Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-14T06:19:22.334Z Has data issue: false hasContentIssue false
  • English
  • Français

A taxometric analysis of health anxiety

Published online by Cambridge University Press:  19 May 2008

E. Ferguson
E. Ferguson*
Affiliation:
Risk Analysis, Social Processes and Health (RASPH) Group, School of Psychology, University of Nottingham, UK
*
*Address for correspondence: Professor E. Ferguson, Risk Analysis, Social Processes and Health (RASPH) Group, School of Psychology, University of Nottingham, Nottingham NG7 2RD, UK. (Email: eamonn.ferguson@nottinghham.ac.uk)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

A long-standing issue in the health anxiety literature is the extent to which health anxiety is a dimensional or a categorical construct. This study explores this question directly using taxometric procedures.

Method

Seven hundred and eleven working adults completed an index of health anxiety [the Whiteley Index (WI)] and indicated their current health status. Data from those who were currently healthy (n=501) and receiving no medical treatment were examined using three taxometric procedures: mean above minus below a cut (MAMBAC), maximum eigenvalue (MAXEIGEN) and L-mode factor analysis (L-MODE).

Results

Graphical representations (comparing actual to simulated data) and fit indices indicate that health anxiety is more accurately represented as a dimensional rather than a categorical construct.

Conclusions

Health anxiety is better represented as a dimensional construct. Implications for theory development and clinical practice are examined.

