10 - Understanding health anxiety  pp. 103-115

Understanding health anxiety

By Kelli Jane K. Harding, Natalia Skritskaya, Emily R. Doherty and Brian A. Fallon

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Introduction

Health anxiety, also known as illness worry, is an umbrella term that encompasses a wide range of excessive health-related concerns (e.g., rumination on having an illness, suggestibility if one reads or hears about a disease, unrealistic fear of infection), somatic perceptions (e.g., preoccupation with bodily sensations or functioning), and behaviors (e.g., repeated reassurance seeking, avoidance of medications or medical personnel). For a person with a medical illness, his/her reaction is out of proportion to what would be expected. While health anxiety is not a term found in the Diagnostic and Statistical Manual of Mental Disorders (DSM), it is a construct linked to various DSM-IV categories. One of those is the most severe form of health anxiety, known as hypochondriasis, in which concerns about having a serious illness persist at least six months despite medical reassurance, and these concerns cause clinically significant impairment or distress (Table 10.1) (American Psychiatric Association 2000). Health anxiety also overlaps with somatization disorder, obsessive–compulsive disorder (OCD), body dysmorphic disorder (BDD), panic disorder, and delusional disorder. This chapter discusses a conceptual framework for health anxiety, focusing on diagnostic considerations, epidemiology, etiology, measures of health anxiety, clinical considerations, practical management, treatments, and future research directions.

Conceptualization of health anxiety

Appropriate behavior when one has a medical concern or a physical symptom, such as pain or discomfort, is to seek the opinion and care of a physician.

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