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Relating Differently to Intrusive Images: the Impact of Mindfulness-Based Cognitive Therapy (MBCT) on Intrusive Images in Patients with Severe Health Anxiety (Hypochondriasis)

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Abstract

Recurrent distressing intrusive images are a common experience in hypochondriasis. The aim of the current study was to assess the impact of mindfulness-based cognitive therapy (MBCT) for hypochondriasis on the occurrence and nature of distressing intrusive imagery in hypochondriasis. A semistructured interview was used to assess intrusive imagery, and an adapted version of the Southampton Mindfulness Questionnaire (SMQ) was used to assess participants’ relationship with their intrusive images. A consecutive series of participants (N = 20) who were receiving MBCT for hypochondriasis as part of an ongoing research program were assessed prior to participating in an 8-week MBCT intervention, immediately following the intervention, and at 3-month follow-up. As compared to the baseline assessment, the frequency of intrusive images, the distress associated with them, and the intrusiveness of the images were all significantly reduced at the post-MBCT assessment. Participants’ adapted SMQ scores were significantly increased following the MBCT intervention, suggesting that participants’ relationship with their intrusive images had changed in that they had developed a more “mindful” and compassionate response to the images when they did occur. Effect sizes from pre- to post-intervention were medium to large (Cohen’s d = 0.75–1.50). All treatment gains were maintained at 3-month follow-up. Results suggest that MBCT may be an effective intervention for addressing intrusive imagery in hypochondriasis.

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Acknowledgments

The authors are grateful to the Lupina Foundation for funding the current study. J. Mark G. Williams and Ann Hackmann were supported by program grant G067797 from the Wellcome Trust.

We would like to thank Isabelle Rudolf Von Rohr for helpful comments on an earlier version of the paper.

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Authors and Affiliations

  1. Department of Psychiatry & Oxford Cognitive Therapy Centre, Warneford Hospital, University of Oxford, Oxford, OX3 7JX, UK

    Freda McManus

  2. Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, OX3 7JX, UK

    Kate Muse, Christina Surawy, Ann Hackmann & J. Mark G. Williams

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  1. Freda McManus
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Correspondence to Freda McManus.

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McManus, F., Muse, K., Surawy, C. et al. Relating Differently to Intrusive Images: the Impact of Mindfulness-Based Cognitive Therapy (MBCT) on Intrusive Images in Patients with Severe Health Anxiety (Hypochondriasis). Mindfulness 6, 788–796 (2015). https://doi.org/10.1007/s12671-014-0318-y

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