Cognitive-behavioral Treatment Research Articles

Neuroeducation and Cognitive Behavioral Interventions: A Narrative Review

This paper provides a comprehensive narrative review at the intersection of neuroeducation and cognitive behavioral interventions (CBI), exploring how insights from cognitive neuroscience can enhance educational practices. It traces the historical progression of neuroeducation, proposes theoretical frameworks linking reading disabilities with comorbid conditions, and details the methodology underpinning the review. Key themes include the role of neuroplasticity in learning, memory, and cognitive development, and the application of CBIs in managing anxiety and other psychological factors in students. The review emphasizes the need for integrating neuroscientific theories into education, the potential of gamified programs and specialized platforms, and the importance of teachers' emotional involvement in student learning. Furthermore, it highlights significant gaps in current research and offers practical recommendations for incorporating neuroeducational principles into teacher training and educational policies. The findings underscore the impact of narrative reviews in advancing neuroeducation, pinpoint key interdisciplinary collaborations, and advocate for ongoing research to support innovation and transformation in education.

Effect of cognitive-behavioral therapy-based physical play intervention on empathic ability of children with intellectual disabilities

Purpose The purpose of this study was to investigate the potential of cognitive-behavioral therapy-based sports game intervention in enhancing empathy abilities among children with intellectual developmental disorder. Methods Thirty-one children aged 7–8, diagnosed with intellectual developmental disorder and attending mainstream schools, were enlisted for this study. They were randomly allocated to either the experimental group (n = 17) or the control group (n = 19). Both groups participated in regular physical activities of similar frequency and consistency throughout the study duration. Additionally, the experimental group underwent an 18-week cognitive-behavioral therapy-based sports game intervention. The Griffith Empathy Measure (GEM) questionnaire was administered to comprehensively evaluate the impact of the intervention program on the participants’empathy abilities. Results No statistically significant discrepancies were observed in the total scores and factor scores of the GEM pre-test between the experimental and control groups (GEM pre-test: p = 0.974 > 0.05). However, following the intervention, the experimental group exhibited notably higher total scores and factor scores in the GEM post-test compared to their pre-test scores, and these scores were significantly higher than those of the control group post-test scores. Conclusion Cognitive-behavioral therapy-based sports game intervention can effectively promote the development of empathy abilities in children with intellectual developmental disorder.

Artificial intelligence as a virtual coach in a cognitive behavioural intervention for perfectionism in young people: A randomised feasibility trial

BackgroundWe examined the feasibility and outcomes of Artificial Intelligence (AI) as a virtual coach in guided self-help (GSH-AI) compared to pure self-help (PSH). MethodParticipants (N = 85 undergraduate university students; M age = 20.65 years [SD = 2.38]; 84 % female) were randomised to PSH (N = 42) or GSH-AI (N = 43). The intervention was a brief 11-module online cognitive behaviour therapy for perfectionism intervention completed over 4-weeks. GSH-AI participants were given suggested questions to ask AI for guidance in completing the intervention. Data were collected at baseline, 4- and 8-weeks post-randomisation. ResultsEngagement was good, only one person in each group did not use any modules; module completion was equivalent across conditions (6.67, SD = 3.22 and 6.18, SD = 3.42 respectively). Between baseline and post-intervention people in the GSH-AI condition showed an almost 3.5 times increase in preferring support to be received from AI versus other modes of support. Only 52 % and 22 % of participants completed 4- and 8-week post-randomisation surveys, with no differences in psychological outcomes between the PSH and GSH-AI groups. Main effects of time indicated moderate to large within-group effect size improvements for disordered eating, stress, anxiety, and perfectionism. ConclusionsQualitative feedback indicated that AI was initially acceptable as a guide and became even more acceptable after it had been experienced. Fully powered trials are required to determine the impact of AI guidance on outcomes, and whether type of AI platform (customised versus generic) and type of mental health disorder interact with its effects.

Pilot Study of a Cognitive Behavioral Intervention for Pelvic Exam Anxiety Among Survivors of Endometrial and Cervical Cancer

No evidence-based interventions exist for anxiety related to pelvic exams after cancer treatment. A 3-session cognitive behavioral intervention, Pelvic Examination and Anxiety Coping Skills for Empowerment (PEACE), was developed. We conducted a proof-of concept pilot study (N=16) to evaluate intervention acceptability and feasibility and changes in anxiety and pain symptoms. Participants completed 3 assessments (baseline, post-intervention, post-pelvic exam) and post-exam interviews. Exploratory outcomes included exam-related distress and pain, and intervention mechanisms of change. The mixed methods findings indicated preliminary acceptability (e.g., 71% endorsed PEACE “made things a lot better”) and feasibility (e.g., 87.5% completed the protocol). PEACE shows promise for reducing procedural distress, which may ultimately improve care engagement.

