Educating the ‘Worried Well’: Description of a Structured Programme and Implications for Treatment and Prevention

Abstract

This paper describes the contents of a cognitive-behavioural treatment for hypochondriasis and health anxiety based on Barsky et al.'s (1988) proposal. Five types of factors that may account for the enhanced experience of physical symptomsÐselective and inadequate attention, muscle tension and bad breathing, environmental factors, stress and dysphoric mood and misinterpretation of somatic symptomsÐwere presented in the form of a group of educational training. Special emphasis was given to the form in which psychological information should be provided to initially resistant patients and to the contexts in which training should occur. The evidence obtained with an heterogeneous group of 14 subjects supports the utility of the programme, not only for target behaviours, but also for other related areas. Finally, the implications of this type of intervention for treatment and prevention are discussed.

Irrational health beliefs and health anxiety

“…These findings also have implications for informing the treatment health anxiety. In the past decade, researchers have demonstrated the efficacy of cognitive‐behavioral therapy (CBT) interventions for treating health anxiety and hypochondriasis (Avia et al, 1996, 1997; Barsky & Ahern, 2004; Bleichard, Timmer, & Rief, 2005; Bouman & Visser, 1998; Clark et al, 1998; Visser & Bouman, 2001). Similar to the treatment of other anxiety disorders, CBT for health anxiety and hypochondriasis involves providing psychoeducation about catastrophic misinterpretations of benign bodily symptoms, teaching relaxation techniques, challenging faulty beliefs through cognitive restructuring, and modifying maladaptive behaviors.…”

Treating Health Anxiety and Fear of Death

“…The cognitive educational intervention was based on the model of Barsky, Geringer, and Wool (1988). There were six sessions (described in Avia et al, 1997), which covered five broad topic areas (a) inadequate and selective attention to bodily sensations, (b) muscle tension and bad breathing habits, (c) environmental factors that effect emotion, (d) stress and dysphoric mood and their effect on symptoms, and (e) the explanations given to somatic signals. Reduction of reassurance seeking was not emphasized, although there was a suggestion that participants try a period of refusing to talk about bodily symptoms as a behavioral experiment.…”

Somatosensory amplification mediates sex differences in psychological distress among cardioverter-defibrillator patients.

“…Educational and psychological interventions are needed that focus on correcting the attributional errors of somatosensory amplifiers. A limited number of trials have demonstrated that cognitive–behavioral therapy (CBT) can effectively reduce amplification of somatic symptoms in individuals with atypical chest pain, palpitations, and hypochondria (Avia et al, 1997; Kirk & Jahoda, 2009; Mayou, Sprigings, Birkhead, & Price, 2002; van Peski-Oosterbaan et al, 1999). CBT as mainstay of treatment, or in combination with cardiac rehabilitation, has also been shown to be beneficial in reducing anxiety in ICD patients (Pedersen, van den Broek, & Sears, 2007).…”