Disease Phobia Research Articles

An Article on Rhinophobia: The Fear of Contracting Diseases

The excessive or unreasonable dread of being sick is known as nosophobia. Sometimes people only refer to this particular fear as "disease phobia. " Because it might lead students to feel they have a sickness after studying it, nosophobia is frequently referred to as the "disease of medical students. " Pathophobia, sickness phobia, and hypochondria are other words for nosophobia. Cyberchondria is another term that has been used to describe nosophobia in recent years. This is due to the fact that "cyberspace" on the Internet contains a large portion of the material that is the source of the anxiety.1 Understanding nosophobia requires a holistic approach that addresses both the cognitive and emotional components of fear. Cognitive - behavioral therapy (CBT) emerges as a promising intervention, helping individuals challenge distorted beliefs, develop coping mechanisms, and gradually confront their fears in a controlled environment. Moreover, fostering a supportive and empathetic environment is crucial in mitigating the stigma surrounding nosophobia and promoting effective treatment - seeking behaviors. Healthcare providers play a pivotal role in providing education, reassurance, and personalized care to individuals struggling with nosophobia, thereby empowering them to regain a sense of control over their health.

The Relation of Health Anxiety to Treatment Utilization Among Patients with Substance Use Disorders: The Moderating Role of Racial/Ethnic Background

Background: Although health anxiety is broadly related to the overutilization of healthcare, limited research has examined this relation among individuals with substance use disorders (SUDs), or the extent to which racial/ethnic differences influence this relationship. Objectives: The purpose of the current study is to examine the moderating role of racial/ethnic minoritized background in the relationship between health anxiety and treatment utilization among individuals with SUDs. In the present study, patients with SUDs receiving residential treatment in Mississippi (N=118; 62% racial/ethnic minoritized status, 35.6% White) completed a measure of health anxiety and answered questions about past mental health, physical health, and substance use treatment. Regression models examined whether racial/ethnic minoritized status (White vs. racial/ethnic minoritized status) moderated the relation of health anxiety to treatment utilization among patients with SUDs. Treatment utilization was examined by asking whether participants had seen a doctor or mental health provider, engaged in substance use treatment, or alcohol treatment prior to their current treatment (dichotomous), as well as the number of times they had engaged in each treatment (physical health, mental health, substance use, and alcohol treatment) in the past year (continuous). Results: Results revealed that the facets of health anxiety involving concerns about pain and disease phobia were positively associated with treatment utilization, but only among racial/ethnic minoritized participants, with concerns about pain positively associated with self-reported physical health treatment utilization (OR=0.70, 95% CI=0.50; 0.97) and disease phobia positively associated with past mental health (B = 0.36, p = 0.023) and alcohol use treatment (B=-0.23, p=.009). Conversely, disease phobia was related to less prior alcohol use treatment among White participants (B=-0.23, p=.009). Conclusions: Overall, among patients in residential treatment for SUDs, racial/ethnic minoritized participants with SUDs reported more health anxiety compared to white participants, and certain facets of health anxiety (i.e., concerns about pain and worry about severe illness) were linked to heightened treatment utilization among racial/ethnic minoritized individuals.

Liberal Democracy in Eclipse: The Economy Post-February 2020, Nourished by Four Odds—Disease Phobia, Profanity in the Media, Unethical Profit Seekers and Tail Risk

Liberal Democracy in Eclipse: The Economy Post-February 2020, Nourished by Four Odds—Disease Phobia, Profanity in the Media, Unethical Profit Seekers and Tail Risk

Clinimetric properties of the diagnostic criteria for psychosomatic research among the elderly.

