anxiety offers several practical benefits:
Recognize Your Safety Behaviors
Safety-seeking behaviors provide temporary relief but fuel anxiety in the long run. Common examples include:
- Repeatedly checking your body for signs of illness
- Excessively researching symptoms online
- Seeking reassurance from others about your health
- Avoiding activities you believe might trigger symptoms
If you notice these patterns in yourself, they may be reinforcing anxiety rather than alleviating it.
Understand Body Vigilance
The study found that body vigilance—paying excessive attention to bodily sensations—was the strongest predictor of health-related safety behaviors. This creates a vicious cycle: the more you monitor your body, the more sensations you notice, which can then be misinterpreted as signs of illness.
Mindfulness practices that involve accepting bodily sensations without judgment can help break this cycle.
Examine Your Health Beliefs
Consider whether you hold any of these common beliefs that contribute to health anxiety:
- “Any unexplained symptom is likely to be serious”
- “My body should function perfectly, and any deviation is dangerous”
- “I need complete certainty about my health to feel at ease”
- “I wouldn’t be able to cope if I were seriously ill”
Challenging these beliefs and developing more balanced perspectives is often key to reducing health anxiety.
When Normal Concern Becomes Health Anxiety
It’s important to remember that health anxiety exists on a continuum. Appropriate concern about health is normal and adaptive, but when worry becomes persistent or interferes with daily life, it may require attention.
Dr. Deacon’s research helps us understand that health anxiety isn’t simply about being “too worried” about health—it involves specific patterns of thinking and behavior that can be identified and addressed.
For those experiencing significant health anxiety, cognitive-behavioral therapy (CBT) has proven effective. CBT targets the exact mechanisms identified in this research: challenging catastrophic beliefs about symptoms and illness, reducing safety-seeking behaviors, and developing more adaptive ways of responding to uncertainty and bodily sensations.
Moving Forward
Understanding the psychological components of health anxiety provides a framework for addressing this common problem. Whether you occasionally find yourself worrying about health concerns or experience more persistent anxiety, recognizing the patterns of thinking and behavior that contribute to health anxiety is the first step toward a more balanced relationship with your body and health.
Based on research by Jonathan S. Abramowitz, Brett J. Deacon, and David P. Valentiner: “The Short Health Anxiety Inventory: Psychometric Properties and Construct Validity in a Non-clinical Sample,” published in Cognitive Therapy and Research.
Leave a Reply