PsicoCare: a pilot randomized controlled trial testing a psychological intervention combining cognitive-behavioral treatment and positive psychology therapy in acute coronary syndrome patients.

Although psychological factors play a significant role in the onset and prognosis of acute coronary syndrome (ACS), psychological interventions (PIs) are rarely included in cardiac rehabilitation (CR) programs due to inconclusive evidence regarding specific intervention components and effect sizes. This study aimed to assess the efficacy of a PI based on cognitive-behavioral treatment (CBT) and positive psychology therapy (PPT) in improving psychological and clinical outcomes in patients with ACS. This PsicoCare trial was an open-label randomized controlled trial that compared a combined CBT and PPT-based PI (the PsicoCare program) with a standard CR program (control group). We recruited 87 ACS patients, and psychological outcomes, functional capacity, biochemical and anthropometric measures, and clinical outcomes were assessed at baseline, 2 months, and 9 months after the ACS event. The PsicoCare group showed significant improvements in depression, anger traits, anger-in, and anger control-out compared to the control group. Additionally, the PsicoCare intervention was associated with the improved maintenance of cognitive function, social support, and spiritual coping styles, while the control group showed deterioration in these areas. Patients experiencing severe ACS showed significant improvement in personal strength and meaning as a result of the PsicoCare intervention. However, no significant effects were observed on anxiety, anger-out, emotion regulation skills, dispositional optimism, other personal strengths, or quality of life. Both groups demonstrated similar improvements in functional capacity and clinical outcomes. The study suggests that CBT and PPT-based PIs may offer additional benefits for ACS patients, particularly regarding their psychological health. Further larger trials are required to confirm these findings. identifier, NCT05287061.

Accommodation of posttraumatic stress symptoms: A scoping review of the literature.

Social support is protective in the recovery from mental health diagnoses. However, well-intended support can also interfere with treatment, as in the case of accommodation, when a support person changes their behaviors to alleviate a patient's distress. This paper describes a scoping review of the research literature regarding posttraumatic stress symptoms (PTSS) and accommodation, conducted using the Preferred Reporting Items extension for Scoping Review Guidelines (PRISMA-ScR). A total of 26 articles were included in the review. Designs and settings were mixed, but most studies examined accommodation by female adult intimate partners of male military members, veterans, and first responders with PTSS. Most participants were White. Accommodation was typically associated with negative relationship outcomes, and some couples treatments (e.g., cognitive behavioral conjoint therapy interventions) were associated with improvements in PTSS accommodation. Future work on PTSS accommodation should prioritize recruiting more diverse participants (i.e., gender, race, ethnicity, military status, types of support people). In addition, researchers should continue to examine accommodation as a mediator or moderator variable. Further examination of accommodation and PTSS may provide helpful insights into the involvement of support people in treatment to increase treatment effectiveness.

Enhancing adolescent mental health through cognitive and social support: Insights from study on depression in Chinese adolescents.

Adolescent depression is a growing global health concern, affecting 14% of adolescents and leading to severe consequences such as academic failure, substance abuse, and suicidal ideation. The study by Yu et al, investigates the cognitive and social factors influencing depression in 795 Chinese adolescents. Findings reveal that negative life events (NLEs) and dysfunctional attitudes are strongly associated with depressive symptoms, while social support moderates the impact of NLEs but not dysfunctional attitudes. The study highlights the need for cognitive-behavioural interventions targeting perfectionism and autonomy, and the importance of strengthening social support systems in schools and communities. Culturally sensitive, holistic approaches to adolescent mental health are crucial for addressing both the internal vulnerabilities and external pressures contributing to depression. Further research is needed to explore the roles of peer and parental support and the long-term effects of these factors across diverse cultural contexts.

The effectiveness of stress-management-based cognitive-behavioral treatments on anxiety sensitivity, positive and negative affect and hope

The effectiveness of stress-management-based cognitive-behavioral treatments on anxiety sensitivity, positive and negative affect and hope

"It Was a Downward Spiral": A Qualitative Study of Young Adult Cancer Survivors' Experiences with Cognitive and Mental Health.