Among the elderly, the availability of tool assessing psychosomatic syndromes is limited. The present study aims at testing inter-rater reliability and concurrent validity of the semi-structured interview for the Diagnostic Criteria for Psychosomatic Research (DCPR-R-SSI) in the elderly of the general population. One hundred eight subjects were recruited. Participants received a clinical assessment which included the DCPR-R-SSI, the Illness Attitude Scale (IAS), the Geriatric Depression Scale (GDS), the Psychosocial Index (PSI), the Toronto Alexithymia Scale-20 (TAS-20). Analyses of inter-rater reliability of DCPR-R-SSI and concurrent validity between DCPR-R-SSI and self-administered questionnaires were conducted. DCPR-R-SSI showed excellent inter-rater reliability with a percent of agreement of 90.7% (K Cohen: 0.856 [SE = 0.043], 95% CI: 0.77-0.94). DCPR-R demoralization showed fair concurrent validity with GDS; concurrent validity was also fair between DCPR-R Alexithymia and TAS-20, and between DCPR-R allostatic overload and PSI allostatic load, while the concurrent validity between DCPR-R Disease Phobia and IAS was moderate. DCPR-R-SSI represents a reliable and valid tool to assess psychosomatic syndromes in the elderly. DCPR-R is in need of being implemented in the elderly clinical evaluation.

Assessment of corona-phobia in university students with the COVID-19 Phobia Scale (C19P-S): A cross-sectional analysis

Introduction. Disease phobia may impose distressing manifestations along with compromised quality of life, particularly in young age. COVID-19 caused substantial psychological concerns in general population which required the attention of health authorities to address the issue as soon as possible. Objective. This study was aimed to determine COVID-19 phobia in Pakistani youth during the current pandemic. Method. A cross-sectional study was conducted to ascertain the extent of fear of COVID-19 among university students in Lahore, Pakistan using the COVID-19 Phobia Scale (C19P-S). Psychological, somatic, social, and economic factors were ascertained among students. The relationship of demographics with the phobia score was determined through appropriate statistical tests. Result. This study included 374 students with a male preponderance (64.7%). The mean C19P-S score was 59.08 ± 14.44 (IQR: 50 - 70), with no significant difference among demographics except gender (male 57.65 ± 14.77 vs female 61.70 ± 13.47; p = .009). The mean psychological, psycho-somatic, economic, and social subscale scores were 19.59 ± 5.00 (25th percentile = 16 and 75th percentile = 24), 12.29 ± 4.56 (25th percentile = 10 and 75th percentile = 15), 11.22 ± 3.67 (25th percentile = 8 and 75th percentile = 14) and 15.97 ± 4.04 (25th percentile = 13.75 and 75th percentile = 19), respectively. Male students had a significantly lower score on social and psychological subscales than females (p #abr# .05). Discussion and conclusion. One fourth of the students achieved a fear score #cer# 70 on C19P-S. These results indicate the need of dire maneuvers for reducing corona-phobia among university students.

Barriers to Premarital Thalassemia Screening in Asia

Thalassemia is a genetic disorder of hemoglobin synthesis. Every year 70,000 infants are born with beta thalassemia globally. Its incidence can be reduced by premarital thalassemia screening This review aims to focus on barriers to premarital thalassemia screening and to observe the current thalassemia practices in Asian countries. This study was conducted on six countries of Asia based on economic status according to World Bank criteria. High income states included Kingdom of Saudi Arabia, and Oman, Iran constituted an upper middle-income country and in lower middle-income category Sri Lanka, Pakistan and Bangladesh were considered. Search engines like PubMed, Research Gate and Google scholar were used to look for relevant articles from 2005 to 2019. A total of (89) articles were reviewed and (61) articles were finally selected to be included in this review. In Saudi Arabia, major obstacles for premarital thalassemia screening included planned weddings (43%), fear of social disgrace (21%), pressure from family (17%), and religious factors (14%). While in Oman, 4% of the people feared positive results and also considered it as an insult. Amongst the Iranian population, financial burden on couples, disease phobia, fear of positive results, difficulty in accessibility, tribal variances and sociodemographic factors were frequent hindrances to a screening program. Religious factors, financial constraint and lack of awareness cause reluctance in Pakistan and Bangladesh. Moreover, in Sri Lanka, factors like cancellation of marriage and sociocultural norms were identified as negative outcomes of the screening. In conclusion, a negative attitude and reluctant response to premarital thalassemia screening was observed in people belonging to all the countries included. Major contributing factors were religious misconceptions, social stigma, varying ethnicities, low financial status and poor accessibility to screening programs. Key words: Beta thalassemia, thalassemia screening, premarital screening, consanguineous marriage, social impact

