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Cognitive Behavioral Model Of Health Anxiety (Salkovskis, Warwick, Deale, 2003)

Health anxiety is characterized by a preoccupation with having or acquiring a serious illness, and a high level of anxiety about health. People with health anxiety will engage in excessive health-related behaviors, such as checking their body for signs of illness, or will avoid situations or stimuli that are perceived as anxiety-provoking. The Cognitive Behavioral Model Of Health Anxiety illustrates how mis-appraisal of body symptoms as threatening results in emotional and physiological feelings of anxiety, safety-seeking behaviours, all of which serve to maintain the threat appraisals.

Information Handout

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Description

Health anxiety is characterized by a preoccupation with having or acquiring a serious illness, and a high level of anxiety about health. People with health anxiety will engage in excessive health-related behaviors, such as checking their body for signs of illness, or will avoid situations or stimuli that are perceived as anxiety-provoking. 

The cognitive behavioral model of health anxiety describes which factors play an important role in the development and maintenence of health anxiety. Cognitive factors include the overestimation of the probability of having or developing a serious illness, overestimation of the seriousness of an illness, and misinterpretations of body sensations / functions / appearance as indications of serious illness. Safety seeking behaviors are also important in health anxiety and include avoidance (of hospitals, sick people, blood, reminders of illness, thought suppression, distraction), checking (of one’s body & bodily functions, of one’s memory), information seeking (via repeated medical consultations and tests, searches for information), and reassurance seeking (from professionals, through searches for information). 

This model of health anxiety conceptualizes threat interpretations as being central to the experience of anxiety. These interpreations lead to feelings of anxiety, physical reactions, and safety behaviors, which all act to reinforce the health appraisals. It suggests that targets for treatment include the client’s appraisals (of symptoms, health, illness, their vulnerability and ability to cope), and their coping behaviors.

Instructions

This is a Psychology Tools information handout. Suggested uses include:

  • Client handout – use as a psychoeducation resource
  • Discussion point – use to provoke a discussion and explore client beliefs
  • Therapist learning tool – improve your familiarity with a psychological construct
  • Teaching resource – use as a learning tool during training

References

  • Rachman, S. (2012). Health anxiety disorders: A cognitive construal. Behaviour Research and Therapy, 50(7-8), 502-512. 
  • Salkovskis, P. M., & Warwick, H. (2001). Making sense of hypochondriasis: A cognitive theory of health anxiety. In Health anxiety: Clinical and research perspectives on hypochondriasis and related conditions (pp. 46-64). Wiley.
  • Salkovskis, P. M., Warwick, H. M. C., Deale, A. C. (2003). Cognitive-Behavioral Treatment for Severe and Persistent Health Anxiety (Hypochondriasis). Brief Treatment and Crisis Intervention, 3, 353-367.