Autobiographical Memory and Episodic Future Thinking in Severe Health Anxiety: A Comparison with Obsessive–Compulsive Disorder
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Severe health anxiety is characterized by intrusive worries about harboring a serious illness. In the present study, 32 patients with severe health anxiety, 32 control participants and a clinical control group of 33 patients with obsessive–compulsive disorder (OCD) reported unprompted and anxiety-related autobiographical memories and episodic future thoughts. Compared to control participants, the patient groups displayed similar patterns in the characteristics of the reported events and regarding the maladaptive cognitive and behavioral strategies used, when the events came to mind. Patients with severe health anxiety reported more events related to their own illness or death than either of the other groups, and exploratory analyses suggested that they were more inclined than OCD patients to check their own bodies when anxiety-related events came to mind. Autobiographical memories and episodic future thoughts have not previously been examined in patients with severe health anxiety, but could play an important role in this disorder.
KeywordsAutobiographical memory Episodic future thoughts Hypochondriasis Severe health anxiety Obsessive–compulsive disorder
The authors thank the Danish National Research Foundation [DNRF89] and the Illum Foundation for funding. They also thank Ditte Hoffmann, Charlotte Ulrikka Rask, Tina B. W. Carstensen, Heidi Berg Nielsen, Astrid Høegh Tuborgh, Heidi Frølund Petersen, Fruszina Eva Toth and the OCD Association in Denmark for assisting in recruiting patients, Josephine Oliva Gammelgaard for coding of event content, and Cecilie Kousholt and Niels Peter Nielsen for technical and practical assistance.
This research was supported in part by the Danish National Research Foundation (DNRF) [Grant Number DNRF89] and the Illum Foundation. The DNRF and the Illum Foundation [Grant Number 03061023] had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication.
Compliance with Ethical Standards
Conflicts of interest
Tine B. Gehrt, Lisbeth Frostholm, Marie-Louise Obermann and Dorthe Berntsen declare that they have no conflict of interest.
All procedures performed in this study were in accordance with the ethical standards of the American Psychological Association and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the local ethics review board.
No animal studies were carried out by the authors for this article.
- Derogatis, L. R. (1983). SCL-90-R. Administration, scoring, and procedures. MANUAL-II. Towson, MD: Clinical Psychometric Research.Google Scholar
- Di Nardo, P. A., Brown, T. A., & Barlow, D. H. (1994). Anxiety Disorder Interview Schedule for DSM-IV: Lifetime version (ADIS-IV-L). New York: Oxford University Press.Google Scholar
- Fink, P., Ewald, H., Jensen, J., Sørensen, L., Engberg, M., Holm, M., et al. (1999). Screening for somatization and hypochondriasis in primary care and neurological in-patients: A seven-item scale for hypochondriasis and somatization. Journal of Psychosomatic Research,46, 261–273.PubMedCrossRefPubMedCentralGoogle Scholar
- Finnbogadóttir, H., & Berntsen, D. (2014). Looking at life from different angles: Observer perspective during remembering and imagining distinct emotional events. Psychology of Consciousness: Theory, Research, and Practice,1, 387–406.Google Scholar
- Hedman, E., Ljótsson, B., Andersson, E., Andersson, G., Lindefors, N., Rück, C., et al. (2015). Psychometric properties of Internet-administered measures of health anxiety: An investigation of the Health Anxiety Inventory, the Illness Attitude Scales, and the Whiteley Index. Journal of Anxiety Disorders,31, 32–37.PubMedCrossRefPubMedCentralGoogle Scholar
- Hedman, E., Ljótsson, B., Axelsson, E., Andersson, G., Rück, C., & Andersson, E. (2017). Health anxiety in obsessive compulsive disorder and obsessive compulsive symptoms in severe health anxiety: An investigation of symptom profiles. Journal of Anxiety Disorders,45, 80–86.PubMedCrossRefPubMedCentralGoogle Scholar
- IBM Corp. (2016). IBM SPSS Statistics for Windows, Version 24.0. Armonk, NY: IBM Corp.Google Scholar
- Lochner, C., Hemmings, S., Kinnear, C., Niehaus, D. J., Nel, D., Corfield, V., et al. (2005). Cluster analysis of obsessive–compulsive spectrum disorders in patients with obsessive–compulsive disorder: Clinical and genetic correlates. Comprehensive Psychiatry,46, 14–19.PubMedCrossRefPubMedCentralGoogle Scholar
- Rasmussen, A. S., Jørgensen, C. R., O’Connor, M., Bennedsen, B. E., Godt, K. D., & Bøye, R. (2017). The structure of past and future events in borderline personality disorder, eating disorder, and obsessive–compulsive disorder. Psychology of Consciousness: Theory, Research, and Practice,4, 190–210.Google Scholar
- Salkovskis, P. M., & Warwick, H. M. C. (2001). Making sense of hypochondriasis: A cognitive model of health anxiety. In G. J. G. Asmundson, S. Taylor, & B. J. Cox (Eds.), Health anxiety: Clinical and research perspectives on hypochondriasis and related conditions. New York: Wiley.Google Scholar
- Speckens, A. E., Hackmann, A., Ehlers, A., & Cuthbert, B. (2007). Imagery special issue: Intrusive images and memory of earlier adverse events in patients with obsessive compulsive disorder. Journal of Behavior Therapy,38, 411–422.Google Scholar
- Taylor, S., & Asmundson, G. J. G. (2004). Treating health anxiety: A cognitive-behavioral approach. New York: The Guildford Press.Google Scholar
- World Health Organization (WHO). (1992). The ICD-10 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines. Geneva: WHO.Google Scholar
- World Health Organization (WHO). (1998). SCAN. Schedules for clinical assessment in neuropsychiatry. Geneva: WHO.Google Scholar
- World Health Organization (WHO). (2019). ICD-11 for mortality and morbidity statistics. Retrieved June 9, 2019 from https://icd.who.int/browse11/l-m/en