Short Health Anxiety Inventory Research Articles

The anxiety response of patients with severe psychiatric disorders to the recent public health crisis

BackgroundThe devastating health, economic, and social consequences of COVID-19 may harm the already vulnerable groups, particularly people with severe psychiatric disorders (SPDs). The present study was conducted to investigate the anxiety response of patients with SPDs during the COVID-19 pandemic.MethodsA total of 351 patients with SPDs [Schizophrenia Spectrum (SSD), Bipolar (BD), Major Depressive (MDD), and Obsessive-Compulsive (OCD) Disorders] and healthy controls in Guilan province, Iran, throughout 2021–2022 were included in this cross-sectional analytical study. The anxiety response consisted of four concepts: COVID-19-related anxiety, general health anxiety, anxiety sensitivity, and safety behaviors. We conducted an unstructured interview and provided sociodemographic and clinical information. Also, the participants were asked to complete four self-report measures of the Corona Disease Anxiety Scale, the Anxiety Sensitivity Index–Revised, the Short Health Anxiety Inventory, and the Checklist of Safety Behaviors.ResultsAnalysis of variance showed a significant difference between the groups of patients with SPDs and the control group in COVID-19-related anxiety (F = 6.92, p = 0.0001), health anxiety (F = 6.21, p = 0.0001), and safety behaviors (F = 2.52, p = 0.41). No significant difference was observed between them in anxiety sensitivity (F = 1.77, p = 0.134). The Games-Howell test showed that the control group obtained a higher mean than the groups of people with BD (p < 0.0001), SSD (p = 0.033), and OCD (p = 0.003) disorders in COVID-19-related anxiety. The patients with MDD (p = 0.014) and OCD (p = 0.01) had a higher mean score than the control group in health anxiety. Tukey’s test showed that the mean of safety behaviors of the control group was significantly higher than the OCD group (p = 0.21). No significant difference was found between the groups of patients with MDD, BD, SSD, and OCD in terms of COVID-19-related anxiety, health anxiety, and safety behaviors.ConclusionAnxiety response to health crisis is different in groups with SPDs and control group. The findings of this study suggest that although health anxiety is present in many of these patients during the pandemic, their anxiety response to the health crisis may be less than expected. There can be various explanations, such as pre-existing symptoms, low health literacy, and possible co-occurring cognitive impairment. The results of this study have many practical and policy implications in meeting the treatment needs of this group of patients during public health crises and indicate that their needs may not be compatible with the expectations and estimates that health professionals and policymakers already have.

Measuring Hypochondria with Short Health Anxiety Inventory: Psychometric Properties in Colombian University Students

Introduction. The Short Health Anxiety Inventory is a commonly used tool for assessing health anxiety, but its psychometric properties and internal structure have not been examined in a Latin American Spanish-speaking population. This study aimed to establish the psychometric properties among Colombian university students. Method. The goodness of fit of four latent structure models of the Short Health Anxiety Inventory was tested using confirmatory factor analysis in a sample of 1004 Colombian university students. Results. The results show that the original model's structure does not fit well (CFI = .808; RMSEA = .074), and the reliability was .796 and .703 for the original two variables. Conclusions. The findings do not support the utilization of the Colombian version of the Short Health Anxiety Inventory by researchers and clinicians among Colombian university students.

Can’t stop, won’t stop - understanding anxiety’s role in cyberchondria among pregnant women

ABSTRACT Online health research is common during pregnancy, especially if women are facing complications. Given the unpleasant emotions women experience after research, it is surprising that cyberchondria, excessive and repeated online health research caused by anxiety that intensifies such anxiety, has not been studied in pregnant women. Therefore, the aim of this study was to examine the predictors of cyberchondria among women with and without pregnancy complications, accounting for health anxiety (a worry regarding personal health) and pregnancy-specific anxiety (concerns related to pregnancy and childbirth). A total of 360 pregnant women completed a questionnaire consisted of Short Health Anxiety Inventory, Pregnancy Concerns Scale and Short Cyberchondria Scale. The results of one-way MANOVA showed that women who had medically complicated pregnancy had higher levels of health anxiety, pregnancy-specific anxiety and cyberchondria compared to those without complications. A hierarchical multiple regression analysis showed that health anxiety and pregnancy-specific anxiety were predictors of cyberchondria but had different roles depending on complications. Pregnancy-specific anxiety predicted cyberchondria in both groups above health anxiety. Health anxiety predicted cyberchondria only in women without complications. In conclusion, women with complications have a higher chance of experiencing cyberchondria. Pregnancy-specific and health anxiety are risk factors for cyberchondria in pregnant women.