Diagnostic Criteria for Psychosomatic Research – revised version by Giovanni A. Fava and his research team

Diagnostic Criteria for Psychosomatic Research (DCPR), developed by a team of Italian and American researchers at the end of the 20th century, was elaborated and then revised based on observations and studies conducted by clinicians. In this paper, we present their current version known as DCPR-R. This classification system departs from the functional/organic dichotomy of disorders. The new criteria allow for the assessment of the role of multiple emotional/behavioural dimensions and responses in the functioning of an affected person. The revised version has four diagnostic modules, i.e., stress, illness behaviour, psychological manifestation, and personality. The authors introduced an additional factor to describe life experiences that contribute to stress (allostatic overload). Illness behaviours include health anxiety, disease phobia, hypochondriasis, thanatophobia, illness denial, persistent somatisation, conversion, and anniversary reaction. Irritable mood, somatic symptoms secondary to a psychiatric disorder and demoralisation are psychological manifestations. Type A behaviour pattern and alexithymia are considered personalityrelated factors. The authors of DCPR-R proposed a certain number of criteria to be met in order to diagnose each of these syndromes. The system makes it possible to clearly determine the presence of a given syndrome, but it does not allow to assess its severity. Psychosomatic syndromes play an important role in the development and/or course of somatic diseases. Inclusion of these syndromes in clinical diagnosis has made it possible to expand the spectrum of information about patient’s functioning, and, once they are diagnosed, offer appropriate psychological assistance, which will translate into an improvement in the quality of life.

Hipohondrijski strahovi i uverenja studenata medicine

Hypochondria is a mental disorder characterized by a preoccupation with fears that a person may be ill or suffering from a serious illness, based on a misinterpretation of problems that cannot be eliminated by appropriate medical reassurance. A special type of hypochondriasis known as Medical Student Syndrome (MSS) refers to student's fears and beliefs that they are ill or may become ill with the illnesses they are learning while studying in pre-clinical and clinical subjects. A cross-sectional study was conducted during the winter semester of the 2019/2020 school year, with a sample of 90 students of the first, third, and sixth year of the Faculty of Medicine, sampled on a random basis. Subjects completed the Illness Attitude Scale (IAS). The aim of study was to investigate whether there is a difference in the incidence of hypochondrial tendencies and beliefs in the students of the Faculty of Medicine in relation to the year of study. The mean values on certain subscales were statistically significantly higher in students of third compared to students of first and sixth year of medicine. Students who have not renewed a year were found to have significantly higher average scores on the Disease Concerns and Pain Concerns subscale, as well as Disease phobia compared to those who renewed the year, while Hypochondrial beliefs were statistically significantly higher in subjects who renewed the year compared to students who had not renewed the year. The presented results support the hypothesis that health anxiety and all its components among the medical students at the preclinical level is most pronounced in the third year of study, and that it shows declining trend in the later stages of study.

Emotional Suppression and Oneiric Expression in Psychosomatic Disorders: Early Manifestations in Emerging Adulthood and Young Patients.