Background/Objectives: Cancer-related cognitive impairment (CRCI) is common and distressing for young adult (YA) cancer survivors; however, subjective CRCI is often attributed to psychological distress rather than true cognitive change. Thus, we aimed to generate hypotheses regarding potential common biobehavioral mechanisms of CRCI and psychological distress. Methods: We conducted semi-structured interviews with YA cancer survivors in peak years for frontal neurocognitive development (ages 18-30), and we asked them to describe their experiences with cognitive and mental health changes during and after treatment for their cancer. An applied thematic analysis was used to identify themes. Results: The participants were 20 YA cancer survivors who were, on average, 23 years old at diagnosis and 26 years old when interviewed. Five themes emerged regarding the connection between cognitive and mental health: depressed mood after diagnosis that decreased mental engagement, cancer-related anxiety consumed cognitive resources during treatment, a bidirectional "downward spiral" during treatment, frustration with forgetfulness, and self-criticism about long-term cognitive limitations. Additionally, participants described receiving minimal information about evidence-based strategies for managing CRCI. Conclusions: Future research is needed to examine common neurological mechanisms among symptoms of depression, anxiety, and CRCI and to address gaps in survivorship care for YA survivors with CRCI. Cognitive-behavioral interventions may address both cognitive and mental health.

Cognitive behavioral therapy-enhanced through videoconferencing for night eating syndrome, binge-eating disorder and comorbid insomnia: a Case Report

BackgroundBoth night-eating syndrome and binge-eating disorder are characterized by episodes of excessive food consumption, significant distress, and functional impairment related to maladaptive eating behaviors. Both types of eating disorders are associated with poorer sleep quality. Cognitive behavioral therapy has demonstrated good outcomes for binge-eating disorder; however, it is unknown if it is effective for night-eating syndrome and comorbid insomnia.Case presentationThe current paper presents a case report of a Dutch woman in her 40’s receiving cognitive behavioral therapy-enhanced for night-eating syndrome, as well as binge-eating disorder. However, to tailor the intervention to her specific needs, throughout the course of treatment, cognitive behavioral therapy-insomnia interventions were also implemented. Her comorbid complaints were insomnia, childhood trauma, a depressive mood disorder, and cluster B and C personality traits. She had a history of bariatric surgery, as well as alcohol addiction, and received various treatments in the past, aiming to become abstinent from binge eating.ConclusionsPost-treatment, she was abstinent from binge eating and, her scores of various eating disorder measures were below clinical cut-points. However, it is unclear if she would show earlier symptom reduction if she received cognitive behavioral therapy-insomnia, prior to cognitive behavioral therapy-enhanced. In addition, the patient reported an increase in her depressive mood and commenced schema therapy after cognitive behavioral therapy- enhanced. Although common, the underlying cause of symptom shifts in patients with an eating disorder remains largely unknown.

Implementing Resourcefulness Training© with Parent Caregivers of Children Dependent on Medical Technology During the COVID-19 Pandemic: Lessons Learned from a Randomized Controlled Trial.

Parent caregivers of children requiring life-saving medical technology (e.g., mechanical ventilation) report higher levels of stress and poorer health than other caregivers, often neglecting health-promoting behaviors for themselves. This article describes an iterative implementation science strategy used to improve intervention delivery for a randomized controlled trial testing a telehealth, cognitive-behavioral resourcefulness intervention with this population during the COVID-19 pandemic. This process consisted of reflective team meetings and content analysis. Initial adjustments were made after content analysis of pilot study materials before intervention delivery including an intervention script, checklist, online daily log, Health Insurance Portability and Accountability Act (HIPAA)-compliant texting option, training material access, and fidelity checks. In vivo adjustments were implemented in four areas: recruitment/engagement, participation and use of resources, in-person delivery, and virtual delivery. Our efforts to streamline intervention delivery were enhanced by incorporating an iterative implementation science strategy including analysis and adjustment of intervention delivery procedures to decrease participant burden and promote intervention adherence. Reflective team meetings and a collaborative, problem-solving approach to resolve the various barriers and challenges with the randomized controlled trial were integral components of intervention delivery. This study informs future intervention research by providing details of barriers faced, pragmatic adjustments made to intervention implementation, and lessons learned (NCT0410524; www.clinicaltrials.gov).

