Health anxiety is a ubiquitous experience that arises when bodily sensations or changes are believed to be indicative of a serious disease. Severe expressions of health anxiety are most often classified as hypochondriasis in the current DSM-IV-TR; however, various alternative classification schemas have been proposed for the DSM-V. Regardless of classification, severe health anxiety has significant negative impacts on well-being, social and occupational functioning, and health care resource utilization. In this review, we focus on classification issues pertinent to severe health anxiety, summarize recent research regarding potential mechanisms underlying the condition, and summarize the state of the art with respect to assessment and treatment. Future research directions are noted and suggested throughout.

Background Cannabis remains the most commonly used illicit substance and use rates are rising. Notably, the prevalence of cannabis use disorders (CUD) nearly equals that of other illicit substance use disorders combined. Thus, the present study aimed to identify cognitive, affective, and situational predictors and consequences of ad-lib cannabis use in a racially diverse sample. Methods The sample consisted of 93 current cannabis users (34.4% female; 57.1% non-Hispanic Caucasian), 87.1% of whom evinced a current CUD. Ecological momentary assessment was used to collect frequent ratings of cannabis withdrawal, craving, affect, cannabis use motives, and peer cannabis use over two weeks. Mixed effects linear models examined within- and between-day correlates and consequences of cannabis use. Results Withdrawal and craving were higher on cannabis use days than non-use days. Withdrawal, craving, and positive and negative affect were higher immediately prior to cannabis use compared to non-use episodes. Withdrawal and craving were higher among those who subsequently used cannabis than those who did not. Cannabis use resulted in less subsequent withdrawal, craving, and negative affect. Enhancement and coping motives were the most common reasons cited for use. Withdrawal and negative affect were related to using cannabis for coping motives and social motives. Participants were most likely to use cannabis if others were using, and withdrawal and craving were greater in social situations when others were using. Conclusions Data support the contention that cannabis withdrawal and craving and affect and peer use play important roles in the maintenance of cannabis use.

Contemporary models of chronic musculoskeletal pain emphasize the critical roles of fear, anxiety, and avoidance as well as biases in attention in the development and maintenance of chronic pain disability. Evidence supports the influence of individual difference variables such as anxiety sensitivity, pain-related anxiety, and catastrophizing on the pain experience and on pain-related attentional biases. Changes in attentional biases have been associated with treatment gains in patients with clinically significant anxiety. The Attentional Modification Paradigm (AMP) is a modification of the dot-probe paradigm used to facilitate such changes in attentional biases. Given the relationship between chronic musculoskeletal pain and anxiety, AMP may be effective in reducing pain as well. Participants included persons (n = 17) with fibromyalgia and were randomly assigned to either an AMP condition or a control condition. The participants completed two 15-minute AMP sessions per week for 4 weeks. Those in the AMP condition reported statistically significant and substantial reductions on several individual difference variables relative to those in the control condition, and a greater proportion experienced clinically significant reductions in pain. These preliminary results offer a promising new avenue for treating chronic musculoskeletal pain that warrants additional research. Comprehensive results, limitations, and future directions are discussed.

Objective Socially anxious cannabis users are especially vulnerable to cannabis-related impairment, yet mechanisms underlying this vulnerability remain unclear. Socially anxious persons may use cannabis despite related problems if they believe such problems are common, and thus socially acceptable. Yet no known studies have examined the impact of beliefs regarding others’ cannabis-related problems on one’s own use-related problems. Method This study investigated the impact of beliefs about a close friend’s experience with cannabis-related problems on the relationship between social anxiety and cannabis-related problems. The sample consisted of 158 (75% female) current (past-month) cannabis-using undergraduates. Results Believing one’s friend experienced more cannabis problems was related to experiencing more cannabis-related problems oneself. In fact, perceived friend’s problems accounted for 40% of the unique variance in one’s own cannabis problems. Descriptive norms (others’ use) and injunctive norms (others’ approval of risky use) were unrelated to number of one’s own problems. Social anxiety was related to experiencing more cannabis problems. This relation was moderated by perceived friend’s problems such that greater social anxiety was related to more cannabis-related problems among participants who believed their friend experienced more cannabis-related problems. This was not the case among participants who believed their friend experienced fewer problems. Conclusions Normative beliefs regarding a close friend’s cannabis problems were robustly and uniquely related to experiencing more cannabis-related impairment. Beliefs regarding friends’ experience with cannabis-related problems may play an especially important role in the experience of cannabis-related problems among socially anxious users.