Severe COVID anxiety among adults in the United Kingdom: cohort study and nested feasibility trial

BackgroundPeople with severe COVID anxiety have poor mental health and impaired functioning, but the course of severe COVID anxiety is unknown and the quality of evidence on the acceptability and impact of psychological interventions is low.MethodsA quantitative cohort study with a nested feasibility trial. Potential participants aged 18 and over, living in the UK with severe COVID anxiety, were recruited online and from primary care services. We examined levels of COVID anxiety in the six months after recruitment, and factors that influenced this, using linear regression. Those scoring above 20 on the short Health Anxiety Inventory were invited to participate in a feasibility trial of remotely delivered Cognitive Behavioural Therapy for Health Anxiety (CBT-HA). Exclusion criteria were recent COVID-19, current self-isolation, or current receipt of psychological treatment. Key outcomes for the feasibility trial were the level of uptake of CBT-HA and the rate of follow-up.Results204 (70.2%) of 285 people who took part in the cohort study completed the six month follow-up, for whom levels of COVID anxiety fell from 12.4 at baseline to 6.8 at six months (difference = -5.5, 95% CI = -6.0 to -4.9). Reductions in COVID anxiety were lower among older people, those living with a vulnerable person, those with lower baseline COVID anxiety, and those with higher levels of generalised anxiety and health anxiety at baseline. 36 (90%) of 40 participants enrolled in the nested feasibility trial were followed up at six months. 17 (80.9%) of 21 people in the active arm of the trial received four or more sessions of CBT-HA. We found improved mental health and social functioning among those in the active, but not the control arm of the trial (Mean difference in total score on the Work and Social Adjustment Scale between baseline and follow up, was 9.7 (95% CI = 5.8–13.6) among those in the active, and 1.0 (95% C.I. = -4.6 to 6.6) among those in the control arm of the trial.ConclusionsWhile the mental health of people with severe COVID anxiety appears to improve over time, many continue to experience high levels of anxiety and poor social functioning. Health anxiety is highly prevalent among people with severe COVID anxiety and may provide a target for psychological treatment.Trial registrationRetrospectively registered at ISRCTN14973494 on 09/09/2021.

Illness Anxiety Disorder and Distress among Female Medical and Nursing Students.

This study aims to compare the prevalence of illness anxiety disorder (IAD) and distress between medical and nursing students and examine their associations with students' characteristics. Cross-sectional data were collected using the Short Health Anxiety Inventory (SHAI, for measuring IAD) and the Medical Students' Disease (MSD) Perception and Distress Scales. Two hundred and sixteen Medical students and 250 Nursing students were recruited from a public female university in Saudi Arabia. Their mean age was 21.27 years. The findings showed that the overall prevalence of IAD (SHAI scores ≥18) among the total sample was 38.8%, with a significantly lower prevalence in medical students compared to the prevalence in nursing students (57.2% vs 17.6%, respectively, X2=45.26, p<.001). Nursing students had significantly higher SHAI scores and lower MSD Perception scores than medical college students, but there were no significant differences among them in the MSD Distress scale. Significant differences in the main study variables scores were reported among nursing students but not among medical students, with the fourth-year level nursing students having higher SHAI and lower MSD Perception and perception scores than other nursing students. The highlights that medical and nursing students are susceptible to developing anxiety-related disorders and distress that may have negative impacts on their academic achievements and future careers. Both nursing and medical faculty should help in identifying strategies to support the students' mental health and well-being.

