Illness Attitude Scales Research Articles

Prediction of Illness Attitude Based on Early Maladaptive Schemas and Intolerance of Uncertainty in Patients with Multiple Sclerosis

Background: The present study was conducted to predict attitudes towards illness based on early maladaptive schemas and intolerance of uncertainty in individuals with Multiple Sclerosis (MS). Methods: This was a cross-sectional study conducted on 62 patients with MS (72% of them were female). They were selected based on availability and voluntary participation. Data were collected through three questionnaires: the Illness Attitudes Scale, the Intolerance of Uncertainty scale, and the Yang Schema Questionnaire. Results: The mean age (±SD) of the participants and duration of diagnosis was 36.10±7.05 yr, and 4.21±3.78 yr, respectively. The results showed that 18 early maladaptive schemas, together with intolerance of uncertainty, can predict up to 8.9% of illness attitude in patients with MS. Among the early maladaptive schemas, schemas of emotional deprivation, social isolation-alienation, abandonment-instability, failure, dependence-underdeveloped self, vulnerability, trapped-victim, emotional inhibition, stubborn/fault-finding standards, self-control disciplinary, seeking attention-seeking approval, and negativity/pessimism had a significant relationship with attitudes towards illness (p<0.05). Additionally, there was a significant relationship between intolerance of uncertainty and all its dimensions with attitudes towards illness (p<0.05). Conclusion: Early maladaptive schemas and intolerance of uncertainty can predict illness attitudes in patients with MS. Patients with MS who have high intolerance of uncertainty are more likely to interpret ambiguous information as threatening. Therefore, effective interventions in the field of uncertainty intolerance for these patients can likely be effective in improving their attitudes towards illness and preventing the exacerbation of their symptoms.

The relationships of personality organization, mental illness attitudes and perspectives toward psychotherapy: The mediating role of emotional self‐disclosure

AbstractThis study investigated the relationships between personality organization, Mental Illness Attitude (MIA), and Perspectives Toward Psychotherapy (PTP) with regard to the mediating role of Emotional Self‐Disclosure (ESD) by utilizing structural equation modeling (SEM). A sample of 266 outpatients with mental health disorders was selected using a purposive sampling method. Data collection involved the use of the Inventory of Personality Organization, The Illness Attitudes Scale, Emotional Self‐Disclosure Scale, and Attitudes Toward Seeking Professional Psychological Help‐The10‐item (ATSPPH‐SF). The results revealed that personality organization, MIA, and ESD have significant associations with PTP. Also, MIA has a positive indirect relationship with PTP through ESD as a mediator, while personality organization negatively correlated to PTP through ESD. Personality organization, MIA, and ESD collectively accounted for 72.8% of the variance in PTP. Findings demonstrated an adequately fitting model about the direct and indirect associations of personality organization and MIA with PTP about the mediating role of ESD. This model has implications for psychotherapeutic and community‐based initiatives in individuals with mental health disorders.

Exploratory study of nocebo effect in senior medical students.

Νocebo Effect is known to induce adverse symptoms after negative expectations which can be manifested on a physical and psychological level. As 6th year medical students often face a wide range of clinical challenges and may be prone to negative expectations or beliefs affecting their pre-clinical and clinical success, we want to investigate how they are affected by the Nocebo Effect. To investigate whether a nocebo effect can be induced when exposing final-year students to the clinical context of their training. We used verbal suggestions as a nocebo mechanism and by using three tools, the Illness Attitude Scales, the Symptom Checklist-90, and the State-Trait Anxiety Inventory, we examined the difference in scores on measures of psychometric parameters in 33 participants who were on their 6th year medical and attended three clinics for the first time during their education. The administrations were given before and after attending each clinic, and negative verbal suggestions were given prior to the first administration. We also measured whether the overall number of clinics, had an effect on psychometric parameters. The results revealed a significant increase in second administration overall in the three clinics in specific psychometric parameters but no statistically significant difference was observed after attending consecutive clinics. Students reported the occurrence of adverse symptoms in the investigated psychometric parameters, which should be noted in order to avoid potential educational clinical failure.