BackgroundThe function of emotions, beginning from the proto-emotions, is the adaptation to the environment. This is based on the Homeorhesis, the equilibrium due to the adaptive operation of excitement and the dissipation of emotions. The object relations of the participants foresee the practice of defense mechanisms in a continuum that goes from the consciousness to the oneiric activities. The predominant and maladaptive use of defense mechanisms in the psychosomatic phenomenology, can be identified with deficits in emotional awareness, with the impossibility to manage excitement and dissipation of emotions foreseen by the oneiric phenomena.MethodsThe observation group is composed by 140 participants, 56 males (43%) and 84 females (57%),with pathological-functional disorders of psychosomatic domain. The study had been conducted with the use of measures related to the conscious defense of suppression (Suppression Mental Questionnaire), to the emotional awareness linked to the psychosomatic phenomena (Diagnostic Criteria for Psychosomatic Research Structured Interview-DCPR-SI) and to the states of perturbation and conservation of oneiric activities (The Manheim Dream Questionnaire-MADRE).ResultsSignificant inverse correlations emerged among rationalization, repressive function and illness Denial, as for the suppression mental questionnaire factors and irritable mood, but for Regression in the service of the Ego; inverse and significant correlations emerged among suppression, repressive function, rationalization and gastrointestinal psychosomatic outcomes and among suppression, repression and cardiological psychosomatic outcomes. Regarding alexithymia, a positive correlation emerged with rationalization and inverse with Regression in the service of the Ego. Positive correlations emerged between illness denial and overall emotional tone, for disease phobia and meaningfulness and for cardiological psychosomatic outcomes and nightmare distress and recurring nightmares.ConclusionThe study of such outcomes due to a prevalent defensive style based on suppression, suggest the identification of a key phenomenon, which translates into maladjustment that goes from functional disorders to parasomnia. The bridge established by the obfuscation of conscious contents until the manifestations of disturbance of ancient activities such as oneiric ones, expresses the need to transform an emotional maladaptive style, in line with classic literature and the current state of art.

Four-year stability, change, and multidirectionality of well-being in very-old age.

We examined stability, change, and dedifferentiation of well-being in 124 participants with a baseline age between 87 and 97 years (M = 90.56, SD = 2.92) across 7 measurement occasions over 4 years. Measures of hedonic (life satisfaction, positive affect and negative affect) and eudaimonic well-being (autonomy, purpose in life, self-acceptance, environmental mastery), as well as indicators of mental distress (depressive symptoms, attitudes toward death and dying, disease phobia) were included. Average levels indicated high well-being at all measurement occasions in the majority of indicators analyzed. However, mean numbers of depressive symptoms were close to the cutoff point of clinical depression. Analyses of intra-individual correlations revealed high loadings of depressive symptoms, positive affect, and environmental mastery on a common factor. However, several well-being indicators were not substantially interrelated on the intra-individual level, suggesting their trajectories were rather independent of each other. Acceptance of death and dying was surprisingly high and even increased, whereas mean levels in fear of death were very low and declined over time. Overall, our findings do not suggest late-life dedifferentiation of well-being trajectories in very-old age. Our results rather support the need to consider indicators of hedonic and eudaimonic well-being, as well as mental distress, to understand the multifaceted and multidirectional dynamics of well-being in very-old age.

Hypochondriacal attitudes and beliefs, attitudes towards complementary and alternative medicine and modern health worries predict patient satisfaction.

SummaryObjectiveTo investigate how hypochondriacal attitudes and beliefs, attitudes towards complementary and alternative medicine (CAM) and modern health worries (MHWs) related to patient satisfaction with their general practitioner.DesignParticipants completed a five-part questionnaire anonymously which measured satisfaction with one’s doctor, hypochondriacal beliefs, attitudes to CAM, MHWs and personality.SettingEnglandParticipantsIncluded 215 adults from a variety of cultural backgrounds.Main outcome measureThe Illness Attitudes Scales measuring the attitudes, fears and beliefs associated with hypochondriasis; Worry about Illness; Concerns about Pain, Health Habits, Hypochondriacal beliefs; Thanatophobia, Disease phobia, Bodily preoccupations; Treatment experience and Effects of symptoms.ResultsCorrelations (around r = .10 to .25) and Regressions (R square from .06 to .09) showed demographic and personality variables only modestly related to patient satisfaction. Hypochondriasis, CAM and MHWs were associated with greater patient dissatisfaction as predicted with the former as the most powerful correlate.ConclusionThe study indicates the different needs of potential patients in a typical medical consultation. It is important to ascertain patients’ health beliefs and practices with regard to medical history, attitudes to CAM and MHWs to increase consultation satisfaction.