Association between health anxiety dimensions and preventive behaviors during the COVID-19 pandemic among Japanese healthcare workers

ObjectiveHealth anxiety (HA), defined as excessive worry about having a serious medical condition, may affect preventive behaviors during the coronavirus disease 2019 (COVID-19) pandemic. We examined the distinct role of two dimensions of HA—perceived likelihood (probability dimension) and awfulness of illness (awfulness dimension)—in self-protection, as reflected in preventive behaviors during the pandemic. MethodsParticipants comprised 657 healthcare workers. Data were collected between February 24 and 26, 2021. The Short Health Anxiety Inventory determined the HA dimensions. Adherence to the government's recommendations for COVID-19 preventive behaviors was self-rated. An independent association between each HA dimension and participants' adherence to the recommendations was examined using multivariable regression. ResultsWithin the analyzed sample of 560 subjects, severe HA was observed in 9.1 %. The more the participants felt awful, the less frequently they engaged in the recommended preventive behaviors (adjusted odds ratio = 0.993, 95 % confidence interval: 0.989, 0.998, p = 0.003) regardless of their profession, working position, psychological distress, sleep disturbance, and current physical diseases. However, the probability dimension was not associated with their preventive behaviors. ConclusionThe awfulness dimension of HA could be a more sensitive marker of preventive behaviors than the probability dimension. Paying particular attention to the awfulness dimension may help optimize self-protection strategies during the COVID-19 pandemic. A two-dimensional understanding of HA may be useful for the maintenance of the healthcare system and public health as well as healthcare workers’ own health.

B - 107 Exploratory Analysis of the Relationship between Health Anxiety (HA) and Neuropsychological Performance in a Validity Controlled Sample of Patients with Post-Acute Sequelae of COVID-19 (PASC).

Since the emergence of COVID-19, research has consistently indicated cognitive difficulties as a primary complaint after infection (Altuna et al., 2021). It is unclear to what extent these cognitive deficits may be attributable to, or exacerbated by, health anxiety (HA) (Venkataramani et al., 2022). This study explored the relationship between HA and cognition in a performance validity controlled sample of patients with PASC complaints. Participants included patients referred for a focused neuropsychological evaluation for persistent cognitive complaints after COVID infection (N = 19). Participants were excluded for Test of Memory Malingering scores below standard cutoff. The sample mean age was 43years (SD = 12.9), 57.9% were female, and 47.4% were from minority racial/ethnic groups. HA was assessed using the Short Health Anxiety Inventory (SHAI). Cognitive abilities were measured using the Wechsler Adult Intelligence Scale-IV (WAIS-IV: Processing Speed Index [PSI]; Letter-Number Sequencing [LNS]) and Trail Making Test Part-A (TMT-A). Regression analyses were conducted to assess the extent to which HA predicts cognitive performance. The SHAI main subscale significantly predicted TMT-A [β= -3.93, p < 0.01] and WAIS-IV PSI [β= -4.60, p = 0.04]. The SHAI negative consequences subscale significantly predicted TMT-A [β= -4.64, p = 0.04] and WAIS-IV LNS [β= 0.49, p = 0.048]. Findings suggest that general HA predicted PSI, while fear of negative health outcomes predicted LNS. Basic attention abilities were predicted by global HA. Future studies will benefit from evaluating the moderating effect of HA on the relationship between subjective symptom severity and cognition.

Association of health anxiety, fatalism and medication adherence among geriatric clients: An exploratory study

ObjectivesThis study explored the relationship between health anxiety, fatalistic beliefs, and medication adherence among geriatric clients. Also, it determines the extent to which health anxiety and fatalism can predict the variance in medication adherence among the same population of geriatric clients. DesignA cross-sectional analytical survey on 200 eligible participants using the Arabic Version of the Short Health Anxiety Inventory, Fatalism Scale, and Morisky Medication Adherence Scale-8 items. ResultsThe study found a statistically significant negative relationship between the studied geriatric clients' fatalism and health anxiety and their medication adherence (r = -0.160, - 0.187, and P = 0.024, 0.008), respectively. ConclusionThis study highlights the importance of considering psychological factors such as health anxiety and fatalistic beliefs in addressing medication adherence among geriatric clients. By addressing these factors, healthcare providers can develop more effective strategies to improve medication adherence and ultimately improve the health outcomes of geriatric clients.

