Intrusive Thoughts and Images in Health Anxiety: Rates, Characteristics, and Responses

OBJECTIVES: Intrusive thoughts and images in Health Anxiety are poorly understood. The current study aims to explore the rates and nature of health-related intrusive thoughts and images in people with and without Health Anxiety. DESIGN: We used a cross-sectional interview and survey design recruiting 82 participants (Health Anxiety: n = 37; control: n = 45). METHODS: Participants completed a diagnostic and clinical interview, and questionnaires to assess experiences and appraisals of intrusive thoughts and images about health. RESULTS: Experiencing an intrusive thought or image was common in both groups (Health Anxiety: 89.2%, control: 55.6%). However, the Health Anxiety group reported their intrusive thoughts as more frequent, more distressing, and associated them with more negative emotions than controls. Further, the Health Anxiety group had increased negative appraisals and specific maladaptive behaviours for both intrusive thoughts and intrusive images compared to controls. CONCLUSIONS: We conclude that, relative to controls, individuals with Health Anxiety experience intrusive thoughts and images more intensely and negatively, have more dysfunctional appraisals of them, and are more likely to respond to them with specific maladaptive behaviours. As such, addressing intrusive thoughts and images as part of cognitive behavioural interventions for Health Anxiety is warranted.