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up (Taylor et al., 2005). BSM may also be especially useful for individuals with comorbid disorders that are aggravated by stress. More research is needed to determine if BSM is as efficacious as CBT and to distinguish the clinically important components that are common to both therapies. The efficacy of treatments for health anxiety (e.g., psychoeducation, cognitive therapy, behavioural therapy, ERP, CBT, and BSM) has been compared in many studies (e.g., Avia et al., 1996; Bouman & Visser, 1998; Clark et al., 1998; Fava, Grandi, Rafanelli, Fabbri, & Cazzaro, 2000; Lidbeck, 1997; Speckens et al., 1995; Stern & Fernandez, 1991; Visser & Bouman, 2001; Warwick et al., 1996). In these studies, effect sizes of treatments were calculated based on participants‘ scores on global measures of health anxiety, anxiety, and depression (e.g., WI, Beck Anxiety Inventory [BAI], Beck Depression Inventory [BDI]) and have been expressed as Cohen‘s d statistic (1998). A small effect size or d is 0.20, a medium effect size is 0.50, and large effect size is 0.80 or higher (Cohen, 1988). Most of the treatments examined were 6 to 21weeks in duration and had small sample sizes (6 – 79 participants). In these studies, more participants tended to drop out of the psychosocial treatment groups (2% - 13%) compared to the control groups (0 %). Psychosocial treatments (e.g., Avia et al., 1996; Bouman & Visser, 1998; Clark et al., 1998; Fava et al., 2000; Lidbeck, 1997; Sorensen et al., 2010; Speckens et al., 1995; Stern & Fernandez, 1991; Visser & Bouman, 2001; Warwick et al., 1996) appear to be 21
more efficacious than wait-list control with effect sizes of d = 0.83 – 2.05 for treatments and an average d = 0.29 for wait-list controls. CBT appears to be the superior treatment because of the greater acceptability, strength, breadth, and durability of the treatment effects (d = 0.83 – 2.05 and average d = 1.74 at follow-up; Clark et al., 1998; Speckens et al., 1995; Stern & Fernandez, 1991; Visser & Bouman, 2001; Warwick et al., 1996). Psychoeducation alone (average d = 1.05) may be a sufficient treatment for individuals with mild health anxiety without depression (Avia et al., 1996; Bouman, 2002; Lidbeck, 1997). CBT may be the superior treatment for individuals with health anxiety and comorbid depression or generalized anxiety (average depression d = 1.36; average generalized anxiety d = 1.90; Clark et al., 1998; Speckens et al., 1995; Stern & Fernandez, 1991; Visser & Bouman, 2001; Warwick et al., 1996). Based on the results of the CBT studies above and more recent studies reviewed below (e.g., Barsky & Ahern, 2004; Bleichhardt et al., 2005; Bouman, 2002; Buwalda, Bouman, & Van Duijn, 2008; Martínez & Botella, 2005; Seivewright, Green, Salkovskis, Barrett, Nur, & Tyrer, 2008; Sorensen, Birket-Smith, Wattar, Buemann, & Salkovskis, 2010; Wattar et. al., 2005), CBT was chosen as the focus of the current research as it appears to be more efficacious than other psychosocial treatments and acceptable to individuals with health anxiety. Recent studies have examined individual CBT sessions (e.g., Barsky & Ahern, 2004; Seivewright et al., 2008; Sorensen et al., 2010), group CBT sessions (e.g., Bouman 2002; Martínez & Botella, 2005), combined individual and group sessions (e.g., 22
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 and 14: Table C7. Comparison of WLC pre- an
Page 15 and 16: this study will inform a future, la
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: within treatment sessions and as ho
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
Page 65 and 66: Table 2 Demographic statistics Mean
Page 67 and 68: Table 3 Comparison of SHB pre- and
Page 69 and 70: was no significant change (t = 1.28
Page 71 and 72: subscale (n = 5); T1 M = 16.80 (SD
Page 73 and 74: treatment participants would have o
Page 75 and 76: At T2 there were significant differ
Page 77 and 78: Table 7 SHB and WLC effect size and
Page 79 and 80: sample size or greater effect size
Page 81 and 82: 3.2.1. Content analysis 3.2. Qualit
Page 83 and 84: analysis resulted in the descriptio
Page 85 and 86:
During the creating subcategories a
Page 87 and 88:
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
Page 105 and 106:
Barsky, A. J., Geringer, E., & Wool
Page 107 and 108:
Coull, G, & Morris, P. G. (2011). T
Page 109 and 110:
Furer, P., Walker, J. R., & Freesto
Page 111 and 112:
Lidbeck, J. (1997). Group therapy f
Page 113 and 114:
Nguyen, T. D., Attkisson, C. C., &
Page 115 and 116:
Salkovskis, P. M., Rimes, K. A., Wa
Page 117 and 118:
Taylor, S., Thordarson, D. S., Jang
Page 119 and 120:
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
Page 127 and 128:
Table C4 Comparison of SHB and WLC
Page 129 and 130:
Table C6 Comparison of WLC pre- and
Page 131 and 132:
Appendix D Draft of unconstrained c
Page 133 and 134:
Questionnaires the questionnaires T
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