Psychosocial correlates of well-being among people who engage in online health-seeking behaviour

We examined the extent to which neuroticism, health anxiety, social anxiety, and social support predicted well-being in a sample of online users engaging in health-seeking behaviour. We used a cross-sectional online survey to recruit participants who engaged in online health-seeking behaviour. The study included 350 participants who were recruited online using social media platforms such as Reddit and Twitter. A multiple regression was conducted to examine the relationships between neuroticism, health anxiety, social anxiety, social support, and well-being. Participants completed a battery of measures on Survey Monkey consisting of a demographic questionnaire, International Personality Item Pool Big Five Markers, Leibowitz Social Anxiety scale, Short Health Anxiety Inventory, World Health Organisation Five Well-Being Index, and the Multidimensional Scale of Perceived Social Support. We found significant negative correlations between the indicated psychological variables and well-being, indicating that higher levels of neuroticism, social anxiety, and health anxiety were related to lower levels of well-being. We also found significant, positive correlations between the social support variables and well-being, indicating that more social support was correlated with better well-being. The results of the multiple regression demonstrate that neuroticism, health anxiety, family support, and friend support were significant predictors of well-being.

The Relationship Between Health Anxiety and Caregiver Burden in Informal Caregivers of Patients with COVID-19

Background: Irrational health anxiety increases due to insufficient information about COVID-19 and misinterpretation of allergy symptoms in favor of COVID-19. The disease increases the caregiver burden in informal caregivers and, subsequently, causes physical and mental disorders for them and negatively affects the provision of care for patients. Objectives: This study aimed to examine the relationship between health anxiety and caregiver burden in informal caregivers of patients with COVID-19. Methods: In this cross-sectional and correlational study, the convenient sampling method was adopted to select 340 informal caregivers of patients with COVID-19 who were discharged during the last three weeks of hospitalization in Vasei Hospital of Sabzevar City, Iran, in 2021. To collect the required data, the online links of the demographic information questionnaire, Salkoviskis's short health anxiety inventory (SHAI), and Novak and Guest's Caregiver Burden Inventory (CBI) were sent to the subjects through messengers. The data were analyzed using SPSS 22 as well as descriptive and analytical statistics. Results: According to the results, the mean caregiver burden score in informal caregivers of patients with COVID-19 was 69.72 ± 14.91, and the mean health anxiety score was 16.22 ± 8.24. Pearson's test results were indicative of a significant relationship between caregiver burden and health anxiety (P &lt; 0.001). Conclusions: Since a significant relationship was found between health anxiety and caregiver burden in informal caregivers of patients with COVID-19 in this study, it was argued that the health of informal caregivers was an important health issue certainly deserving serious attention of the health service providers.

The Role of COVID-19 Pandemic Anxiety and Perceptions in COVID-19 Vaccination

IntroductionSince stress and anxiety are significant manifestations of psychological distress during the COVID-19 pandemic, we studied their role in making a decision about vaccination.ObjectivesTo study the relationship between the intention to be vaccinated against COVID-19 with health anxiety and stress levels.MethodsThe methodological complex includes the author’s socio-demographic questionnaire (Pervichko, 2020, 2021, 2022); the questionnaire “Scale of perceived stress-10” (Ababkov, 2016); the questionnaire “Perceptions of the COVID-19 pandemic” (Pervichko et al., 2020), developed on the basis of the Russian-language version of the E. Broadbent’s short questionnaire about the perception of disease (Broadbent, 2006); the State-Trait Anxiety Inventory (STAI) (Spielberger, 2002) and the “Short Health Anxiety Inventory” (Pervichko et al., 2020).The study involved 232 respondents who did not have COVID-19 (average age – 29.1 ± 13.7 years). Among the respondents, 68.5% have already been vaccinated, 23.3% do not plan to be vaccinated and 8.2% plan to perform the procedure.ResultsThe methodological complex includes the author’s socio-demographic questionnaire (Pervichko, 2020, 2021, 2022); the questionnaire “Scale of perceived stress-10” (Ababkov, 2016); the questionnaire “Perceptions of the COVID-19 pandemic” (Pervichko et al., 2020), developed on the basis of the Russian-language version of the E. Broadbent’s short questionnaire about the perception of disease (Broadbent, 2006); the State-Trait Anxiety Inventory (STAI) (Spielberger, 2002) and the “Short Health Anxiety Inventory” (Pervichko et al., 2020).The study involved 232 respondents who did not have COVID-19 (average age – 29.1 ± 13.7 years). Among the respondents, 68.5% have already been vaccinated, 23.3% do not plan to be vaccinated and 8.2% plan to perform the procedure.ConclusionsHigher health anxiety, situational anxiety, perceived stress, and greater perceived life threat due to coronavirus contribute to COVID-19 immunization procedures, which is accompanied by perceptions of greater control of the pandemic.Disclosure of InterestNone Declared

