Abstract
In this article, we present an Arabic adaptation and validation of the Multidimensional Inventory of Hypochondriacal Traits (MIHT). This measure is based on the cognitive-behavioral model of health anxiety. For this purpose, two studies (i.e., validation and cross-validation), using three independent samples (i.e., community samples and clinical sample), were carried out. The two studies failed to confirm the 4-factor model of the MIHT. Consequently, we proposed a short-form of the scale containing the items with factor loadings ≥ .60 (i.e, a 17-item MIHT-SF). Confirmatory factor analyses supported the 4-factor structure of the MIHT-SF. The MIHT-SF scores demonstrated good reliability and were significantly and positively related to negative affectivity and perceived stress. Results of the receiver operating characteristic (ROC) curve analysis indicated good accuracy of the MIHT-SF. Using a cutoff score of 63.50, the MIHT-SF can be prudently used as a screening tool for pathological hypochondriasis (sensitivity = .64, specificity = .74, and accuracy = .74). In conclusion, the results of this study provide validity evidence for the MIHT-SF as a measure of hypochondriasis, and thus, could be utilized in research and clinical settings.
Similar content being viewed by others
Notes
Hayduk (2014) wondered “how is a researcher to proceed if half the items in a scale do not reflect the latent factor supposedly being measured?” (p. 8).
References
Abdel-Khalek, A. M. (1998). Internal consistency of an Arabic adaptation of the Beck depression inventory in four Arab countries. Psychological Reports, 82(1), 264–266. https://doi.org/10.2466/pr0.1998.82.1.264.
Alansari, B. (2016). The big five inventory (BFI): Reliability and validity of its Arabic translation in non-clinical simple. European Psychiatry, 33, 209–210. https://doi.org/10.1016/j.eurpsy.2016.01.500.
American Educational Research Association, American Psychological Association, & National Council on Measurement in Education. (2014). Standards for educational and psychological testing. Washington, DC: American Educational Research Association.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders: DSM-IV. Washington, DC: Author.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, fifth edition (DSM-5). Arlington: American Psychiatric Publishing.
Bailer, J., Kerstner,T., Witthöft, M., Diener, C., Mier, D & Rist, F. (2016) Health anxiety and hypochondriasis in the light of DSM-5, Anxiety, Stress, and Coping, 29:2, 219–239. DOI: https://doi.org/10.1080/10615806.2015.1036243.
Bardeen, JR., & Fergus, TA. (2017). Multidimensional inventory of Hypochondriacal Traits: An Examination of a Bifactor Model and Measurement Invariance between those with and without a Self-Reported Medical Condition. Assessment. doi: https://doi.org/10.1177/1073191117725173.
Barsky, A. J., Wyshak, G., & Klerman, G. L. (1990). The somatosensory amplification scale and its relationship to hypochondriasis. Journal of Psychiatric Research, 24, 323–334.
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.
Bentler, P. M. (1990). Comparative fit indexes in structural models. Psychological Bulletin, 107, 238–246 doi.org/10.1037/0033-2909.107.2.238.
Browne, M. W., & Cudeck, R. (1993). Browne, M. W. & Cudeck, R. (1993). Alternative ways of assessing model fit. In: Bollen, K. a. & long, J. S. (Eds.) testing structural equation models. Pp. 136–162. Beverly Hills, CA: Sage. In K. A. Bollen & J. S. Long, Testing Structural Equation Models (p. 136-162). Beverly Hills: CA: Sage.
Chaaya, M., Osman, H., Naassan, G., & Mahfoud, Z. (2010). Validation of the Arabic version of the Cohen perceived stress scale (PSS-10) among pregnant and postpartum women. BMC Psychiatry, 10, 111. https://doi.org/10.1186/1471-244X-10-111.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2e ed.). Hillsdale, N.J: Routledge.
Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385–396.
Fink, P., Ornbol, E., Toft, T., Sparle, K. C., Frostholm, L., & Olesen, F. (2004). A new, empirically established hypochondriasis diagnosis. American Journal of Psychiatry, 161, 1680–1691. https://doi.org/10.1176/appi.ajp.161.9.1680.
Gana, K., & Broc, G. (2019). Structural equation modeling with lavaan. Hoboken, NJ, USA: Wiley-ISTE.
Ghubash, R. O., El-Rufaie, O. E., Zoubeidi, T. A., Al-shboul, Q., & Sabri, S. M. (2004). Profile of mental disorders among the elderly United Arab Emirates population: Sociodemographic correlates. International Journal of Geriatric Psychiatry, 19(4), 344–351.
Guadagnoli, E., & Velicer, W. F. (1988). Relation of sample size to the stability of component patterns. Psychological Bulletin, 103(2), 265–275.
Hair, J. F., Tatham, R. L., Anderson, R. E., & Black, W. (2014). Multivariate data analysis (Seventh ed.). Pearson Education Limited: Harlow.
