Inhibitory Learning-Based Exposure Therapy for Patients With Pathological Health Anxiety: Results From a Single Case Series Study

Abstract

Exposure to illness-related stimuli is a crucial component of CBT for pathological health anxiety. Modern exposure approaches focus on forming inhibitory associations and provide promising results. An implementation in the treatment of pathological health anxiety is still missing. The present single case series study investigated the applicability and effects of an inhibitory learning-based exposure approach (12 sessions) on health anxiety, safety behavior, and tolerance for aversive states in n = 7 outpatients (age: M = 35.14, SD = 8.43) with a DSM-5 Illness Anxiety Disorder or Somatic Symptom Disorder with predominant health worries in multilevel models. A high intervention satisfaction and little adverse effects were reported. A significant(ly) (steepened) reduction of health anxiety (b = −0.10, pbaseline < .001, ppre-intervention = .003), and body checking behavior (b = −0.14, pbaseline/pre-intervention < .001), and a significant increase in distress tolerance (b = 0.07, pbaseline = .02, ppre-intervention = .004), discomfort tolerance (b = 0.11, pbaseline/pre-intervention < .001), and insecurity tolerance (b = 0.13, pbaseline/pre-intervention < .001) were observed during the intervention in comparison to the baseline and pre-intervention phase. The present study provided first evidence that the principles of inhibitory learning can be effectively applied to the exposure-based treatment of pathological health anxiety.