Confronting health anxiety

For some, it starts with a sudden heart palpitation. For others, it might be an unexpected ache, or perhaps a strange mole or bruise. "What is it? Where did it come from? What does it mean? Am I sick?"

Everyone has worried moments like these—but for some, those worries are ongoing, maybe even at times unrelenting.

Health anxiety (which in the past has sometimes been referred to as hypochondriasis in clinical diagnosis) may be more common than you think: population studies have found that anywhere between 1 and 10 per cent of people may suffer from it. And new research from Dal student Chantal Gautreau offers insight into the cycles that perpetuate it.

"People worry about their health on a regular basis, and that's quite normal," says Gautreau, who graduated last May with her BSc in Psychology and has worked as a research assistant at Dal since then. "Health anxiety is a disproportionate worry; it's worry when there's not the cause to be as worried as you are."

A vicious cycle

Her research, published recently in Behavioural and Cognitive Psychotherapy, looks at the relationship between health anxiety and what's known as the "catastrophizing" of body sensations. In other words: Gautreau's work explores how an individual's exaggerated thoughts about minor changes or occurrences with their health (the catastrophizing) connect with and affect how they feel (the anxiety).

"We were trying to show that it is a cycle: that someone who is anxious about their health will think about their health in an extreme, catastrophic, and this then makes the anxiety worse."

Sure enough, that's what Gautreau's research found, based on data from more than 450 undergraduate-aged adults with sub-clinical level s of health anxiety (ie. they do not necessarily have a clinical diagnosis of for health anxiety). This may seem like an obvious conclusion, and certainly one that would be expected given existing research. However, Gautreau's work is the first to examine, in detail, this relationship between catastrophizing of body sensations and health anxiety.

The study, which doubled as her honours project, was supervised by Simon Sherry and Sherry Stewart of the Department of Psychology and Neuroscience. (Dr. Stewart is also a faculty member in the Department of Psychiatry.) Gautreau's research is notable as it's rare for undergraduate research in the field to be published in scholarly journals.

A costly problem

The reason it's important to understand health anxiety, explains Gautreau, is that it can lead to heavy costs for both individuals and the health-care system.

"It takes a toll on an individual, and sometimes their efforts to seek treatment or talk about it with friends will only make it worse," she says. "They may also seek medical advice for illnesses they don't have, or undergo costly procedures that could cause medical complications in the future."

It's notable that the data for Gautreau's research is based on undergrads: health anxiety, like many anxiety disorders, often onsets during one's late teens or early 20s, meaning that identifying and understanding sub-clinical health anxiety can help young adults manage the condition better.

"It's really important for medical professionals to recognize health anxiety," says Gautreau. "One way to possibly intervene that's suggested by my study is working on those catastrophizing thoughts: helping patients think differently about their bodily sensations."