The Effect of Psychological Factors on COVID-19 Vaccination Side Effects: A Cross-Sectional Survey in South Korea.

Side effects from the coronavirus disease-2019 (COVID-19) vaccine, such as pain, headache, nausea, and fatigue, have caused vaccine hesitancy. Research on the effects of psychological factors on COVID-19 vaccine side effects is insufficient. This study aims to investigate the effect of psychological factors on COVID-19 vaccination side effects. We recruited a total of 226 individuals registered for the COVID-19 vaccine in Seoul, South Korea, for this study. Participants completed a pre-vaccination questionnaire, including the 5C antecedents of vaccination, and a survey of psychological factors (Patient Health Questionnaire-9 [PHQ-9], Generalized Anxiety Disorder-7, Somatic symptom amplification scale [SSAS], and Illness Attitude Scale [IAS]). After vaccination, participants completed an online questionnaire regarding vaccine side effects at 20 minutes, three days, and seven days after vaccination. We added a discrete set of hierarchical variables with vaccine side effects as the dependent variable to the hierarchical regression analysis: demographics for Model 1, 5C antecedents of vaccination for Model 2, and psychological factors for Model 3. Our results indicated that the risk factors for side effects 20 minutes after vaccination were young age, high PHQ, and SSAS scores. Risk factors for side effects three days after vaccination were young age, high constraints, and calculation, and the risk factor for side effects at seven days was a high IAS score. Our study confirmed that there is a significant relationship between psychological factors and COVID-19 vaccine side effects in chronological order. Psychosocial factors should be examined when assessing side-effect reactions to the COVID-19 vaccine.

Joint factor analysis and approximate equipercentile linking of common trait health anxiety measures: a cross-sectional study of the 14-, 18- and 64-item health anxiety inventory, the illness attitude scale, and the 14-item Whiteley Index

BackgroundResearch on health anxiety has bloomed in recent years, but summaries of the literature are complicated by the use of dissimilar self-report questionnaires. Furthermore, these instruments have rarely been administered in parallel, and especially not in clinical samples. In this study, we aimed to investigate the relationship between five widespread health anxiety measures, and to draft guidelines for the conversion of different sum scores.MethodsClinical trial participants with principal pathological health anxiety (n = 335) and a sample of healthy volunteers (n = 88) completed the 14-item Whiteley Index (WI-14), the Illness Attitude Scale (IAS), and the 14-, 18-, and 64-item Health Anxiety Inventory (the HAI-64, HAI-18, and HAI-14). Cross-sectional data from all participants were pooled (N = 423) and we conducted a joint factor analysis and approximate equipercentile linking of the WI-14, IAS, HAI-64, HAI-18, and HAI-14.ResultsInter-scale correlations were high (rs ≥ 0.90 and ≥ 0.88 in adjusted analyses), and the scree plot of the joint factor analysis spoke for a unifactorial solution where 89/105 items (85%) had loadings ≥ 0.40. Most items at the core of this broad trait health anxiety factor pertained to the worry about health, the fear of having or developing a serious disease, and to some extent bodily preoccupation. We present a cross-walk table of observed equipercentile linked sum scores.ConclusionsThis study speaks clearly in favor of the WI-14, IAS, HAI-64, HAI-18, and HAI-14 all tapping into the same trait health anxiety construct, the core of which appears to concern the worry about health, the fear of having or developing a serious disease, and to some extent bodily preoccupation. Based on recently reported cut-offs for the HAI-14, a reasonable cutoff for pathological health anxiety in a psychiatric setting probably lies around 7–8 on the WI-14, 52–53 on the IAS, 82–83 on the HAI-64, and 26–27 on the HAI-18.Trial registrationClinicalTrials.gov NCT01966705, NCT02314065.

Effect of psychological factors on COVID-19 vaccine hesitancy.

