Effects of Text Message Reminders of Safety Behavior Reduction on Health Anxiety: A Randomized Controlled Trial

Abstract

Health anxiety is a chronic issue associated with poor functioning that is especially important to study in the context of the COVID-19 pandemic. Cognitive-behavioral models of health anxiety posit that safety behaviors are a key maintenance factor in health anxiety. The present study evaluated the effects of a safety behavior reduction text message reminder on symptoms of health anxiety. A sample of health-anxious participants (N = 99) were randomized to either a safety behavior reduction (SB) or mindfulness-based present-centered (PC) condition. Participants received text messages every other day for four weeks reminding them either to stop using their most common safety behaviors (SB) or to remain focused on the present (PC). Measures of safety behavior use, mindfulness, and health anxiety symptoms were completed at baseline, mid-treatment, post-treatment, and a four-week follow-up. It was hypothesized that participants in both conditions would report significant reductions in health anxiety symptoms over time, and that participants in the SB condition would report significantly greater reductions in health anxiety symptoms over time relative to the PC condition. Results indicated that participants in both conditions experienced significant reductions in health anxiety symptoms over time, with no significant difference in reductions between the two conditions. These findings suggest that both increasing mindfulness and reducing safety behavior use are relevant mechanisms through which health anxiety can be reduced. Implications for further development of scalable interventions for anxiety-related disorders are discussed.