Harsh, C. M. (1940). Constancy and variation in patterns of factor loadings. Journal of Educational Psychology, 31(5), 335–359.
Hayduk, L. A. (2014). Shame for disrespecting evidence: The personal consequences of insufficient respect for structural equation model testing. BMC Medical Research Methodology, 14(1), 1–10. https://doi.org/10.1186/1471-2288-14-124.
Howren, M. B., & Suls, J. (2011). The symptom perception hypothesis revised: Depression and anxiety play different roles in concurrent and retrospective physical symptom reporting. Journal of Personality and Social Psychology, 100(1), 182–195. https://doi.org/10.1037/a0021715.
Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6, 1–55 doi.org/10.1080/10705519909540118.
Ingram, R. E., & Luxton, D. D. (2005). Vulnerability-stress models. In B. L. Hankin & J. R. Z. Abela (Eds.), Development of psychopathology: A vulnerability-stress perspective (pp. 32–46). Thousand Oaks, CA: Sage Publications, Inc.. https://doi.org/10.4135/9781452231655.n2.
International Test Commission. (2017). The ITC Guidelines for Translating and Adapting Tests (Second edition).[www.intestcom.org].
John, O. P., & Srivastava, S. (1999). The big-five trait taxonomy: History, measurement, and theoretical perspectives. In L. A. Pervin & O. P. John (Eds.), Handbook of personality: Theory and research (Vol. 2, pp. 102–138). New York: Guilford Press.
Kellner, R. (1987). Abridged manual of the illness attitude scales. Albuquerque: University of New Mexico, School of Medicine, Department of Psychiatry.
Kotov, R., Krueger, R. F., Watson, D., Achenbach, T. M., Althoff, R. R., Bagby, R. M., Brown, T. A., Carpenter, W. T., Caspi, A., Clark, L. A., Eaton, N. R., Forbes, M. K., Forbush, K. T., Goldberg, D., Hasin, D., Hyman, S. E., Ivanova, M. Y., Lynam, D. R., Markon, K., Miller, J. D., Moffitt, T. E., Morey, L. C., Mullins-Sweatt, S. N., Ormel, J., Patrick, C. J., Regier, D. A., Rescorla, L., Ruggero, C. J., Samuel, D. B., Sellbom, M., Simms, L. J., Skodol, A. E., Slade, T., South, S. C., Tackett, J. L., Waldman, I. D., Waszczuk, M. A., Widiger, T. A., Wright, A. G. C., & Zimmerman, M. (2017). The hierarchical taxonomy of psychopathology (HiTOP): A dimensional alternative to traditional nosologies. Journal of Abnormal Psychology, 126(4), 454–477. https://doi.org/10.1037/abn0000258.
Longley, S. L., Watson, D., & Noyes Jr., R. (2005). Assessment of the hypochondriasis domain: The multidimensional inventory of Hypochondriacal traits (MIHT). Psychological Assessment, 17(1), 3–14. https://doi.org/10.1037/1040-3590.17.1.3.
Lucock, M. P., & Morely, S. (1996). The health anxiety questionnaire. British Journal of Health Psychology, 1, 137–150.
MacSwain, K. L. H., Sherry, S. B., Stewart, S. H., Watt, M. C., Hadjistavropoulos, H. D., & Graham, A. R. (2009). Gender differences in health anxiety: An investigation of the interpersonal model of health anxiety. Personality and Individual Differences, 47(8), 938–943. https://doi.org/10.1016/j.paid.2009.07.020.
Magariños, M., Zafar, U., Nissenson, K., & Blanco, C. (2002). Epidemiology and treatment of hypochondriasis. CNS drugs, 16(1), 9–22. Doi :https://doi.org/10.2165/00023210-200216010-00002.
Marcus, D. K., Gurley, J. R., Marchi, M. M., & Bauer, C. (2007). Cognitive and perceptual variables in hypochondriasis and health anxiety: A systematic review. Clinical Psychology Review, 27(2), 127–139. https://doi.org/10.1016/j.cpr.2006.09.003.
Metz, C. E. (1978). Basic principles of ROC analysis. Seminars in Nuclear Medicine, 8, 283–298.
Otto, M. W., Demopulos, C. M., McLean, N. E., Pollack, M. H., & Fava, M. (1998). Additional findings on the association between anxiety sensitivity and hypochondriacal concerns: Examination of patients with major depression. Journal of Anxiety Disorders, 12, 225–232. https://doi.org/10.1016/S0887-6185(98)00011-5.
Pilowsky, I. (1967). Dimensions of hypochondriasis. British Journal of Psychiatry, 113, 89–93.
Pilowsky, I., Spence, N., Cobb, J., & Katsikitis, M. (1984). The illness behavior questionnaire as an aid to clinical assessment. General Hospital Psychiatry, 6(2), 123–130. https://doi.org/10.1016/0163-8343(84)90070-7.