Dimensional Assessment of Hypochondriacal Fears and Beliefs

Background: The hypochondriacal spectrum includes several clinical phenomena, such as disease phobia, thanatophobia and health anxiety. The major challenge for a dimensional tool is to capture the different features which sensitively differentiate the hypochondriacal syndrome from other clinical phenomena, such as somatization. This article provides a qualitative review of the instruments designed for the dimensional assessment of hypochondriacal fears and beliefs. Methods: Articles were retrieved by means of both computerized (Medline, PsycINFO) and manual searches. Results: In the 1960s, the Whiteley Index (WI) was the first instrument specifically built to measure the severity of hypochondriacal symptoms. In the 1980s, Kellner developed the nine Illness Attitude Scales (IAS), each of them concerns a specific cluster of attitudes, fears and beliefs. They were designed to reflect the clinimetric properties, in particular content validity and sensitivity to treatment-related changes. In the 1990s, the refinement of the cognitive-behavioral model of hypochondriasis was followed by an upsurge of questionnaires aimed at assessing the dimensions of hypochondriasis according to this model. However, most of these instruments need to be further validated and the amount of incremental information they yield remains to be established. In the last decade, the interest of the studies has been focused on the measurement of specific features of hypochondriasis, such as response to medical reassurance and obsessive-compulsive symptoms. Conclusions: Kellner’s IAS and Pilowsky’s WI are the most validated and widely used instruments. The clinimetric properties make the IAS the gold standard for the dimensional assessment of hypochondriacal fears and beliefs. Keywords: Cognitions About Body and Health Questionnaire, Health Anxiety Inventory, Health Anxiety Questionnaire, Hypochondriasis Yale-Brown Obsessive-Compulsive Scale, Illness Attitude Scales, Multidimensional Inventory of Hypochondriacal Traits, Reassurance Questionnaire, Somatosensory Amplification Scale, Whiteley Index.

Vertigo “In the Pink”: The Impact of Female Gender on Psychiatric-Psychosomatic Comorbidity in Benign Paroxysmal Positional Vertigo Patients

Comorbidity between vestibular and psychiatric disorders in predisposed individuals is underestimated, untreated, and may result in chronicization and poor quality of life. There are few studies concerning the type and the prevalence of psychiatric-psychosomatic distress in patients with benign paroxysmal positional vertigo (BPPV). The aim of this study was to evaluate psychiatric-psychosomatic comorbidities, in particular anxiety, depression, somatization symptoms, and alexithymia, in a group of BPPV patients compared with healthy subjects, and according to gender. Case-control study comparing 92 BPPV patients recruited at the ENT Unit of Modena General Hospital between November 2007 and December 2010, and 141 healthy controls. The Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Diagnostic Criteria for Psychosomatic Research (DCPR), Brief Symptom Inventory (BSI), and Toronto Alexithymia Scale (TAS-20) were used to perform psychometric assessment. BPPV patients scored higher than controls, with statistical significance, at BDI, BSI somatization, anxiety, and phobic anxiety subscales, and STAI state anxiety; a larger proportion of BPPV patients suffered from clinically significant BDI depressive symptomatology; DCPR disease phobia, functional somatic symptoms secondary to a psychiatric disorder, and demoralization were more common among BPPV subjects. High levels of symptomatology were still found among BPPV female patients, but not among males, even after controlling for symptom severity. Affective symptomatology, such as depression, demoralization, phobia and anxiety, and somatization, were significantly prevalent in BPPV patients, and female gender may be a predisposing factor.