Investigation of coronavirus anxiety, health anxiety, and anxiety symptom levels in vertigo patients during COVID-19 pandemic.

The COVID-19 pandemic adversely affects the mental health of vertigo patients. Thus, this study aimed to investigate the effects of coronavirus anxiety, health anxiety, anxiety symptom levels, and demographic variables on vertigo and its severity in vertigo patients during the pandemic. This cross-sectional study was conducted from May 15 to November 15, 2021. In total, 118 patients with vertigo and 82 healthy controls participated in the study. Besides demographic and clinical data, Coronavirus Anxiety Scale (CAS), Hospital Anxiety Depression Scale-Anxiety Subscale (HAD-A), and Short Health Anxiety Inventory (SHAI) were applied to all participants. Additionally, Vertigo Symptom Scale-Short Form (VSS-SF) was administered to vertigo patients. According to the findings, vertigo patients experienced higher levels of coronavirus anxiety, health anxiety, and anxiety disorder compared to the healthy controls. In vertigo patients, the rate of coronavirus anxiety was 20.3%, and the rate of anxiety disorder was 32.2%. Majority of the patients (80.5%) were found to have severe-level vertigo. Additionally, most of the patients (82.1%) reported that the severity of vertigo during the pandemic was higher than before the pandemic. The COVID-19 pandemic causes serious mental health problems in vertigo patients, and pathological levels of these problems increase the discomfort of vertigo. Therefore, psychological assessment should be considered in these patients, and required psychological support and guidance services should be provided.

Investigating the correlation between perceived stress and health anxiety with obsessive–compulsive disorder and quality of life during COVID-19 pandemic

Background and aimsThe present study aimed to investigate the correlation between perceived stress and health anxiety with obsessive–compulsive symptoms and quality of life during COVID-19 pandemic.MethodsThis cross-sectional study was performed in the general public in Isfahan and Bandar Abbas. 559 citizens were selected by convenience sampling. An online questionnaire was used to collect the data, which consisted of: short health anxiety inventory, perceived stress scale, world health organization quality of life questionnaire and Padua inventory. Data analysis was performed using SPSS-24 and Amos-21.ResultsThere were significant positive correlations between health anxiety and perceived stress (r = 0/338), obsessive–compulsive symptoms and perceived stress (r = 0/16), obsessive–compulsive symptoms and health anxiety (r = 0/344). Also there were significant negative correlations between obsessive–compulsive symptoms and quality of life (r = − 0/21), health anxiety and quality of life (r = − 0/366), perceived stress and quality of life (r = − 0/715).Conclusionhealth anxiety and perceived stress during COVID-19 affect the obsessive–compulsive symptoms and quality of life. Therefore, it is recommended to pay attention to these psychological disorders during this global crisis and take actions to prevent and treat them.