Changes in hoarding-related beliefs and associated neural changes during a simulated discarding task after cognitive-behavioral treatment for hoarding disorder

Hoarding disorder (HD) is maintained by maladaptive beliefs about possessions, and recent research has demonstrated that changes in these beliefs partially mediate improvement in cognitive-behavioral therapy (CBT) for hoarding. It is not yet known whether changes in neural activity, particularly when discarding possessions, are associated with cognitive change during CBT for HD. Adults who completed group CBT for HD (N = 58) participated in a simulated discarding task before and after CBT. Neural activity was measured using functional magnetic resonance imaging (fMRI) as participants made simulated discarding decisions. At baseline, activity in the left middle insula and left anterior cingulate cortex was significantly associated with hoarding-related beliefs. After receiving CBT for HD, decreases in maladaptive hoarding-related beliefs were significantly associated with increased activity compared to baseline in the right anterior ventral insula, along the left middle frontal gyrus and bilateral inferior temporal lobe, and in visuospatial areas. These results demonstrate that maladaptive beliefs in HD are associated with activation of specific neural regions during discarding decisions and that reduction in beliefs over a course of CBT for HD is associated with specific changes in neural activity.

Systematic review and meta-analysis of combined cognitive-behavioral therapy and physical activity and exercise interventions for pediatric chronic disease.

Cognitive-behavioral (CBT) interventions combined with either a physical activity (CBT+PA) or exercise intervention (CBT+Ex) are becoming more common in pediatric populations. Considering the independent effects of PA and exercise on health and psychological outcomes, it is unclear whether CBT alone differs from CBT+PA or CBT+Ex in efficacy. The main objective of this systematic review and meta-analysis of randomized clinical trials (RCTs) was to assess the efficacy of CBT+PA and CBT+Ex interventions in pediatric chronic disease. This review included RCTs in children (≤18 years) with a chronic condition, a CBT+Ex or CBT+PA intervention, and an objective measure of PA&Ex. Seven databases were searched using MeSH terms and key terms and included studies published before July 1, 2023. Abstracts were reviewed for inclusion by two independent reviewers, data was extracted by three independent reviewers. Risk of bias (RoB 2) and study quality were coded. Random effect meta-analyses of differences in between-group change in PA&Ex were conducted. Eligible studies (k = 5) reported outcomes for a combined 446 children. A small, nonsignificant overall effect was found (d = 0.10, 95% CI -0.16, 0.35) indicating intervention groups (CBT+PA or CBT+Ex) increased engagement in PA&Ex more than comparator groups (CBT). Additional analyses were inconclusive due to the small number of eligible studies. Additional RCTs are needed with integrated PA&Ex interventions targeting pediatric chronic disease. Future trials should report more detailed PA&Ex data. The full protocol for this analysis was prospectively registered in Open Science Framework (project ID: osf.io/m4wtc).

A Systematic Review of Parental Involvement in Digital Cognitive Behavioural Therapy Interventions for Child Anxiety.

Cognitive behavioural therapy (CBT) is an efficacious intervention for child anxiety that has been translated into accessible digital formats, many of which involve parents in treatment. However, the value of parental involvement in treatment is not clearly understood. This systematic review examined characteristics of parental involvement (i.e., format and content of sessions, level of therapist guidance, and parent session compliance) in digital CBT for child anxiety (mean child age ≤ 12years) and their relation to child outcomes (primary disorder remission, clinician-, parent-, and child-rated anxiety, and global functioning). Systematic searches in CINAHL, Embase, ERIC, PsychINFO, PubMed, and Scopus up to 14th August 2023, and citation searching, identified 27 articles (as 23 studies) assessing 14 interventions. Two were parent-only programmes for 3-6-year-old children, with the remaining being parent-child programmes targeting older children. Parents were actively involved as coaches/collaborators, assisting their children with anxiety management and exposure, and less often as co-clients working on their own difficulties. Benefits of treatment were observed across interventions, except for one, psychoeducation-based programme. Higher remission rates were more frequently observed in interventions delivered in controlled settings, those with fewer parent-only sessions, or those incorporating more parent- or therapist-led exposure sessions. Most studies were conducted with affluent samples, limiting generalisability, and several received a high risk of bias rating. Future research should examine parent and family related mechanisms of change and modify interventions for improved adherence, such as restricting the number of modules parents are required to complete and teaching key therapeutic strategies such as exposure early in the programme.

Neurofeedback to enhance sleep quality and insomnia: a systematic review and meta-analysis of randomized clinical trials.

