Contents of It's not All in Your Head by Asmundson and Taylor

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1. INTRODUCTION AND LITERARTURE REVIEW Health anxiety is a psychological construct that ranges on a continuum from normal health awareness to hypochondriasis in its extreme form (Taylor & Asmundson, 2004). Individuals with health anxiety believe they are physically ill, are often hypervigilant to bodily sensations and changes, and experience recurrent thoughts about serious disease (Taylor & Asmundson, 2004). Until recently, there were no effective treatments for health anxiety (Avia, Ruiz, Olivares, & Crespo, 1996; Barsky, Bailey, Fama, & Ahern, 2000; Barsky, Geringer, & Wool, 1988; Taylor & Asmundson, 2004); however, a number of empirically supported treatment options such as cognitive- behavioural therapy (CBT) are now available (Taylor, Asmundson, & Coons, 2005). During a typical CBT protocol for health anxiety, individuals learn about the nature of health-related anxiety, are exposed to health and disease-related stimuli, endure the associated anxiety, and learn that the outcomes of anxiety will not be catastrophic (Taylor & Asmundson, 2004). Most recently, efforts have been directed at translating therapist-delivered CBT treatments into more accessible self-help programs for health anxiety and a spectrum of related disorders (i.e., the health anxiety disorders). However, these approaches have not received much empirical scrutiny and warrant further investigation. The purpose of this feasibility trial was to determine the efficacy (capacity for beneficial change) of a CBT self-help book for health anxiety (i.e., It’s Not All in Your Head, Asmundson & Taylor, 2005), relative to a wait-list control group. The findings of 1
this study will inform a future, large-scale randomized controlled trial of the self-help book. 1.1. Health anxiety Health is an important source of security so most people occasionally experience health anxiety (Furer & Walker, 2005). Cognitive-behavioural researchers and clinicians state health anxiety encompasses any worry people may have about their health (Furer & Walker, 2005). Maladaptive expressions of health anxiety may take the form of disorders such as hypochondriasis, illness phobia, somatic delusions, panic disorder, and some somatoform disorders (Taylor & Asmundson, 2004). Health anxiety ranges on a continuum from healthy and adaptive to excessive and maladaptive (Taylor & Asmundson, 2004). Symptoms of health anxiety may be assessed with individual- difference measures such as the Whiteley Index (WI; Pilowsky, 1967). For the most part, health anxiety is adaptive when it prompts us to seek medical care for symptoms of a true medical problem; if an individual‘s health is at risk, a lack of anxiety about the symptoms can be maladaptive (Taylor & Asmundson, 2004). Sometimes a degree of health consciousness and concern is socially encouraged (Taylor & Asmundson, 2004). Health anxiety has a long history. It is noteworthy that the term hypochondria was first used in 350 BC (Ladee, 1966). In fact, a disorder called hypochondrium was hypothesized by Hippocrates (470 BC to 410 BC) as being caused by the mental and physical effects of the humors excreted from the hypochondrium — a hypothetical area 2
Page 1 and 2: RANDOMIZED CONTROLLED FEASIBILITY T
Page 3 and 4: Abstract The purpose of this feasib
Page 5 and 6: Acknowledgement This research was f
Page 7 and 8: Table of Contents Abstract………
Page 9 and 10: 3.2.1. Content analysis…………
Page 11 and 12: List of figures Figure 1. The cogni
Page 13: Table C7. Comparison of WLC pre- an
Page 17 and 18: Disorders Draft (APA, 2010) propose
Page 19 and 20: The cognitive symptoms of health an
Page 21 and 22: somatosensory amplification have a
Page 23 and 24: clients with health anxiety from cl
Page 25 and 26: Interview Schedule [Robins, Helzer,
Page 27 and 28: Today, effective clinically-support
Page 29 and 30: decreased disease conviction, witho
Page 31 and 32: identification and reattribution of
Page 33 and 34: within treatment sessions and as ho
Page 35 and 36: more efficacious than wait-list con
Page 37 and 38: participants‘ functioning. The CB
Page 39 and 40: at follow-up (e.g., Bouman, 2002, a
Page 41 and 42: et al., 2003). Self-help treatments
Page 43 and 44: 1.2. Statement of purpose The purpo
Page 45 and 46: an Internet format because it was m
Page 47 and 48: � Do you carry things to use in t
Page 49 and 50: dimensional scales: (a) affective s
Page 51 and 52: severe (15 - 19), and extremely sev
Page 53 and 54: 86 indicate a poor alliance. The HA
Page 55 and 56: included depression symptoms, gener
Page 57 and 58: mailed Part 1, Part 2, and Part 3 o
Page 59 and 60: equests were honored. All randomize
Page 61 and 62: literature; therefore, we had reaso
Page 63 and 64: 3. RESULTS 3.1. Quantitative data a
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Table 2 Demographic statistics Mean
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Table 3 Comparison of SHB pre- and
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was no significant change (t = 1.28
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subscale (n = 5); T1 M = 16.80 (SD
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treatment participants would have o
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At T2 there were significant differ
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Table 7 SHB and WLC effect size and
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sample size or greater effect size
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3.2.1. Content analysis 3.2. Qualit
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analysis resulted in the descriptio
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During the creating subcategories a
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coded the entire data set. There we
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anxiety. After ethical clearance wa
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SHB group symptoms when compared to
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pain, fatigue, and poor health, tha
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3.4. Limitations The results of thi
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usy schedules, worry about reading
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attery of tests is not recommended
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ecommended that the program is exte
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4. REFERENCES American Psychiatric
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Barsky, A. J., Geringer, E., & Wool
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Coull, G, & Morris, P. G. (2011). T
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Furer, P., Walker, J. R., & Freesto
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Lidbeck, J. (1997). Group therapy f
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Nguyen, T. D., Attkisson, C. C., &
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Salkovskis, P. M., Rimes, K. A., Wa
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Taylor, S., Thordarson, D. S., Jang
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5. APPENDICIES Appendix A Contents
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o Week 4 o Week 5 o Things to Remem
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Appendix B SELF-HELP PROGRAM FOR HE
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Table C2 Comparison of SHB complete
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Table C4 Comparison of SHB and WLC
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Table C6 Comparison of WLC pre- and
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Appendix D Draft of unconstrained c
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Questionnaires the questionnaires T
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