Cognitive behavior therapy for diabetes distress, depression, health anxiety, quality of life and treatment adherence among patients with type-II diabetes mellitus: a randomized control trial

ObjectiveDiabetes distress typically causes depressive symptoms; common comorbidity of diabetes unpleasantly affects patients’ medical and psychological functions. Psychotherapeutic interventions are effective treatments to treat depressive symptoms and to improve the quality of life in many chronic diseases including diabetes. The present study investigated the efficacy of cognitive behavior therapy (CBT) to treat depressive symptoms in patients with type 2 diabetes mellitus (T2DM) using experimental and waitlist control conditions.Materials and MethodsA total of 130 diagnosed patients with T2DM were taken from outdoor patients services of different hospitals in Faisalabad. Ninety patients met the eligibility criteria and were randomly assigned to experimental (n = 45) and waitlist control (n = 45) conditions. All the patients completed clinical interviews and assessment measures at pre-and post-assessment stages (16 weeks intervals). Medical consultants at the respective hospitals diagnosed the patients on the base of their medical reports and then referred those patients to us. Then we used different scales to assess primary and secondary outcomes: Diabetes Distress Scale (DDS) and Patient Health Questionnaire (PHQ) to assess primary outcomes, and a Short Health Anxiety Inventory (SHAI), a Revised Version of the Diabetes Quality of Life Questionnaire (DQLQ), and a General Medication Adherence Scale (GMAS) were used to investigate secondary outcomes. Repeated measure ANOVA was used to analyze the results.ResultsThe findings indicated that patients who received CBT got a significant reduction in their diabetes distress F(1,60) = 222.710, P < 0.001, η2 = .788), depressive symptoms F(1,60) = 94.436, P < 0.001, η2 = .611), health anxiety F(1,60) = 201.915, P < .0.001, η2 = 771), and a significant improvement in their quality of life F(1,60) = 83.352, P < 0.001, η2 = .581), treatment adherence F(1,60) = 67.579, P < 0.001, η2 = .566) and physical activity schedule F(1,60) = 164.245, P < .0.001, η2 = .736 as compared to the patients in waitlist control condition.ConclusionIt is concluded that cognitive behavior therapy is an effective and promising intervention for depressive symptoms, diabetes distress, and health anxiety which also helps the person to promote quality of life, treatment adherence and physical activity.

Prevalence and correlates of health anxiety among medical students: a cross-sectional study from the United Arab Emirates

BackgroundIt is often reported that medical students repeatedly develop health anxiety related to the diseases that they are studying. To the best of our knowledge, health anxiety has not been investigated in medical students in the United Arab Emirates (UAE). Therefore, we aimed to investigate the prevalence of health anxiety among a sample of medical students attending the United Arab Emirates University (UAEU). We conducted a cross-sectional study of 193 undergraduate medical students (68 males, 125 females) across the 6 years of the College of Medicine at the UAEU. Students were screened for health anxiety using the Short Health Anxiety Inventory (SHAI).ResultsEighteen students (9.3%) reached the threshold for clinically significant health anxiety on the SHAI (score ≥ 27). There was no statistically significant difference between those with and those without health anxiety in age, gender, place of origin, or year of study. There was a statistically significant difference (p < 0.05) between the two groups as regards a past history of medical or mental health conditions influencing their choice of college. No specific student demographic or background characteristics significantly predicted the occurrence of clinically significant health anxiety.ConclusionsHealth anxiety was prevalent in a significant proportion of subjects in our sample (almost one in every ten students). Individual experiences of medical and mental illness may play a role in the development of health anxiety and in the choice of studying medicine.

Hypochondriasis in Graves’ disease: the role of pathologic factors and clinical characteristics endocrinopathy

Clinical qualification of hypochondriasis or illness anxiety disorder (IAD) in Graves' disease (GD) and verification of associated personality and endocrinological factors. A sample consisted of 27 patients (25 female and 2 male, mean age 48.4 years) with GD and personality disorders (PDs). The patients were examined clinically and with interviews for the assessment of PD according to DSM-IV (SCID-II-PD) and the Short Health Anxiety Inventory (SHAI). IAD was diagnosed in 8 cases (29.6%), of which the main study group was formed. The remaining 19 patients, who did not show signs of IAD, were assigned to the control group. In the main group, the average score on the SHAI «health anxiety» subscale was significantly higher (10.2 vs 4.8 points, p<0.05) corresponding to the clinical qualification of the condition as IAD. When assessing the frequency of categorical PDs, it was found that there were no affective PDs in the main group, likewise there were no anxiety cluster PDs in the control group (p<0.05). In turn, in the main group, PDs were characterized by such dimensions as the phenomena of psychopathological diathesis, reactive lability, neuropathy, which were not observed in the control group. The endocrinological factor that differed significantly in main and control groups was the frequency of recurrence of GD (75.0% vs, 40.1%, p<0.05). Despite the generally relatively favourable prognosis of GD, there is a significant frequency of IAD, the key role in the formation of which is apparently played by the parameters of the premorbid characteristics, as well as GD recurrence.