Determinants of Public Phobia About Infectious Diseases in South Korea

This study investigated the individual and social determinants of the public's phobia of infectious diseases in South Korea, where collective action was recently fueled by the public phobia over mad cow disease (bovine spongiform encephalopathy [BSE]). Gender-specific multivariate regression was used to compare the public perception of BSE and highly pathogenic avian influenza (HPAI). The analysis results differentiated between the determinants of the phobia for the 2 diseases, BSE and HPAI (N = 1002). As with HIV/AIDS and leprosy, the public fear of HPAI was expressed as a disease phobia that seeks to ensure the social exclusion of infection sources, whereas the fear of BSE was influenced by social and communication factors. Therefore, BSE, unlike previous HPAI, can be rapidly amplified amid the growing distrust in health communication, in which case the social determinants of disease phobia are associated with communicator trust, social values, and political attitude toward diseases rather than disease perception.

Framing, Agenda Setting, and Disease Phobia of AIDS-Related Coverage in the South Korean Mass Media

There has been little research on the concrete role of the press in discourses on AIDS. This study investigated the AIDS discourses created by the major media. In particular, from the perspective of the agenda-setting theory, it examines differences in the framing of AIDS-related news depending on the political orientation and news sources of the press. This study analyzed the thematic frames and news sources implied by AIDS-related coverage. The 2 major media representing conservatism and progressivism were selected as the objects of analysis. As for the search engine for content analysis, the Korean Integrated Newspaper Database System was used, and 151 articles containing "AIDS" or "HIV" over 5 years from January 2005 to December 2010 were analyzed. According to the results of the analysis, there were the 6 following frames: aid/support, accident, human rights, risk, prevention, and biomedicine. Whereas the conservative press in South Korea continued to frame AIDS in the traditional way, the progressive press tended relatively more often to attempt new agenda setting, from the perspective of human rights and inequality. However, both newspaper companies tended mostly to select experts as the sources of AIDS news, thus continuing to exclude infectees and civil and society organizations.

Hypochondriacal attitudes comprise heterogeneous non-illness-related cognitions

BackgroundHypochondriacal attitudes were associated with cognitions not related to illness: Social fears, low self-esteem, and reduced warm glow effect, i.e. less positive appraisal of familiar stimuli. Only a single study had investigated the correlation of hypochondriacal attitudes with the warm glow effect so far and the present study aimed to corroborate this association. Particularly, the present investigation tested for the first time whether social fears, low self-esteem, and reduced warm glow effect represent distinct or related biases in hypochondriacal attitudes.MethodsFifty-five volunteers filled in the Hypochondriacal Beliefs and Disease Phobia scales of the Illness Attitude Scales, two scales enquiring social fears of criticism and intimacy, and the Rosenberg Self-Esteem Scale. The interaction of valence and spontaneous familiarity ratings of Chinese characters indicated the warm glow effect.ResultsA stepwise regression model revealed specific covariance of social fears and warm glow with hypochondriacal attitudes independent from the respective other variable. The correlation between low self-esteem and hypochondriacal attitudes missed significance.ConclusionsHypochondriacal attitudes are embedded in a heterogeneous cluster of non-illness-related cognitions. Each social fears and a reduced cognitive capacity to associate two features – positive appraisal and familiarity - could diminish the susceptibility to safety signals such as medical reassurance. To compensate for reduced susceptibility to safety signals, multifocal treatment and repeated consultations appear advisable.

P-389 - Psychiatric comorbidity in benign paroxymal positional vertigo patients: A case-controlled study

Vestibular disorders can trigger the onset of psychiatric disorders in predisposed individuals: these comorbidities are often underestimated, untreated and may consequently result in chronicization and poor quality of life. There are still few studies concerning the type and the prevalence of psychiatric disorders in patients with benign paroxysmal positional vertigo (BPPV). To evaluate psychiatric comorbidities, in particular anxiety, depression, somatisation disorder and alexithymia in a group of BPPV, patients compared to healthy subjects. Case-control study. We compared for psychiatric morbidity 92 BPPV patients and 141 controls (not suffering from BPPV) recruited at the ENT Unit of Modena General Hospital between November 2007 and December 2010. Beck Depression Inventory (BDI), Spielberger State-Trait Anxiety Inventory (STAI), Diagnostic Criteria for Psychosomatic Research (DCPR), Brief Symptom Inventory (BSI) and Toronto Alexithymia Scale (TAS-20) were used to assess psychiatric symptoms. BDI and STAI scores, BSI subscales for somatization, anxiety and phobic anxiety, DPCR subscales for disease phobia, functional somatic symptoms secondary to a psychiatric disorder and demoralization were significantly different between patients and controls. Conversely, significant differences between the two groups were not found for alexithymia scores. Affective disorders, such as depression, demoralization, phobia and anxiety, and somatisation appeared to be significantly prevalent in BPPV patients. Contrary to expectations, alexithymia was not found to be more common in these subjects. Further studies are needed, in order to identify psychiatric sufferings at early stages in this population.