Pinday, S., Parikh, M., Brahmbhatt, M., Vankar, G.K. (2017). Clinical study of illness anxiety disorder in medical outpatients. Archives of Psychiatry and Psychotherapy, 4: 32–4. DOI: https://doi.org/10.12740/APP/76932 review, 31, 146–160.
Raykov, T. (1997). Estimation of composite reliability for congeneric measures. Applied Psychological Measurement, 21, 173–184. https://doi.org/10.1177/01466216970212006.
Rief, W., & Martin, A. (2014). How to use the new DSM-5 somatic symptom disorder diagnosis in research and practice: A critical evaluation and a proposal for modifications. Annual Review of Clinical Psychology, 10, 339–367. https://doi.org/10.1146/annurev-clinpsy-032813-153745.
Robinson, J. P., Shaver, P. R., & Wrightsman, L. S. (1991). Criteria for scale selection and evaluation. In J. P. Robinson, P. R. Shanver, & L. S. Wrightsman (Eds.), Measures of personality and social psychological attitudes. San Diego, California: Academic Press.
Salkovskis, P. M., & Warwick, H. M. (1986). Morbid preoccupations, health anxiety, and reassurance: A cognitive behavioral approach to hypochondriasis. Behavior Research and Therapy, 24, 597–602.
Salkovskis, P. M., Rimes, K. A., Warwick, H. M. C., & Clark, D. M. (2002). The health anxiety inventory: Development and validation of scales for the measurement of health anxiety and hypochondriasis. Psychological Medicine, 32(5), 843–853. https://doi.org/10.1017/S0033291702005822.
Scarella, T. M., Laferton, J. A. C., Ahern, D. K., Fallon, B. A., & Barsky, A. (2016). The relationship of hypochondriasis to anxiety, depressive, and somatoform disorders. Psychosomatics: Journal of Consultation and Liaison Psychiatry, 57(2), 200–207. https://doi.org/10.1016/j.psym.2015.10.006.
Steinbrecher, N., Koerber, S., Frieser, D., & Hiller, W. (2011). The prevalence of medically unexplained symptoms in primary care., 52(3), 263–271. https://doi.org/10.1016/j.psym.2011.01.007.
Streiner, D. L., & Cairney, J. (2007). What's under the ROC? An introduction to receiver operating characteristics curves. The Canadian Journal of Psychiatry, 52, 121–128.
Stewart, S. H., Sherry, S. B., Watt, M. C., Grant, V. V., & Hadjistavropoulos, H. D. (2008). Psychometric evaluation of the multidimensional inventory of Hypochondriacal traits: Factor structure and relationship to anxiety sensitivity. Journal of Cognitive Psychotherapy: An International Quarterly, 22, 97–114.
Tanios, C. Y., Abou-Saleh, M. T., Karam, A. N., Salamoun, M. M., Mneimneh, Z. N., & Karam, E. G. (2009). The epidemiology of anxiety disorders in the Arab world: A review. Journal of Anxiety Disorders, 23, 409–419.
van de Vijver, P. J. R. (2016). Test adaptations. In F. T. L. Leong, D. Bartram, F. M. Cheung, K. F. Geisinger, & D. Iliescu (Eds.), The ITC international handbook of testing and assessment (pp. 364–376). New York, NY: Oxford University Press.
van den Heuvel, O. A., Veale, D., & Stein, D. J. (2014). Hypochondriasis: Considerations for ICD-11. Revista Brasileira de Psiquiatria, 36 supp1, S21–S27. doi:https://doi.org/10.1590/1516-4446-2013-1218.
Warwick, H. M., & Salkovskis, P. M. (1990). Hypochondriasis. Behaviour Research and Therapy, 28, 105–117.
Williams, P. G. (2004). The psychopathology of self-assessed health: A cognitive approach to health anxiety and hypochondriasis. Cognitive Therapy and Research, 28, 629–644. https://doi.org/10.1023/B:COTR.0000045569.25096.44.
Witthöft, M., Haaf, A., Rist, F., & Bailer, J. (2010). Erfassung von krankheitsangst mit dem multidimensional inventory of Hypochondriacal traits (MIHT) = German validation of the multidimensional inventory of Hypochondriacal traits (MIHT). Diagnostica, 56(1), 2–12. https://doi.org/10.1026/0012-1924/a000005.
Witthöft, M., Weck, F., & Gropalis, M. (2015). The multidimensional inventory of Hypochondriacal traits: Factor structure, specificity, reliability, and validity in patients with hypochondriasis. Assessment, 22(3), 361–373. https://doi.org/10.1177/1073191114545489.
Acknowledgments
We would like to thank the psychiatrists and psychologists who allowed us to have a sample of patients.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Ethical Approval All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed Consent
Informed consent was obtained from all individual participants included in the study.
Conflict of Interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Boudouda, N.E., Gana, K. Validity Evidence for the Arabic Version of the Multidimensional Inventory of Hypochondriacal Traits (MIHT). Curr Psychol 41, 1516–1525 (2022). https://doi.org/10.1007/s12144-020-00687-3
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12144-020-00687-3