Keywords

Assessmentdiagnosishypochondriasismeasurementtaxometric
Type
Original Articles
Information
Psychological Medicine , Volume 39 , Issue 2 , February 2009 , pp. 277 - 285
Copyright
Copyright © 2008 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Association: Washington, DC.Google Scholar
Barsky, AJ (1979). Patients who amplify bodily sensations. Annals of Internal Medicine 91, 63–70.CrossRefGoogle ScholarPubMed
Barsky, AJ, Coeytaux, RR, Sarnie, MK, Cleary, PD (1993). Hypochondriacal patients' beliefs about good health. American Journal of Psychiatry 150, 1085–1089.Google ScholarPubMed
Barsky, AJ, Frank, CB, Cleary, PD, Wyshak, G, Klerman, GL (1991). The relationship between hypochondriasis and age. American Journal of Psychiatry 148, 923–928.Google Scholar
Barsky, AJ, Wyshak, G, Klerman, GL (1986). Hypochondriasis. Archives of General Psychiatry 43, 493–500.CrossRefGoogle ScholarPubMed
Barsky, AJ, Wyshak, G, Klerman, GL (1990). Transient hypochondriasis. Archives of General Psychiatry 47, 746–752.CrossRefGoogle ScholarPubMed
Baune, BT, Adrian, I, Jacobi, F (2007). Medical disorders affect health outcome and general functioning depending on comorbid major depression in the general population. Journal of Psychosomatic Research 62, 109–118.CrossRefGoogle ScholarPubMed
Boissonnault, WG, Badke, MB (2005). Collecting health history information: the accuracy of a patient self-administered questionnaire in an orthopedic outpatient setting. Physical Therapy 85, 531–543.CrossRefGoogle Scholar
Bradford, VP, Graham, BP, Reinert, KG (1993). Accuracy of self-reported health histories: a study. Military Medicine 158, 264–265.CrossRefGoogle ScholarPubMed
Brown, HD, Kosslyn, SM, Delmater, B, Fama, J, Barsky, A (1999). Perceptual and memory biases for health-related information in hypochondriacal individuals. Journal of Psychosomatic Research 47, 67–78.CrossRefGoogle ScholarPubMed
Cleary, PD, Jette, AM (1984). The validity of self-reported physician utilization measures. Medical Care 22, 796–803.CrossRefGoogle ScholarPubMed
Cohen, J, Cohen, P (1983). Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences. Lawrence Erlbaum Associates: London.Google Scholar
De Boeck, P, Wilson, M, Acton, GS (2005). A conceptual and psychometric framework for distinguishing categories from dimensions. Psychological Bulletin 112, 129–158.Google ScholarPubMed
Ferguson, E (2000). Hypochondriacal concerns and the five-factor model of personality. Journal of Personality 68, 705–724.CrossRefGoogle ScholarPubMed
Ferguson, E (2004). Personality as a predictor of hypochondriacal concerns: results from two longitudinal studies. Journal of Psychosomatic Research 56, 307–312.CrossRefGoogle ScholarPubMed
Ferguson, E (2005). Hypochondriasis: defining boundaries, exploring risk factors and immunology. In Somatoform Disorders (WPA Series in Evidence and Experience in Psychiatry) (ed.Maj, M., Akiskal, H. S., Mezzich and, J. E.Okasha, A.), vol. 9, pp. 170–172. Wiley: New York.Google Scholar
Ferguson, E (2008). Health anxiety moderates the day-time cortisol slope. Journal of Psychosomatic Research 64, 487–494.CrossRefGoogle Scholar
Ferguson, E, Moghaddam, NG, Bibby, PA (2007). Memory bias in health anxiety is related to the emotional valence of health related words. Journal of Psychosomatic Research 62, 263–274.CrossRefGoogle Scholar
Fink, P, Ewald, H, Jensen, J, Sorensen, L, Engberg, M, Holm, M, Munk-Jorgensen, P (1999). Screening for somatisation and hypochondriasis in primary care and neurological in-patients: a seven-item scale for hypochondriasis and somatisation. Journal of Psychosomatic Research 46, 261–273.CrossRefGoogle Scholar
Fink, P, Ornbol, E, Toft, T, Sparle, KC, Frostholm, L, Olesen, F (2004). A new, empirically established hypochondriasis diagnosis. American Journal of Psychiatry 161, 1680–1691.CrossRefGoogle ScholarPubMed
Gupta, S, Mitchell, I, Giuffre, RM, Crawford, S (2001). Covert fears and anxiety in asthma and congenital heart disease. Child: Care, Health and Development 47, 335–348.CrossRefGoogle Scholar
Hadjistavropoulos, HD, Hadjistavropoulos, T, Quine, A (2000). Health anxiety moderates the effect of distraction versus attention to pain. Behaviour Research and Therapy 38, 425–438.CrossRefGoogle ScholarPubMed
Haug, TT, Svebak, S, Wilhelsen, I, Berstad, A, Ursin, H (1994). Psychological factors and somatic symptoms in functional dyspepsia: a comparison with duodenal ulcer and health controls. Journal of Psychosomatic Research 38, 281–291.CrossRefGoogle Scholar
Hiller, W, Rief, W, Fichter, MM (2002). Dimensional and categorical approaches to hypochondriasis. Psychological Medicine 32, 707–718.CrossRefGoogle ScholarPubMed
Katon, W, Russo, J, Ashley, RL, Buchwald, D (1999). Infectious mononucleosis: psychological symptoms during acute and sub-acute phases of illness. General Hospital Psychiatry 21, 21–29.CrossRefGoogle Scholar
Kellner, R (1986). Somatization and Hypochondriasis. Prager: New York.Google Scholar
Kessler, RC (2002). Epidemiology perspectives for the development of future diagnostic systems. Psychopathology 35, 158–161.CrossRefGoogle ScholarPubMed
Looper, KJ, Kirmayer, LJ (2001). Hypochondriacal concerns in a community population. Psychological Medicine 31, 577–584.CrossRefGoogle Scholar
MacLeod, AK, Haynes, C, Sensky, T (1998). Attributions about common bodily sensations: their associations with hypochondriasis and anxiety. Psychological Medicine 28, 225–228.CrossRefGoogle ScholarPubMed
