The Effects of Safety Behaviors on Health Anxiety: Conceptualizing Hypochondriasis as an Anxiety Disorder

Abstract

Research in the anxiety disorders has shown that safety behaviors function to maintain pathological anxiety by preventing the disconfirmation of inaccurate threat beliefs. The present study examined if such safety behaviors might also contribute to the development and exacerbation of symptoms of health anxiety. The present study tested this notion in a sample of students that were randomized to a safety-behavior (n = 30) or a control (n = 30) condition. After a week-long baseline period, participants in the safety-behavior condition spent 1 week engaging in a clinically representative array of health-related safety behaviors on a daily basis, followed by a second baseline period. Participants in the control condition were instructed to monitor their normal use of safety behaviors. Subsequent to the manipulation, participants in the safety behavior manipulation evidenced statistically significant increases in health anxiety, contamination fear, disgust sensitivity, and cognitive and avoidant responses to three health-related behavioral avoidance tasks compared to those in the control condition. However, anxiety and depressive symptoms remained stable and did not differ between the two groups. These findings suggest that health-related safety behaviors may cause an increase in health anxiety and related processes. The implications of these findings for a cognitive-behavioral model of hypochondriasis are discussed.