Vaccine hesitancy can prevent full immunization against coronavirus infectious disease-19 (COVID-19). We hypothesized that multiple factors, including an individual's personality and psychological factors, are associated with vaccine hesitancy. A total of 275 non-vaccinated individuals were recruited for this study. Participants completed a self-report questionnaire including sociodemographic factors, health status, COVID-19 literacy and psychological factors (depressive symptoms, generalized anxiety, somatization, illness anxiety, temperament and character). In a hierarchical logistic regression analysis, a discrete set of hierarchical variables with vaccine acceptance or hesitancy as the dependent variable was added to the demographic factors for Model 1; Model 1+health status for Model 2; Model 2+COVID-19 literacy for Model 3 and Model 3+psychological factors for Model 4. Models 3 and 4 could predict vaccine hesitancy. High scores on the Generalized Anxiety Disorder-7 and the Illness Attitude Scale, low confidence, low collective responsibility and low reward dependence were risk factors for vaccine hesitancy. The present study demonstrates that psychological factors play critical roles in vaccine hesitancy. In addition to conventional policies that emphasize COVID-19 vaccines' safety and efficacy and the collective benefits of vaccination, a more individualized approach that considers an individual's emotions and personality is necessary.

OCCURRENCE AND PATTERN OF ILLNESS ANXIETY DISORDER AMONG MEDICAL STUDENTS OF KERALA

Background: Illness anxiety disorder previously known as hypochondriasis is an unrealistic fear of having a serious medical condition or fear being at high risk of becoming ill. Illness anxiety is common among medical students due to the vast amount of medical knowledge they acquire during studies and exposure to new clinical experiences and competitive environment. Students misinterpret typical body functions as signs of illness and these anxieties result in distress among them which interfere with their academic performance and mental well-being. This study is intended to nd out the prevalence of illness anxiety disorder among medical students in a private medical college in Thiruvananthapuram district, Kerala. A cross sectional study was conducted among the medical students Methods: of a private medical college in Thiruvananthapuram. Students from all academic years including internship were included in the study. Calculated sample size was 554. Illness attitude scale containing 29 items was used to assess the illness anxiety. The total score of the scale is 108 and cut-off of 47 and above diagnosed as illness anxiety disorder. Results: Among 554 students participated 102 (18.41%, 95% CI :15.3- 21.9) was found to have illness anxiety disorder. Anxiety is found to be more among students of preclinical and paraclinical years than clinical years. There is a signicant association between year of study and illness anxiety with p value= 0.001. Illness anxiety affects day to day life causing distress in 47(8.48%) of students. In this study about Conclusion: 18.41% of medical students is found to suffer from illness anxiety disorder. All medical students should be made aware of illness anxiety disorders which can occur during their learning process. Medical Curriculum for undergraduates should include educational sessions to counteract such ideas and fears by incorporating different coping techniques and counselling.

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.

A biopsychosocial model of severe fear of COVID-19.

IntroductionCOVID-19 is a respiratory infection that causes not only somatic health issues, but also frequently psychosocial burdens. The aims of this study were to investigate biopsychosocial factors that might further aggravate fear of COVID-19, and to establish a biopsychosocial model of severe fear of COVID-19.Methods368 participants were included in this study. Biopsychosocial factors observed comprised biological factors (somatic risk), psychological factors (state/trait anxiety, physical symptoms of anxiety, severe health anxiety, specific phobias, depression), and psychosocial factors (social support, financial losses, social media consumption, social contacts with COVID-19 infected people). Psychometric questionnaires included State-Trait Anxiety Inventory, Beck’s Anxiety Inventory, Whiteley-Index / Illness Attitude Scales, Specific Phobia Questionnaire, WHO-5 and Social Support Survey.Results162/368 (44.0%) participants had almost no fear, 170/368 (46.2%) participants had moderate fear, and 45/368 (12.2%) participants had severe fear of COVID-19. Female participants showed higher levels of fear of COVID-19 than male participants (gender: χ2 = 18.47, p<0.001). However, the level of fear of COVID-19 increased in male participants when they had contact with people who were infected with COVID-19, while in contrast the level of fear of COVID-19 decreased in female participants when they had such contacts [ANCOVA: fear of COVID-19 (contact x gender): F(1,363) = 5.596, p = .019]. Moreover, participants without relationships showed higher levels of fear of COVID-19 (marital status: χ2 = 14.582, p = 0.024). Furthermore, financial losses due to the COVID-19 were associated with higher levels of fear of COVID-19 [ANCOVA: fear of COVID-19(financial loss x gender): F(1, 363) = 22.853, p< .001]. Multiple regression analysis revealed female gender, severe health anxiety (WI-IAS) and state /trait anxiety (STAI) as significant predictors of severe fear of COVID-19.ConclusionIn this study significant predictors of severe fear of COVID-19 were female gender, pre-existing state and trait anxiety, as well as severe health anxiety. The finding of significant predictors of fear of COVID-19 might contribute to detect people who might suffer most from severe, overwhelming fear of COVID-19 at an early stage.

