0000000000020119
AUTHOR
Josef Bailer
Modern health worries and idiopathic environmental intolerance.
Abstract Objective We conducted two studies to test whether modern health worries (MHWs) were associated with central features of a condition called idiopathic environmental intolerance (IEI) and medical care utilization. Methods In Study 1, 474 Internet users completed an Internet-based questionnaire that assessed MHWs, IEI features, and medical care utilization. In Study 2, the diagnostic specificity of MHWs was investigated by comparing the level of MHWs of three diagnostic groups: 46 people with IEI, 38 people with somatoform disorder but without IEI, and 46 people with neither IEI nor somatoform disorder. Results The good psychometric properties of the MHW scale were confirmed. MHWs we…
Abnormalities in cognitive-emotional information processing in idiopathic environmental intolerance and somatoform disorders
Idiopathic environmental intolerance (IEI) represents a functional somatic syndrome marked by diverse bodily complaints attributed to various substances in the environment. Evidence for abnormalities in affective information processing similar to somatoform disorders (SFD) has recently been found in people with IEI. In order to further investigate these cognitive-emotional abnormalities, we compared people with IEI (n=49), SFD only (n=43), and non-somatoform controls (n=54) with respect to their performance in the extrinsic affective Simon task (EAST). This task allowed us to dissociate indicators of automatic affective associations and emotional intrusion effects of both bodily complaints …
Predictors of Psychological Distress and Coronavirus Fears in the First Recovery Phase of the Coronavirus Disease 2019 Pandemic in Germany
Objectives: While previous research has mainly focused on the impact of the first acute phase of the COVID-19 pandemic on mental health, little empirical knowledge exists about depression, anxiety, and somatic symptom levels and possible predictors of symptom levels in the pandemic’s recovery phase. The present study aimed to analyze the mental burden of a convenience ample of the general German population during the first recovery phase of the pandemic and to identify significant predictors of symptom levels.Methods: Standardized measures of anxiety (GAD-2), depression (PHQ-2), somatic symptoms (PHQ-15), and health anxiety, as well as measures of COVID-19 fears and possible vulnerability f…
Cough is dangerous : neural correlates of implicit body symptoms associations
The negative interpretation of body sensations (e.g., as sign of a severe illness) is a crucial cognitive process in pathological health anxiety (HA). However, little is known about the nature and the degree of automaticity of this interpretation bias. We applied an implicit association test (IAT) in 20 subjects during functional magnetic resonance imaging (fMRI) to investigate behavioral and neural correlates of implicit attitudes towards symptom words. On the behavioral level, body symptom words elicited strong negative implicit association effects, as indexed by slowed reaction times when symptom words were paired with the attribute harmless (incongruent condition) relative to a control …
Health anxiety and hypochondriasis in the light of DSM-5.
Background: In the DSM-5, the diagnosis of hypochondriasis was replaced by two new diagnositic entities: somatic symptom disorder (SSD) and illness anxiety disorder (IAD). Both diagnoses share high health anxiety as a common criterion, but additonal somatic symptoms are only required for SSD but not IAD.Design: Our aim was to provide empirical evidence for the validity of these new diagnoses using data from a case–control study of highly health-anxious (n = 96), depressed (n = 52), and healthy (n = 52) individuals.Results: The individuals originally diagnosed as DSM-IV hypochondriasis predominantly met criteria for SSD (74%) and rarely for IAD (26%). Individuals with SSD were more impaired,…
Optimizing Exposure Therapy for Pathological Health Anxiety: Considerations From the Inhibitory Learning Approach
Abstract Exposure therapy has demonstrated its efficacy in the treatment of pathological health anxiety—however, psychotherapy research reveals that many patients do not show a clinically significant change. Therefore, improvements are necessary to optimize psychotherapy for pathological health anxiety. Most treatment rationales refer to habituation during exposure as the central mechanism of change. However, there is evidence that extinction learning is mediated by inhibitory learning processes. Targeting these processes may help to improve treatment outcomes in pathological health anxiety. The aim of this review was to adapt, from the inhibitory learning approach and empirical findings, t…
Impaired cognitive control over emotional material in euthymic bipolar disorder.