Marcus, DK, Gurely, JR, Marchi, MM, Bauer, C (2007). Cognitive and perceptual variables in hypochondriasis and health anxiety: a systematic review. Clinical Psychology Review 27, 127–139.CrossRefGoogle ScholarPubMed
Marcus, DK, John, SL, Edens, JF (2004). A taxometric analysis of psychopathic personality. Journal of Abnormal Psychology 113, 626–635.CrossRefGoogle ScholarPubMed
Marcus, DK, Lilienfeld, SO, Edens, JF, Poythress, NG (2006). Is antisocial personality disorder continuous or categorical? A taxometric analysis. Psychological Medicine 36, 1571–1581.CrossRefGoogle ScholarPubMed
Meehl, PE (1995). Bootstrap taxometrics: solving the classification problem in psychopathology. American Psychologist 50, 266–275.CrossRefGoogle ScholarPubMed
Meehl, PE, Golden, R (1982). Taxometric methods. In Handbook of Research Methods in Clinical Psychology (ed.Kendall and, P.Butcher, I.), pp. 127–181. Wiley: New York.Google Scholar
Meehl, PE, Yonce, LJ (1994). Taxometric analysis. I: Detecting taxonicity with two quantitative indicators using means above and below a sliding cut (MAMBAC procedure). Psychological Reports 74, 1059–1274.Google Scholar
Noyes, R (2005). Hypochondriasis: a review. In Somatoform Disorders (WPA Series in Evidence and Experience in Psychiatry) (ed.Maj, M., Akiskal, H. S., Mezzich, J. E. and Okasha, A.), vol. 9, pp. 129–160. Wiley: New York.Google Scholar
Noyes, R, Carney, CP, Hillis, SL, Jones, LE, Langbehn, DR (2005). Prevalence and correlates of illness worry in the general population. Psychosomatics 46, 529–539.CrossRefGoogle ScholarPubMed
Noyes, R, Hartz, AJ, Doebbeling, CG, Malis, RW, Happel, RL, Werner, LA, Yagla, SJ (2000). Illness fears in the general population. Psychosomatic Medicine 62, 318–325.CrossRefGoogle ScholarPubMed
Noyes, R, Stuart, SP, Langbehn, DR, Happel, RL, Longley, SL, Muller, BA, Yagla, SJ (2003). Test of an interpersonal model of hypochondriasis. Psychosomatic Medicine 65, 292–300.CrossRefGoogle ScholarPubMed
Noyes, R, Watson, DB, Carney, CP, Letuchy, EM, Peloso, PM, Black, DW, Doebbeling, BN (2004). Risk factors for hypochondriacal concerns in a sample of military veterans. Journal of Psychosomatic Research 57, 529–539.CrossRefGoogle Scholar
Office for National Statistics. National Statistics Online (www.statistics.gov.uk/). Age data (www.statistics.gov.uk/cci/nugget.asp?id=6). Sex and age trends (www.statistics.gov.uk/downloads/theme_social/Social_Trends37/Social_Trends_37.pdf). Accessed 11 December 2007.Google Scholar
Pauli, P, Alpers, GW (2002). Memory bias in patients with hypochondriacal and somatoform disorder. Journal of Psychosomatic Research 52, 45–53.CrossRefGoogle Scholar
Pilowsky, I (1967). Dimensions of hypochondriasis. British Journal of Psychiatry 113, 89–93.CrossRefGoogle ScholarPubMed
Rief, W, Hessel, A, Braehler, E (2001). Somatization symptoms and hypochondriacal features in the general population. Psychosomatic Medicine 63, 595–602.CrossRefGoogle ScholarPubMed
Ruscio, J, Haslam, N, Ruscio, AM (2006). Introduction to the Taxometric Method: A Practical Guide. Lawrence Erlbaum Associates: Mahwah, NJ.Google Scholar
Ruscio, J, Ruscio, AM (2004 a). A nontechnical introduction to the taxometric method. Understanding Statistics 3, 151–194.CrossRefGoogle Scholar
Ruscio, J, Ruscio, AM (2004 b). Clarifying boundary issues in psychopathology: the role of taxometrics in a comprehensive program of structural research. Journal of Abnormal Psychology 113, 24–38.CrossRefGoogle Scholar
Ruscio, J, Ruscio, AM, Keane, TM (2004). Using taxometric analysis to distinguish a small latent taxon from a latent dimension with positively skewed indicators: the case of involuntary defeat syndrome. Journal of Abnormal Psychology 113, 145–154.CrossRefGoogle ScholarPubMed
Ruscio, J, Zimmerman, M, McGlinchey, JB, Chelminski, I, Young, D (2007). Diagnosing major depressive disorder. XI. A taxometric investigation of the structure underlying DSM-IV symptoms. Journal of Nervous and Mental Disease 195, 10–19.CrossRefGoogle Scholar
Strong, DR, Glassmire, DM, Frederick, RJ, Greene, RL (2006). Evaluating the latent structure if the MPI-2 F(p) scale in a forensic sample. A taxometric analysis. Psychological Assessment 18, 250–261.CrossRefGoogle Scholar
Strong, DR, Greene, RL, Schinka, JA (2000). A taxometric analysis of MMPI-2 infrequency scales [F and F(p)] in clinical settings. Psychological Assessment 12, 166–173.CrossRefGoogle Scholar
Tedstone, JE, Tarrier, N (2003). Posttraumatic stress disorder following medical illness and treatment. Clinical Psychology Review 23, 409–448.CrossRefGoogle ScholarPubMed
Ungar, WJ, Coyte, PC (1998). Health services utilization reporting in respiratory patients. Journal of Clinical Epidemiology 51, 1335–1342.CrossRefGoogle ScholarPubMed
Waldinger, RJ, Schulz, MS, Barsky, AJ, Ahern, DK (2006). Mapping the road from childhood trauma to adult somatization: the role of attachment. Psychosomatic Medicine 68, 129–135.CrossRefGoogle ScholarPubMed
Waller, NG, Meehl, PE (1998). Multivariate Taxometric Procedures. Sage: Thousand Oaks, CA.Google Scholar
Warwick, HMC, Salkovskis, PM (1990). Hypochondriasis. Behavioural Research and Therapy 28, 105–117.CrossRefGoogle ScholarPubMed
Widiger, TA, Trull, TJ (2007). Plate tectonics in the classification of personality disorder. American Psychologist 62, 71–83.CrossRefGoogle ScholarPubMed