Personality Pathology and Functional Impairment in Patients With Hypochondriasis.

Research indicates substantial co-occurance of personality pathology and hypochondriasis, which both involve significant psychosocial impairment. This study sought to investigate the role of personality pathology for explaining functional impairment in patients with hypochondriasis, while accounting for the influence of health anxiety severity. Patients diagnosed with hypochondriasis (N=84; 60% women) were administered interview- and self-report instruments for personality pathology, health anxiety severity, and functional impairment (general, social, and physical): The Structured Clinical Interview for DSM-IV Axis II (SCID-II), the Personality Inventory for DSM-5 (PID-5), the Short Health Anxiety Inventory (SHAI), the 36-item Short Form health survey (SF-36), and the Global Assessment of Functioning (GAF). Hierarchical regression analyses were performed with boot-strapping (1000 samples). Findings overall showed that personality pathology incrementally explained functional impairment over the influence of health anxiety severity. More specifically, findings revealed that the incremental effect of PID-5 trait dimensions was substantially larger than the SCID-II personality disorder criterion-count. Functional impairment was specifically associated with SCID-II symptoms of Avoidant Personality disorder and dependent personality disorder as well as PID-5 trait domains of negative affectivity, detachment, and psychoticism. The findings highlight the potential significance of personality pathology for understanding and clinical management of functional impairment in patients with hypochondriasis. The personality features that best explained functional impairment were avoidant personality disorder and dependent personality disorder and, in particular, DSM-5 and the International Classification of Diseases, 11th revision personality trait domains of negative affectivity, detachment, and psychoticism.

The role of emotional functioning in the relationship between health anxiety and cyberchondria

Access to health information can have positive effects in the form of increased health awareness. However, self-diagnosis based on information available on websites can be dangerous, causing distress as an increasing amount of time is spent on searching. The main aim of the study was to determine the role of emotional functioning in the relationship between health anxiety and cyberchondria. The study included N = 615 participants aged 18 to 83 years (M = 43.86, SD = 14.57). The authors used the Cyberchondria Severity Scale, the Short Health Anxiety Inventory, the Life Orientation Test, the Difficulties in Emotion Regulation Scale, and the Kessler 6 Psychological Distress Scale. The results demonstrate that health anxiety is significantly related to cyberchondria and that pessimism and difficulties in emotion regulation act as mediators in this relationship.

Impact and attitudes toward genetic counseling and testing in individuals at high risk for familial Alzheimer’s Disease.

AbstractBackgroundPre‐symptomatic genetic testing for individuals with dominantly inherited Alzheimer’s disease (DIAD) is now attracting interest due to the existence of therapeutic trials available to this population. Although the impact and the main drivers influencing the decision to seek genetic testing have been widely studied in High‐Income Countries, these reasons remain relatively unknown in Latin America (LatAm).MethodsThis study was designed to explore attitudes toward genetic testing and the impact of finding a disease‐causing mutation for early‐onset Alzheimer’s disease. The genetic counseling sessions, included a culturally sensitive program, developed in collaboration with local experts. Asymptomatic, first‐degree relatives of patients with Alzheimer’s disease dementia from an extended Colombian family (∼300) with a presenilin 1 pathogenic variant (p. I416T) were interviewed before and after genetic testing. Pre and post genetic counseling and testing measurements included the Montgomery Depression Scale, the Zung Anxiety Rating, and Genetic Counseling Outcome Scale. Primary analyses examined change in anxiety and depression scores 3 months after disclosure using linear mixed effects models and chi‐squared tests. Secondary outcomes included short Health Anxiety Inventory and knowledge about Alzheimer disease.ResultsTwenty‐five participants were invited and enrolled in the study (Figure 1). Nineteen individuals completed the genetic counseling sessions and 8/18 (44.4%) learned their genetic status. Three months after genetic status disclosure, we found no significant differences between the group that learned their genetic status and those how did not learn their genetic status in anxiety (mean = 13.5, SD = 3.2 vs. 15.1, SD = 2.5, p = 0.2) or depression (mean = 5.4, SD = 2.3 vs mean = 8.0, SD = 6.5, p = 0.6) scores. For both groups, anxiety and depression scores remained below cutoffs for clinical concern and without significant changes relative to baseline values levels.ConclusionOur pilot study shows that a structured genetic counseling and testing protocol for individuals at‐risk of DIAD is safe and and may provide psychological benefits. Future studies should include larger cohorts and expand to other countries in LatAm.