Abstract Background Previous research suggests that bipolar disorder (BD) is characterized by deficits in cognitive control (CC). Impaired CC has been found in high-risk samples and is associated with the maintenance of BD symptoms. It remains unclear, however, whether BD is characterized by a general deficit in CC or by a deficit that is specifically related to the processing of emotional material. Methods The sample consisted of 42 remitted bipolar patients and 39 healthy controls (HC). We examined whether BD individuals display impaired CC when confronted with negative as well as positive material using an arithmetic inhibition task that required inhibition of pictorial stimulus material…
Elektronische Tagebücher optimieren die Kognitive Verhaltenstherapie bei Krankheitsängsten : eine randomisiert-kontrollierte Studie
Zentrale Komponenten in kognitiv-behavioralen Erklärungsmodellen der Hypochondrie und den daraus abgeleiteten Behandlungen sind eine selektive Aufmerksamkeitslenkung auf körperliche Empfindungen und ein katastrophisierender Symptominterpretationsbias. Wir untersuchten, ob sich die Effektivität einer störungsspezifischen Kognitiven Verhaltenstherapie (KVT) für Patienten mit Hypochondrie durch ein zusätzliches zweiwöchiges elektronisches Tagebuchtraining (TBT), das auf eine Korrektur der Symptominterpretationen abzielt, verbessern lässt. Zu diesem Zweck wurden 35 Patienten mit Hypochondrie randomisiert zwei Interventionsformen zugewiesen: Gruppe 1 (N = 16) erhielt vor der KVT (16 Einzelsitzu…
On the origin of worries about modern health hazards: Experimental evidence for a conjoint influence of media reports and personality traits
Objective: Worries about health threatening effects of potential health hazards of modern life (e.g. electric devices and pollution) represent a growing phenomenon in Western countries. Yet, little is known about the causes of this growing special case of affective risk perceptions termed Modern Health Worries (MHW). The purpose of this study is to examine a possible role of biased media reports in the formation of MHW. Design: In two experiments, we investigated whether typical television reports affect MHW. In Study 1, 130 participants were randomly assigned to a film on idiopathic environmental intolerance (IEI) or a control film about cystic fibrosis. In Study 2, 82 participants were ra…
Emotion dysregulation in hypochondriasis and depression
Background The aim of this study was to explore whether certain aspects of emotion dysregulation (i.e., facets of alexithymia and rumination) are more closely linked to hypochondriasis than to depression and vice versa. Methods Nineteen patients with hypochondriasis (HYP), 33 patients with depression, and 52 healthy control participants completed the Toronto Alexithymia Scale, the Response Styles Questionnaire, and additional symptom and illness behaviour scales. A clinical interview was used to establish DSM-IV diagnoses and to exclude all cases with more than one axis I diagnosis. Results Depression patients reported more difficulties describing feelings and more symptom- and self-focused…
Neuronal and Behavioral Correlates of Health Anxiety: Results of an Illness-Related Emotional Stroop Task
<b><i>Background:</i></b> Health anxiety (HA) is defined as the objectively unfounded fear or conviction of suffering from a severe illness. Predominant attention allocation to illness-related information is regarded as a central process in the development and maintenance of HA, yet little is known about the neuronal correlates of this attentional bias. <b><i>Methods:</i></b> An emotional Stroop task with body symptom, illness, and neutral words was employed to elicit emotional interference in healthy participants with high (HA+, n = 12) and low (HA–, n = 12) HA during functional magnetic resonance imaging. <b><i>Results:</i>…
Grundlagen der kognitiven Verhaltenstherapie
Verhaltenstherapie hat sich als eigener Forschungs- und Praxisbereich historisch seit ca. 1950 kontinuierlich entwickelt. Dies geschah in etwa zeitgleich in den USA, in England und in Sudafrika, aber mit unterschiedlichen Schwerpunktsetzungen. In den USA wurden verhaltenstherapeutische Interventionen bevorzugt als praktische Anwendung der Gesetzmasigkeiten des operanten Lernens entwickelt. Aus dieser Zeit stammt der wichtige Ansatz der funktionalen Analyse von problematischem Verhalten hinsichtlich seiner Kontrolle durch vorausgehende und nachfolgende Bedingungen. Funktionale Analysen lieferten die Basis fur erfolgreiche Interventionen bei einer Vielzahl von Verhaltensstorungen, z. B. Stott…
Do patients with pathological health anxiety fear COVID-19? A time-course analysis of 12 single cases during the “first wave” of the COVID-19 pandemic in Germany
Objective Pre-existing health anxiety is associated with an intensified affective response to the novel COVID-19 pandemic in the general population. Still, results on the reaction of people with a diagnosis of pathological health anxiety (i.e., hypochondriasis) are scarce. Methods In the present study, we investigated the course of (health) anxiety related to SARS-CoV-2/COVID-19 in comparison to (health) anxiety related to other severe diseases (e.g., cancer) in a sample of 12 patients with the diagnosis of pathological health anxiety during the “first wave” of the COVID-19 pandemic in Germany. Both SARS-CoV-2 related anxiety and anxiety related to other severe diseases were assessed weekly…
Cognitive Biases in Pathological Health Anxiety
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…
Neural correlates of an attentional bias to health-threatening stimuli in individuals with pathological health anxiety
Background: An attentional bias to health-threat stimuli is assumed to represent the primary pathogenetic factor for the development and maintenance of pathological health anxiety (PHA; formerly termed “hypochondriasis”). However, little is known about the neural basis of this attentional bias in individuals with PHA.Methods: A group of patients with PHA, a group of depressed patients and a healthy control group completed an emotional Stroop task with health-threat (body symptom and illness) words and neutral control words while undergoing functional MRI.Results: We included 33 patients with PHA, 28 depressed patients and 31 controls in our analyses. As reflected in reaction times, patients…
Evidence for a specific link between the personality trait of absorption and idiopathic environmental intolerance.
Absorption as a personality trait refers to the predisposition to get deeply immersed in sensory (e.g., smells, sounds, pictures) or mystical experiences, that is, to experience altered states of consciousness. Absorption is markedly related to constructs openness to experiences, hypnotic suggestibility, imagination, and dissociation. Although absorption was hypothesized to be a risk factor for medically unexplained symptoms (MUS), the construct has yet not been investigated in individually suffering from idiopathic environmental intolerance (IEI), formerly better known as multiple chemical sensitivity (MCS). IEI is a complex condition marked by MUS, which patients attribute to various chem…