This systematic review and meta-analysis of randomized-clinical trials aims to analyze the effect of interventions incorporating surface neurofeedback techniques on self-perceived sleep quality and insomnia in patients with or without sleep disturbances. The review was completed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement and was deposited in the Prospero international prospective registry of systematic reviews (CRD42024528401). Seven clinical trials with different main outcomes but with pre-post intervention records of self-perceived sleep quality or insomnia symptoms assessed by questionnaires met our inclusion criteria, including a publication date within the last 10 years. Five trials investigated sleep quality through scores on the Pittsburgh sleep quality Index (PSQI) and three trials signs of insomnia severity assessed with validated scales. The methodological quality of the included studies was assessed using the Cochrane Collaboration's tool for assessing the risk of bias and showed a high quality of them. A total of 5 studies that evaluated sleep quality with the PSQI total score were included in the meta-analysis. The results revealed that control conditions succeeded in improving PSQI-assessed sleep quality more than the analyzed Neurofeedback interventions (PSQI total score 0.57; 95% CI 0.13 to 1.01; p = 0.01). On the other hand, a total of 3 studies that evaluated insomnia severity with various insomnia scales were included in the meta-analysis The results revealed that neither the NF interventions nor the control conditions show a favorable outcome relative to each other (-0.13; 95% CI -0.44 to 0.18; p = 0.41). The interventions studied mostly apply a neurofeedback training protocol based on maintaining alpha waves in a range between 8 and 12 Hz, with electrode positioning in the frontal area or in the sensorimotor cortex and with a number of neurofeedback sessions ranging from 8 to 20 sessions. The meta-analysis showed that interventions incorporating surface neurofeedback do not produce additional benefits in self-perception of sleep quality or insomnia compared to a wide variety of control conditions including cognitive behavioral treatment or other biofeedback modalities. PROSPERO - International prospective register of systematic reviews - CRD42024528401 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=528401.

Changes in insomnia and binge-eating symptom severity before and after treatment of eating disorders in individuals with non-low-weight binge-spectrum disorders.

Although emerging research suggests insomnia is a significant problem among people with eating disorders, little is known about how insomnia symptoms may serve as risk factors for eating disorder symptoms, treatment outcome, and relapse. University students with non-low-weight eating disorders (N = 89) completed a mobile guided self-help cognitive behavioural intervention for eating disorders. Insomnia and binge-eating symptoms were assessed at pre-treatment and end-of-treatment using the Insomnia Severity Index and Eating Pathology Symptoms Inventory. Multiply imputed datasets were used to test associations between insomnia and binge eating before, during and after treatment. Insomnia was positively associated with binge-eating symptoms prior to treatment (r = 0.47). Baseline insomnia symptoms were associated with binge-eating symptoms at end-of-treatment (est = 0.269). Eating disorder treatment modestly reduced insomnia (d = -0.38); however, about half of people with clinically significant insomnia prior to treatment remained symptomatic. Insomnia symptoms and binge-eating symptoms did not change concurrently during treatment. Overall, results support an association between insomnia and binge eating. Although eating disorder treatment may impact insomnia, many individuals remained symptomatic for sleep problems, suggesting the need for follow-up treatments, such as cognitive behavioural therapy for insomnia, or the development of integrated insomnia-eating disorder treatments. Future studies are needed to examine causal links between insomnia and eating disorder symptoms, and test if insomnia predicts relapse after eating disorder treatment.

Mental healthcare in paediatric epilepsy clinics: implementation by non-mental health professionals

ObjectivesResearch has shown that children with epilepsy often experience mental health disorders but face barriers to effective care. One solution is to train healthcare professionals within paediatric epilepsy services to...

Enhancing Quality of Life in Symptomatic Paroxysmal Atrial Fibrillation Patients: A Systematic Analysis of Cognitive Behavioral Therapy Interventions.

Paroxysmal atrial fibrillation (PAF) significantly impacts patients' lives, contributing to morbidity, reduced quality of life (QoL), and psychological distress. Conventional treatment approaches primarily focus on rhythm control through pharmacologic therapy, often overlooking the patient's holistic well-being. Cognitive behavioral therapy (CBT), a well-established intervention for modifying dysfunctional thoughts and behaviors, may provide a beneficial nonpharmacological approach to improving QoL in symptomatic PAF patients. A systematic review was conducted in accordance with Cochrane methodology and PRISMA guidelines. A comprehensive search was performed using PubMed, Scopus, and Google Scholar to identify relevant studies on the effects of CBT on QoL in PAF patients. Various CBT interventions, including exposure-based, internet-delivered, and mindfulness-based approaches, were analyzed. Study quality was assessed using JBI and Cochrane tools to evaluate the risk of bias. The review found that CBT interventions led to statistically significant improvements in several QoL domains, including physical and emotional well-being. Psychological well-being and self-management skills were notably enhanced, as CBT helped address maladaptive cognitive patterns and improved coping strategies. The studies reviewed consistently demonstrated a low risk of bias, indicating reliability in the findings. CBT shows promise as a holistic, nonpharmacological intervention for managing PAF, improving both psychological and physical QoL. However, future research is needed to establish standardized protocols, increase sample sizes, and conduct long-term follow-ups to further validate its effectiveness in this population. Incorporating CBT into PAF management could substantially enhance patient outcomes and well-being.

