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Attentional bias toward health-threat in health anxiety: a systematic review and three-level meta-analysis

Published online by Cambridge University Press:  10 January 2022

Congrong Shi Open the ORCID record for Congrong Shi [Opens in a new window] ,
Steven Taylor Open the ORCID record for Steven Taylor [Opens in a new window] ,
Michael Witthöft Open the ORCID record for Michael Witthöft [Opens in a new window] ,
Xiayu Du ,
Tao Zhang ,
Shan Lu  and
Zhihong Ren Open the ORCID record for Zhihong Ren [Opens in a new window]
Congrong Shi
Affiliation:
Key Laboratory of Adolescent Cyberpsychology and Behaviour (Ministry of Education), Key Laboratory of Human Development and Mental Health of Hubei Province, School of Psychology, Central China Normal University, Wuhan, China
Steven Taylor
Affiliation:
Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
Michael Witthöft
Affiliation:
Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes Gutenberg University Mainz, Mainz, Germany
Xiayu Du
Affiliation:
Key Laboratory of Adolescent Cyberpsychology and Behaviour (Ministry of Education), Key Laboratory of Human Development and Mental Health of Hubei Province, School of Psychology, Central China Normal University, Wuhan, China
Tao Zhang
Affiliation:
Key Laboratory of Adolescent Cyberpsychology and Behaviour (Ministry of Education), Key Laboratory of Human Development and Mental Health of Hubei Province, School of Psychology, Central China Normal University, Wuhan, China
Shan Lu
Affiliation:
Key Laboratory of Adolescent Cyberpsychology and Behaviour (Ministry of Education), Key Laboratory of Human Development and Mental Health of Hubei Province, School of Psychology, Central China Normal University, Wuhan, China
Zhihong Ren*
Affiliation:
Key Laboratory of Adolescent Cyberpsychology and Behaviour (Ministry of Education), Key Laboratory of Human Development and Mental Health of Hubei Province, School of Psychology, Central China Normal University, Wuhan, China
*
Author for correspondence: Zhihong Ren, E-mail: ren@ccnu.edu.cn
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Abstract

Attentional bias toward health-threat may theoretically contribute to the development and maintenance of health anxiety, but the empirical findings have been controversial. This study aimed to synthesize and explore the heterogeneity in a health-threat related attentional bias of health-anxious individuals, and to determine the theoretical model that better represents the pattern of attentional bias in health anxiety. Four databases (Web of Science, PubMed, PsycINFO, and Scopus) were searched for relevant studies, with 17 articles (N = 1546) included for a qualitative review and 16 articles (18 studies) for a three-level meta-analysis (N = 1490). The meta-analytic results indicated that the health anxiety group, compared to the control group, showed significantly greater attentional bias toward health-threat (g = 0.256). Further analyses revealed that attentional bias type, paradigm, and stimuli type were significant moderators. Additionally, compared to the controls, health-anxious individuals displayed significantly greater attention maintenance (g = 0.327) but nonsignificant attention vigilance to health-threat (g = −0.116). Our results provide evidence for the attention maintenance model in health-anxious individuals. The implications for further research and treatment of elevated health anxiety in the context of coronavirus disease-2019 (COVID-19) were also discussed.

Keywords

Attentional biasCOVID-19health anxietythree-level meta-analysis
Type
Review Article
Information
Psychological Medicine , Volume 52 , Issue 4 , March 2022 , pp. 604 - 613
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Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press

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