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Autobiographical Memory and Episodic Future Thinking in Severe Health Anxiety: A Comparison with Obsessive–Compulsive Disorder

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Abstract

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.

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Notes

  1. Severe health anxiety is termed hypochondriasis in the ICD-10 and ICD-11 (World Health Organization (WHO) 1992, 2019), and illness anxiety disorder or somatic symptom disorder (Newby et al. 2017) in the DSM-5 (American Psychiatric Association, 2013).

  2. In addition to the items reported in this article, participants completed a series of questionnaires addressing individual differences in cognition, which will be reported elsewhere.

  3. Distance from present age to the reported events was measured in days for the everyday events. For the anxiety-related events, participants noted the age at which the event happened/might happen. One participant reported an age one year older than his/her current age in the anxiety-related past event. The written description of the event indicated that it was a past event, and the value was changed to the participant’s current age. Nine participants indicated an age lower than their current age in the anxiety-related future event. Of these, three indicated their age at the future event to be zero, this value was changed to the participant’s current age. Six participants reported other values and were treated as missing. The written descriptions of all nine events indicated that they were future events.

  4. Simple effects analyses for interactions are reported more fully in Supplemental material C.

  5. Simple effects analyses for interactions are reported more fully in Supplemental material C.

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Acknowledgements

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.

Funding

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.

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Authors and Affiliations

  1. Center on Autobiographical Memory Research, Aarhus University, Bartholins Allé 11, 8000, Aarhus, Denmark

    Tine B. Gehrt & Dorthe Berntsen

  2. Research Clinic for Functional Disorders, Aarhus University Hospital, Aarhus, Denmark

    Lisbeth Frostholm

  3. Clinic for OCD and Anxiety Disorders, Aarhus University Hospital, Aarhus, Denmark

    Marie-Louise Obermann

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  1. Tine B. Gehrt
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  2. Lisbeth Frostholm
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  4. Dorthe Berntsen
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Correspondence to Tine B. Gehrt.

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Tine B. Gehrt, Lisbeth Frostholm, Marie-Louise Obermann and Dorthe Berntsen declare that they have no conflict of interest.

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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.

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Appendix A

Appendix A

See Tables 4, 5 and 6.

Table 4 A full list of the event categories employed in the present study
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Table 5 Means and standard deviations for characteristics of four autobiographical events presented according to group membership
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Table 6 Frequency (in percent) of event categories for four autobiographical events presented according to group membership
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Gehrt, T.B., Frostholm, L., Obermann, ML. et al. Autobiographical Memory and Episodic Future Thinking in Severe Health Anxiety: A Comparison with Obsessive–Compulsive Disorder. Cogn Ther Res 44, 89–107 (2020). https://doi.org/10.1007/s10608-019-10058-3

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