Health anxiety and habitual rumination: The mediating effect of serenity

• We examine the impact of serenity on the relationship between health anxiety and rumination.
• Increasing serenity will decrease rumination and health anxiety.
• Psychotherapeutic implications of the results for the cognitive cycle between health anxiety and rumination were discussed.

Health anxiety and rumination are frequently observed in primary care. The aim of the present study is to examine which role positive affect with low physiological arousal, such as serenity, plays in this relationship. It is hypothesized that serenity moderates the impact of rumination on health anxiety.In a questionnaire study, a sample of consecutive primary care patients (N = 219) completed different measures of health anxiety (Whiteley 7), rumination (Rumination–Reflection Questionnaire) and serenity (Serenity Index).The findings demonstrated that rumination and health anxiety were positively related. However, serenity correlated negatively with health anxiety and rumination. As hypothesized, serenity is significantly predicted by health anxiety, so that high serenity has a decreasing impact on the cognitive cycle between rumination and health anxiety.The relationship between health anxiety, rumination and serenity was examined within a framework of the cognitive-behavioral model of health anxiety by Salkovskis and Warwick (2001). The results showed that the buffering function of serenity extend the cognitive-behavioral model of health anxiety and underlined the meaning of resources in coping health-related symptoms.