Hypochondriacal attitudes may reflect a general cognitive bias that is not limited to illness-related thoughts

Previous findings suggested that hypochondriacal attitudes could originate from a pessimistic trait independent of illness-related thoughts. We hypothesised that hypochondriacal attitudes correlated with a general cognitive tendency towards negative interpretations and reduced familiarisation. Healthy non-patients were invited to participate. The sum score from the Hypochondriacal Beliefs and Disease Phobia scales of the Illness Attitude Scales assessed hypochondriacal attitudes. Participants without any knowledge of the Chinese language were asked to guess whether or not each of eight Chinese characters had a positive meaning and whether the characters appeared familiar. Stimuli without semantic content avoided a reference to illness in order to assess a general cognitive bias. Participants with high hypochondriasis scores rated apparently familiar stimuli as being less positive in comparison to low hypochondriacal participants, F(1,78) = 9.2, p = 0.003, η 2 = 0.10; correlation of hypochondriasis scores to the differences between ratings of familiar and unfamiliar characters: ρ = 0.345, p = 0.002. Positivity and familiarity ratings did not correlate with hypochondriacal attitudes independent of each other. A less positive appraisal of familiar experiences, which is unrelated to illness-related thoughts, may maintain hypochondriacal concerns. A general distrustful attitude towards familiar procedures should be considered in hypochondriasis.

Disease phobia and disease conviction are separate dimensions underlying hypochondriasis

The current study uses data from a large nonclinical college student sample ( N = 503) to examine a structural model of hypochondriasis (HC). This model predicts the distinctiveness of two dimensions (disease phobia and disease conviction) purported to underlie the disorder, and that these two dimensions are differentially related to variables important to health anxiety and somatoform disorders, respectively. Results were generally consistent with the hypothesized model. Specifically, (a) body perception variables (somatosensory amplification and anxiety sensitivity – physical) emerged as significant predictors of disease phobia, but not disease conviction; (b) emotion dysregulation variables (cognitive avoidance and cognitive reappraisal) emerged as significant predictors of disease conviction, but not disease phobia; and (c) both disease phobia and disease conviction independently predicted medical utilization. Further, collapsing disease phobia and disease conviction onto a single latent factor provided an inadequate fit to the data. Conceptual and therapeutic implications of these results are discussed.

Criteria for Psychosomatic Research (DCPR) in the Medical Setting

The Diagnostic Criteria for Psychosomatic Research (DCPR) represent a diagnostic and conceptual framework that aims to translate psychosocial variables derived from psychosomatic research into operational tools whereby individual patients can be identified. A set of 12 syndromes was developed: disease phobia, thanatophobia, health anxiety, illness denial, persistent somatization, functional somatic symptoms secondary to a psychiatric disorder, conversion symptoms, anniversary reaction, irritable mood, type A behavior, demoralization, and alexithymia. The aim of this article is to survey the research evidence that has accumulated on the DCPR in several clinical settings (cardiology, oncology, gastroenterology, endocrinology, primary care, consultation psychiatry, nutrition, and community), to examine prevalence and specific diagnostic clusters of the more prevalent DCPR syndromes, and to review their clinical utility in terms of clinical decision, prediction of psychosocial functioning, and treatment outcomes. The implications for classification purposes (DSM-V) are also discussed.