Validation of the Arabic version of the Childhood Illness Attitudes Scales.

Excessive health anxiety can lead to significant disorders such as hypochondriasis. In children, assessment of the severity of health anxiety has been performed using the Childhood Illness Attitudes Scales (CIAS); however, no validated Arabic version of this tool exists. This study developed and validated an Arabic version of the CIAS questionnaire in Jordan in 2017 to provide a tool to measure the severity of health anxiety in the Arabic-speaking world. The CIAS was translated from English to Arabic then back-translated by a different translator and the 2 versions were compared before cognitive interviews were conducted. The final version of the questionnaire was circulated to 597 children. Of these, 200 were asked to retake the questionnaire after 10-15 days to evaluate test-retest reliability. Confirmatory factor analysis (CFA) on the 4-factor model suggested by the original questionnaire version was performed. Internal consistency and test-retest reliability were evaluated. The CFA showed good fit (goodness of fit index = 0.92) with the 4-factor model of fears, help seeking, treatment experience, and symptom effects. Test-retest reliability was high and the model had good discriminant validity and internal consistency. The Arabic version of the CIAS provides a suitable tool to investigate the prevalence and severity of childhood anxiety in the Middle East.

Incremental Validity Of The Diagnostic Criteria For Psychosomatic Research – Revised (DCPR-R) To Clinical Assessment In Primary Care

Psychosocial problems are highly prevalent among primary care (PC) patients, but they often remain undetected using traditional classification systems. The aim of the present study was to test the incremental validity of the revised version of the Diagnostic Criteria for Psychosomatic Research (DCPR-R), in addition to standard psychiatric assessment based on DSM-5, with regard to the prediction of psychosocial functioning of PC patients. Two-hundred PC patients were consecutively recruited. A comprehensive assessment was performed using two clinical interviews and three self-rating questionnaires (the PsychoSocial Index [PSI], the Short-Form Health Survey [SF-12] and the Illness Attitude Scales [IAS]) for the assessment of psychopathology and psychosocial functioning. Adding the DCPR-R to DSM-5, the amount of explained variance significantly increased by 9% to 16% in the PSI subscales, by 13% in the SF-12 mental component summary, and by 2% to 6% in the IAS scales. The joint use of DCPR-R and DSM-5 thus significantly increased the prediction of psychosocial functioning of primary care patients. These findings further support the use of the DCPR-R in PC settings, particularly in patients who do not satisfy DSM-5 criteria and yet present with high psychological distress, maladaptive illness behavior, impaired psychological well-being and quality of life.

Attitudes Associated with Hypochondria and Abnormal Behavior Towards Illness in Health Science Students.

The objective of this study was to evaluate attitudes towards the disease and its association with the presence of hypochondria in students of the health sciences area. The research was developed in 279 students in the health science area, with the application of Short Health Anxiety Inventory (SHAI) test and the Illness Attitude Scale (IAS) test was performed, and the descriptive, comparative and association statistical analyses were carried out. All students answered the previously mention surveys. Values above Cut-off ≥27 were obtained in the SHAI test was 6.8% (n = 19), and the percentage of students with values ≥50 Cut-off in the test of IAS was 15.7% (n = 44). IAS subtests involving an increase in the SHAI value are IAS for the disease (W), hypochondria beliefs (HB), body concerns (BP), treatment experiences (TE), and effect of symptoms (ES) with regression values of S = 3.9 with a square R adjusted to 64.9%. Therefore, according to the surveys used, a considerable sample of students showed abnormal behaviors towards the disease associated with the hypochondria, so it is important to continue monitoring students to reduce these factors.