There is Little or No Association Between Independently Assessed Communication Strategies and Patient Ratings of Clinician Empathy.

Quality of care is increasingly assessed and incentivized using measures of patient-reported outcomes and experience. Little is known about the association between measurement of clinician communication strategies by trained observers and patient-rated clinician empathy (a patient-reported experience measure). An effective independent measure could help identify and promote clinician behaviors associated with good patient experience of care. (1) What is the association between independently assessed clinician communication effectiveness and patient-rated clinician empathy? (2) Which factors are associated with independently assessed communication effectiveness? One hundred twenty adult (age > 17 years) new or returning patients seeking musculoskeletal specialty care between September 2019 and January 2020 consented to video recording of their visit followed by completion of questionnaires rating their perceptions of providers' empathy levels in this prospective study. Patients who had operative treatment and those who had nonoperative treatment were included in our sample. We pooled new and returning patients because our prior studies of patient experience found no influence of visit type and because we were interested in the potential influences of familiarity with the clinician on empathy ratings. We did not record the number of patients or baseline data of patients who were approached, but most patients (> 80%) were willing to participate. For 7% (eight of 120 patients), there was a malfunction with the video equipment or files were misplaced, leaving 112 records available for analysis. Patients were seen by one provider among four attending physicians, four residents, or four physician assistants or nurse practitioners. The primary study question addressed the correlation between patient-rated clinician empathy using the Jefferson Scale of Patient Perceptions of Physician Empathy and clinician communication effectiveness, independently rated by two communication scholars using the Liverpool Communication Skills Assessment Scale. Based on a subset of 68 videos (61%), the interrater reliability was considered good for individual items on the Liverpool Communication Skills Assessment Scale (intraclass correlation coefficient [ICC] 0.78 [95% confidence interval (CI) 0.75 to 0.81]) and excellent for the sum of the items (that is, the total score) (ICC = 0.92 [95% CI 0.87 to 0.95]). To account for the potential association of personal factors with empathy ratings, patients completed measures of symptoms of depression (the Patient-Reported Outcome Measurement Information System depression computerized adaptive test), self-efficacy in response to pain (the two-item Pain Self-Efficacy Questionnaire), health anxiety (the five-item Short Health Anxiety Inventory), and basic demographics. Accounting for potentially confounding variables, including specific clinicians, marital status, and work status in the multivariable analysis, we found higher independent ratings of communication effectiveness had a slight association (odds ratio [OR] 1.1 [95% CI 1.0 to 1.3]; p = 0.02) with higher (dichotomized) ratings of patient-rated clinician empathy, while being single was associated with lower ratings (OR 0.40 [95% CI 0.16 to 0.99]; p = 0.05). Independent ratings of communication effectiveness were slightly higher for women (regression coefficient 1.1 [95% CI 0.05 to 2.2]); in addition, two of the four attending physicians were rated notably higher than the other 10 participants after controlling for confounding variables (differences up to 5.8 points on average [95% CI 2.6 to 8.9] on a 36-point scale). The observation that ratings of communication effectiveness by trained communication scholars have little or no association with patient-rated clinician empathy suggests that either effective communication is insufficient for good patient experience or that the existing measures are inadequate or inappropriate. This line of investigation might be enhanced by efforts to identify clinician behaviors associated with better patient experience, develop reliable and effective measures of clinician behaviors and patient experience, and use those measures to develop training approaches that improve patient experience. Level I, prognostic study.