Web-Based Intervention (SunnysideFlex) to Promote Resilience to Posttraumatic Stress Disorder Symptoms During Pregnancy: Development and Pilot Study.

Approximately 4% to 8% of pregnant individuals meet the criteria for current posttraumatic stress disorder (PTSD), a known risk factor for a multitude of adverse maternal and child health outcomes. However, PTSD is rarely detected or treated in obstetric settings. Moreover, available prenatal PTSD treatments require in-person services that are often inaccessible due to barriers to care. Thus, web-based interventions offer great potential in extending PTSD treatment to high-risk pregnant individuals by providing affordable, accessible care. However, there are currently no web-based interventions designed specifically for the treatment of PTSD symptoms during pregnancy. This study aims to develop and pilot a 6-week, web-based, cognitive behavioral therapy intervention for PTSD, SunnysideFlex, in a sample of 10 pregnant women with current probable PTSD. Consistent with established guidelines for developing and testing novel interventions, the focus of this pilot study was to evaluate the initial feasibility and acceptability of the SunnysideFlex intervention and preintervention to postintervention changes in PTSD and depression symptoms. This approach will allow for early refinement and optimization of the SunnysideFlex intervention to increase the odds of success in a larger-scale clinical trial. The SunnysideFlex intervention adapted an existing web-based platform for postpartum depression, Sunnyside for Moms, to include revised, trauma-focused content. A total of 10 pregnant women in weeks 16 to 28 of their pregnancy who reported lifetime interpersonal trauma exposure (ie, sexual or physical assault) and with current probable PTSD (scores ≥33 per the PTSD checklist for DSM-5) were enrolled in the SunnysideFlex intervention. Assessments took place at baseline and 6 weeks (postintervention). All participants were retained through the postintervention assessment period. Engagement was high; participants on average accessed 90% of their lessons, logged on to the platform at least weekly, and reported a generally positive user experience. Moreover, 80% (8/10) of participants demonstrated clinically meaningful reductions in PTSD symptoms from baseline to postintervention, and 50% (5/10) of participants no longer screened positive for probable PTSD at postintervention. Most (6/10, 60%) of the participants maintained subclinical depression symptoms from baseline to postintervention. Findings from this small pilot study indicate that SunnysideFlex may be a feasible and acceptable mechanism for delivering PTSD intervention to high-risk, trauma-exposed pregnant women who might otherwise not have opportunities for services. Larger-scale trials of the intervention are necessary to better understand the impact of SunnysideFlex on PTSD symptoms during pregnancy and the postpartum period.

Intrusive Thoughts and Images in Health Anxiety: Rates, Characteristics, and Responses.

Intrusive thoughts and images in Health Anxiety are poorly understood. The current study aims to explore the rates and nature of health-related intrusive thoughts and images in people with and without Health Anxiety. We used a cross-sectional interview and survey design recruiting 82 participants (Health Anxiety: n = 37; control: n = 45). Participants completed a diagnostic and clinical interview, and questionnaires to assess experiences and appraisals of intrusive thoughts and images about health. Experiencing an intrusive thought or image was common in both groups (Health Anxiety: 89.2%, control: 55.6%). However, the Health Anxiety group reported their intrusive thoughts as more frequent, more distressing, and associated them with more negative emotions than controls. Further, the Health Anxiety group had increased negative appraisals and specific maladaptive behaviours for both intrusive thoughts and intrusive images compared to controls. We conclude that, relative to controls, individuals with Health Anxiety experience intrusive thoughts and images more intensely and negatively, have more dysfunctional appraisals of them, and are more likely to respond to them with specific maladaptive behaviours. As such, addressing intrusive thoughts and images as part of cognitive behavioural interventions for Health Anxiety is warranted.