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Abstract
This program of research investigated the psychological processes that underpin health anxiety, using experimental studies among young people with varying levels of health anxiety. Studies 1 and 2 examined the proposition that rumination might impact the content (Study 1) and specificity (Study 2) of autobiographical memories. Study 1 found that ruminative thinking led participants to retrieve more ‘self-defining’ memories that were illness-related. Study 2 showed that rumination led to more specific, illness-related, memories. Study 3 explored whether heightening health-related concerns using the mortality salience paradigm would impact upon behavioural approach/avoidance tendencies. Heightened mortality salience led to more avoidance in response to a generalised health threat (illness-related pictures), but to lesser avoidance towards a personalised health-threat (cancer risk assessment questionnaire). Study 4 examined whether self-efficacy might modulate these effects. Only depression symptoms led to greater avoidance of a cancer risk assessment questionnaire. Study 5 examined the proposition that heightening self-efficacy might facilitate more effective health-related problem-solving. No significant impact of self-efficacy was found, however higher health anxiety predicted more effective problem-solving. Studies 6-9 explored future thinking processes in the context of healthy anxiety. Study 6 examined the impact of rumination, and found that it led to more overgeneral, illness-related future imaginings. Study 7 examined future thinking under conditions of heightened mortality salience; results found that mortality salience, together with higher health anxiety and having a personal/family illness history, predicted more specific illness-related future imaginings. Study 8 and 9 explored the potential role of self-efficacy in future thinking processes. Study 8 indicated that participants whose self-efficacy was boosted showed future imaginings that were both illness-related in content, and specific in nature. Study 9 sought to establish whether self-efficacy could mitigate the effects of mortality salience. Participants exposed to mortality salience and provided an opportunity to bolster their self-efficacy showed more specific future imaginings overall, relative to participants exposed to mortality salience and a low self-efficacy induction. This program of research extends current theories of adjustment in the context of health concerns by identifying psychological mechanisms that may maintain healthy anxiety, across both healthy and illness populations.