Manifestations of health anxiety in patients with heart transplant

BackgroundHealth anxiety is an important component of psychological adjustment to chronic medical conditions. However, it has been overlooked after heart transplantation. ObjectivesTo examine demographic, clinical, and psychological correlates of health anxiety in heart transplanted patients and to compare health anxiety between patients and a sample of matched controls from the general population. MethodsThe study design was observational. Seventy-three cardiac recipients and 73 controls completed the Illness Attitude Scales and the Symptom Questionnaire. Patients’ clinical parameters were collected. ResultsHealth anxiety was significantly associated with clinical variables suggesting a worse outcome, especially a higher NYHA class and occurrence of cancer. Compared to controls, patients had significantly more “hypochondriacal responses” (32.9% vs. 16.4%), an index of clinically significant health anxiety. ConclusionsHealth anxiety affects a significant subset of heart transplanted patients and deserves a thorough assessment. Cardiologists’ and nurses’ specific communication skills and psychological treatment strategies may be necessary.

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.

Use of Web-Based Health Services in Individuals With and Without Symptoms of Hypochondria: Survey Study.

BackgroundAn increasing number of people consult physicians because of distressing information found online. Cyberchondria refers to the phenomenon of health anxiety because of online health information.ObjectiveThis study aimed to examine online health research of individuals with and without symptoms of hypochondria and their impact on health anxiety as well as behavior.MethodsAn online survey was conducted. Demographic data, health-related internet use, and general health behavior were assessed. The illness attitude scale was used to record symptoms of hypochondria.ResultsThe final sample consisted of N=471 participants. More than 40% (188/471) of participants showed at least some symptoms of hypochondria. Participants with symptoms of hypochondria used the internet more frequently for health-related purposes and also frequented more online services than individuals without symptoms. Most online health services were rated as more reliable by individuals with symptoms of hypochondria. Changes to behavior such as doctor hopping or ordering nonprescribed medicine online were considered more likely by individuals with symptoms of hypochondria.ConclusionsResults show that individuals with symptoms of hypochondria do not turn to online research as a result of lacking alternatives but rather consult health services on- as well as offline.

Knowledge and perceptions of Indian primary care nurses towards mental illness.

To assess nurses' knowledge and perceptions towards mental illness. This was a cross-sectional descriptive study conducted among 126 randomly selected nurses those are working under District Mental Health program in Karnataka (India). The data was collected through self-reported questionnaires Using the modified version of Public perception of mental illness questionnaire and Attitude Scale for Mental Illness. The findings revealed that majority of the subjects were women (74.4%), Hindus (92.1%) and were from rural background (69.8%). The mean Knowledge score 10.8±1.6 adequate knowledge (maximum possible =12) among 91% of the subjects, and 52% of them hold negative attitudes towards people with mental illness (88.9±13.6). While majority of the subjects hold negative attitudes in 'Separatism' (53.5%), 'Stereotyping' (73%), 'Benevolence' (54%), 'Pessimistic prediction' (53%) domains, they hold positive attitudes in 'Restrictiveness' (88%) and 'Stigmatization' (72%) domains. Women than men endorsed positive attitudes towards persons with mental illness in Stereotyping' (p<0.001), 'Restrictiveness' (p<0.01), 'Benevolence' (p<0.001) and 'Pessimistic prediction' (t= 2.22, p<0.05) domains. Similarly, Auxiliary Nursing Midwifery found to be less restrictive (p<0.05), more benevolent (p<0.001) and less pessimistic (p<0.05) compared to nurses with higher education (General Nursing and Midwifery and Bachelor of Science in Nursing). The present study showed adequate knowledge on mental illness among nurses. Yet they hold stigmatizing and negative attitudes towards mental illness. Hence, it is an urgent priority to develop and implement educational programs to inculcate positive attitudes towards people with mental illness to provide optimal care to this vulnerable population.

