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

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y T3 (see Table 3). Scores on the SHAI were the only SHB scores that were outside the healthy normative range at T1, therefore, the other study measures could not be assessed for clinical significance. Based on the SHAI results, treatment helped participants to decrease their cognitive (disease preoccupation, hypervigillance to bodily sensations, somatosensory amplification), somatic (anxiety-related bodily sensations), behavioural (reassurance seeking and bodily checking), and affective symptoms (excessive worry about health) of health anxiety. However, when compared to the Salkovskis et al., (2002) healthy normative sample, the participants‘ health anxiety levels were still above the mean and they were not fully recovered from their excessive health anxiety. Above average scores on the SHAI may have remained because participants‘ physical symptoms had not disappeared and they were still anxious about that or the possibility of becoming ill in the future. The beliefs about illness risks and indicators of disease may take longer to change and the physical symptoms of anxiety may remain until these beliefs are successfully altered. SHB scores on the MIHT were compared to the healthy normative sample means reported in the Longley et al., (2005) validation study (Table 3). MIHT behavioural subscale scores were above average at T1 and by T3 they were approximately average (t = 4.03, df = 9, p = .002; power = .94 [high power]; see Table 3). Perception subscale scores were elevated at T1 and were also reduced by T3 (t = 4.19, df = 9, p = .001; power = .96 [high power]). On the cognitive subscale, scores at T1 were above average but there 55
was no significant change (t = 1.28, df = 9, p = .117); power = .18 [low power]. Affective subscale scores were also above average at T1 and were reduced by T3 (t = 2.02, df = 9, p = .028; power = .48 [low power]). The most robust findings were the reductions in scores on the behaviour and perception subscales because they had statistical significance and sufficient power, unlike the affect subscale. The effect sizes were large for perception (d = 1.42) and behaviour (d = 1.42) and small for cognition (d = 0.49) and affect (d = 0.44). Based on the MIHT results, treatment helped participants to decrease their reassurance seeking from others (behavioural subscale), perceptual-somatic preoccupation with body sensations (perceptual subscale), and worry about health (affective subscale) but the treatment did not change their feelings of alienation due to their beliefs (cognitive subscale). Reassurance seeking, preoccupation with body sensations, and worry may have changed quickly due to the psychoeducation, behavioural exercises, and ERP treatment components. Participants may have continued to feel alienated by significant others because repairing these interpersonal relationships may take longer. The MIHT results are consistent with the SHAI results indicating that participants had fewer health anxiety symptoms after treatment but they had some residual symptoms. The SHB T1 score on the CES-D was greater than 16, indicating the presence of depressive illness (Radloff, 1997); this was reduced by T3 (t = 2.68, df = 9, p = .013; power = .66 [low power]; see Table 3). This finding suggests treatment had a positive effect on participants‘ moods, possibly because of the reduction in health anxiety 56
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RANDOMIZED CONTROLLED FEASIBILITY T
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Abstract The purpose of this feasib
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Acknowledgement This research was f
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Table of Contents Abstract………
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3.2.1. Content analysis…………
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List of figures Figure 1. The cogni
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Table C7. Comparison of WLC pre- an
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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 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
Page 65 and 66: Table 2 Demographic statistics Mean
Page 67: Table 3 Comparison of SHB pre- and
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
Page 89 and 90: anxiety. After ethical clearance wa
Page 91 and 92: SHB group symptoms when compared to
Page 93 and 94: pain, fatigue, and poor health, tha
Page 95 and 96: 3.4. Limitations The results of thi
Page 97 and 98: usy schedules, worry about reading
Page 99 and 100: attery of tests is not recommended
Page 101 and 102: ecommended that the program is exte
Page 103 and 104: 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
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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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