Health anxiety disorders: A cognitive construal

The features of severe health anxiety, intense and persistent anxiety about one's present and future health, are described. In common with other anxiety disorders such as GAD, PTSD and OCD, the core of HAD is distressing, uncontrollable anxiety, and is classifiable as an Anxiety Disorder, Health Anxiety Disorder (HAD). The cognitive construal of HAD proposes that health anxiety is caused by catastrophic misinterpretations of the significance of sensations and/or changes in bodily functions and appearance (such as swellings, pain, loss of energy, dizzy spells). The nature, causes, triggers, persistence, assessment and treatment of HAD are reviewed, and the present status of the cognitive model is appraised. Suggestions are made for future research and clinical applications, and the need for incisive evaluations of the main premises of the model is emphasized.

► Considerable progress has been made in describing severe health anxiety (HAD).
► It is now classifiable as one of the anxiety disorders, such as OCD, GAD, PTSD.
► The cognitive model of HAD has laid the basis for a cognitive behavioural treatment (CBT) for this disorder.
► The results obtained in randomised control trials are impressively positive, but limited in number.
► The present status of the cognitive construal is appraised, and the need for direct tests of its main propositions is emphasized.