Knowledge and perceptions of indian primary care nurses towards mental illness

Objective. To assess nurses’ knowledge and perceptions towards mental illness. Methods. This was a cross-sectional descriptive study conducted among 126 randomly selected nurses those are working under District Mental Health program in Karnataka (India). The data was collected through self-reported questionnaires Using the modified version of Public perception of mental illness questionnaire and Attitude Scale for Mental Illness. Results. The findings revealed that majority of the subjects were women (74.4%), Hindus (92.1%) and were from rural background (69.8%). The mean Knowledge score 10.8±1.6 adequate knowledge (maximum possible =12) among 91% of the subjects, and 52% of them hold negative attitudes towards people with mental illness (88.9±13.6). While majority of the subjects hold negative attitudes in ‘Separatism’ (53.5%), ‘Stereotyping’ (73%), ‘Benevolence’ (54%), ‘Pessimistic prediction’ (53%) domains, they hold positive attitudes in ‘Restrictiveness’ (88%) and ‘Stigmatization’ (72%) domains. Women than men endorsed positive attitudes towards persons with mental illness in Stereotyping’ (p<0.001), ‘Restrictiveness’ (p<0.01), ‘Benevolence’ (p<0.001) and ‘Pessimistic prediction’ (t= 2.22, p<0.05) domains. Similarly, Auxiliary Nursing Midwifery found to be less restrictive (p<0.05), more benevolent (p<0.001) and less pessimistic (p<0.05) compared to nurses with higher education (General Nursing and Midwifery and Bachelor of Science in Nursing). Conclusion. The present study showed adequate knowledge on mental illness among nurses. Yet they hold stigmatizing and negative attitudes towards mental illness. Hence, it is an urgent priority to develop and implement educational programs to inculcate positive attitudes towards people with mental illness to provide optimal care to this vulnerable population.

Hypochondriac concerns and correlates of personality styles and affective states in bipolar I and II disorders

BackgroundHypochondriac concerns are associated with the treatment-difficulty of bipolar disorder, which might be due to the personality styles and affective states.MethodsWe invited outpatients with bipolar I disorder (BD I, n = 87), bipolar II disorder (BD II, n = 92) and healthy volunteers (n = 129) to undergo the Illness Attitude Scales and Parker Personality Measure tests, and measurements of concurrent affective states.ResultsCompared to healthy volunteers, BD I and BD II patients scored significantly higher on mania, hypomania and depression. BD I and BD II patients also scored significantly higher on Symptom Effect and Treatment Seeking, and BD II patients scored higher on Patho-thanatophobia and Hypochondriacal Belief. BD II in addition scored higher on Patho-thanatophobia than BD I did. In controls, the Dependent style predicted Patho-thanatophobia and Symptom Effect, Schizoid with Hypochondriacal Belief; in BD I, Narcissistic (−) with Hypochondriacal Belief, Histrionic with Patho-thanatophobia and Hypochondriacal Belief, depression with Hypochondriacal Belief, and hypomania with Symptom Effect and Hypochondriacal Belief; in BD II, depression with Symptom Effect and Hypochondriacal Belief, mania with Symptom Effect.ConclusionsBipolar disorder, especially BD II, is associated with greater hypochondriac concerns, which relates to personality disorder functioning styles and concurrent affective states.

