Subjects: Psychology >> Clinical and Counseling Psychology submitted time 2024-06-05
Abstract： Health anxiety, characterized by excessive fear and worry about one’s health, is closely linked to interpretation bias as outlined in the comprehensive model of health anxiety. Research suggests that individuals with health anxiety often exhibit catastrophizing interpretations, and mitigating these interpretations can alleviate health anxiety symptoms. This study aims to examine the effects of internet-based cognitive bias modification of interpretation (iCBM-I) training on health anxiety, catastrophizing interpretation, anxiety, and depression symptoms. It also explores the longitudinal mediating mechanism of catastrophizing interpretation, providing insights for internet-based interventions for health anxiety.
In this randomized controlled trial, 228 participants with health anxiety (Short Health Anxiety Inventory SHAI scores ≥ 15) were randomly assigned to an iCBM-I group (100% positive feedback, N = 76), an attention control group (50% positive and 50% negative feedback, N = 76), or a wait-list control group (N = 76). Participants in the iCBM-I and attention control groups completed internet-based tasks over 12 days (one session every three days, totaling four sessions). Health anxiety, catastrophizing interpretation, anxiety, and depression were measured at pre-treatment, post-treatment, and a one-month follow-up to assess the immediate and long-term effects of the iCBM-I program.
The intent-to-treat principle was employed, and the generalized linear mixed model analyzed the intervention effects. Two-factor analysis of variance and hierarchical regression examined the moderating effects of demographic and baseline symptom variables. Additionally, the parallel development latent growth curve model analyzed the longitudinal mediating effect of catastrophizing interpretation.
Results indicated that the iCBM-I group with 100% positive feedback showed significant immediate effects on reducing catastrophizing interpretation, anxiety, and depression symptoms compared to the wait-list group. One-month follow-up results revealed significant effects on health anxiety, catastrophizing interpretation, anxiety, and depression. Marital status, baseline health anxiety symptoms, and catastrophizing interpretation moderated the iCBM-I intervention effects, with catastrophizing interpretation serving as a longitudinal mediator.
This study developed an iCBM-I self-help intervention mini-program for health anxiety, demonstrating its feasibility, efficacy, and psychological mechanisms. The findings provide empirical support for cognitive theories of emotion and offer a novel perspective for networked interventions in health anxiety. Future research should consider integrating top-down and bottom-up combined intervention therapies to further investigate their effects and mechanisms in health-anxious individuals.
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