O10.2. PSYCHOTIC EXPERIENCES ARE ASSOCIATED WITH HEALTH ANXIETY AND FUNCTIONAL SOMATIC SYMPTOMS IN PRE-ADOLESCENCE

BackgroundPsychotic experiences (PE) in children and adolescents include hallucinations, delusions and thought-disturbances in the absence of psychotic disorders. Psychosis can be viewed on a continuum ranging from subclinical PE throughout the life span, to clinical psychosis syndromes. Psychosis and PE often co-occur with anxiety and depression, and several studies point towards an affective pathway to psychosis.Health anxiety (HA) is a relatively new concept in child and adolescent psychiatry, characterized by obsessive rumination, with thoughts about suffering from a disease and misinterpretation of benign bodily sensations and changes. HA at age 11–12 years are associated with emotional disorders and functional somatic symptoms (FSS). In adolescence extensive physical changes occur, and it has been suggested that increased bodily awareness in some cases is accompanied aberrantly by anxiety regarding somatic sensations and somatic health.We hypothesized that PE would be associated with HA and FSS, and that the associations would remain significant after adjustment for general psychopathology, suggesting a particularly strong specific link between these specific psychopathologies over and above the general multidimensionality of psychopathology.MethodsThe study population consists of 1572 children from the general population who participated in the 11–12 year follow-up of the Copenhagen Child Cohort 2000 (CCC2000). PE were assessed face-to-face by the Kiddie Schedule for Affective Disorders and Schizophrenia present and life-time version, and were rated dichotomously as either present (likely or definitely) or not present. HA was self-reported using the Childhood Illness Attitude Scale and FSS were self-reported using the Children’s Somatization Inventory, Child Report Form, revised. HA and FSS were scored dichotomously into high (high 10%) and low (bottom 90%) scores. The associations between PE and HA + FSS were adjusted for i) general psychopathology, rated by parents, using the Strengths and Difficulties Questionnaire total score, ii) chronic physical conditions assessed by parent report, iii) onset of puberty onset defined by Tanner-stage I vs II-IV and iv) sex.ResultsPE were associated with HA (OR 2.91 (CI95% 1.86–4.57)) and FSS (OR 4.61 (CI95% 3.08–6.89)) in univariate analyses. In a mutually adjusted multivariate model which was further adjusted for general psychopathology, puberty, chronic physical conditions and sex, the associations still held significance for both HA (OR 1.73 (CI95% 1.03–2.90)) and FSS (OR 3.39 (CI95% 2.15–5.35)).DiscussionOur study is, to our knowledge, the first to estimate the role of HA and FSS with regard to PE. Our hypothesis, that PE are associated with HA and FSS in pre-adolescence, was confirmed. The statistical effects were reduced, but remained significant after mutual adjustment and adjustment for general psychopathology. This shows that part of the association is confounded by a general load of psychopathology, but also indicates that HA and FSS contribute to PE over and above general psychopathology. Our study warrants further longitudinal studies, exploring if HA and FSS might constitute a specific pathway in psychosis development.

Measurement invariance across Genders on the Childhood Illness Attitude Scales (CIAS)

ObjectiveThe Childhood Illness Attitude Scales (CIAS) were created as a developmentally appropriate measure for symptoms of health anxiety (HA) in school-aged children. Despite overall sound psychometric properties reported in previous studies, more comprehensive examination of the latent structure and potential response bias in the CIAS is needed. The purpose of the present study was to cross-validate the latent structure of the CIAS across genders and to examine gender-specific variations in CIAS scores. MethodsThe sample comprised data from 602 Canadian and Danish school-aged children (Mage=10.54, SD=0.99; 52.5% girls). Confirmatory factor analyses were conducted to test 3-, modified 3-, and 4-factor models in both samples. Multigroup confirmatory factor analysis was performed to test factor structure invariance across boys and girls in a combined sample. Differential Item Functioning (DIF) was assessed using test characteristic curves. ResultsA modified 3-factor solution (i.e., fears=11 items, help-seeking=6 items, and symptom effects=4 items) provided the best fit to the data (χ2 (364, N=602)=681.7, p<0.001; χ2/df=1.803; RMSEA=0.037; CFI=0.926). The factor structure was stable, well-fitting, and indicated measurement invariance across groups. DIF analyses revealed no gender-based response bias at the scale level. ConclusionResults support a revised 3-factor version of the CIAS that can be used with confidence to assess symptoms of HA in school-aged boys and girls.