THE’anxiety for health (or hypochondria) is a psychopathological condition characterized by an erroneous interpretation of body sensations or physical changes such as pathological signals.
These subjects are constantly afflicted by the concern/conviction of being able to be affected or to be about to develop a serious illness.
Followed by monitoring of their physical functions (e.g. check the heartbeat or pressure), body controls in search of signals of confirmation of their fear (e.g. examine the in), medical examinations and repeated diagnostic tests (e.g.mm, CT, electrocardiogram).
Individuals suffering from hypochondria They come to be so obsessed with these fears that the socio-relational functioning is very compromised and often also physical health itself risks being damaged really by excessive useless diagnostic investigations.
The theoretical-metadological model cognitive-behavioral proposed for the understanding of the anxiety disorder for health (Salkovskis & Warwick, 2001) places four particularly relevant cognitive beliefs at the center of the phenomenology of the disorder:
- The perceived probability of being able to have a serious health problem in the course of life (vulnerability)
- The perceived gravity and the terribility of the potential condition of illness
- The inability perceived in knowing how to face a possible health problem
- The perceived inadequacy of medical-health services in the treatment of diseases.
The data of literature confirmed the association between these cognitive beliefs and the symptoms of anxiety for healthboth in terms of significance and specificity (Hadjistavropoulos et al., 2012; Fergus, 2014): these distortions of thought therefore are strongly associated with hypochondriac concerns and this correlation is significantly greater than the link between the same cognitive distortions and other anxiety disorders (e.g. DOC).
Recent evolutions in the study of HEALTH ENGLISH DISORDER They proposed new pathways of conceptualization and treatment of the same, such as cognitive-behavioral therapy based on Mindfulness (Mcmanus et al., 2012), Act (IE Acceptance and Commitment Therapy; Eilenberg et al., 2015) or metacognitive therapy (Wells, 2009).
While the first two approaches have so far provided only clinical applications for the treatment of hypochondria, the studies conducted in the frame of the metacognitive theory They also investigated the mechanisms underlying the symptoms.
The central postulate of metacognitive theory places the metacognitions And, consequently, the focus of metacognitive therapy is aimed at metacognitive beliefs rather than to dysfunctional thoughts and cognitive beliefs, such as those mentioned above (Wells, 2009).
From the research carried out so far, the metacognitive processes that are implicated in health anxiety disorder are the mobble and the rumination (Fergus, 2013).
On the other hand, the metacognitive beliefs associated with hypochondriac symptoms have certainly been less investigated and the only data available to us indicate a positive (if moderate) association between health anxiety and metacognitions relating to the uncontrollability and danger of the brood (Bailey & Wells, 2013).
A recent Italian study (Melli et al., 2016) investigated, in a large sample of non -clinical subjects (N = 342), the relationship between the hypochondriac symptoms, the cognitive distortions of Salkovskis and Warwick and the metacognitions related to health anxiety (Bouman & Meijer, 1999):
- Uncontrollability and interference of thoughts relating to diseases
- Awareness of one’s thoughts
- Negative consequences of the mobble on health
- Positive beliefs regarding the utility of the brood
The results showed that the hypochondriac symptoms were significantly associated with the metacognitive beliefs investigated, and in particular touncontrollability and interference of illness thoughtswhose association was stronger than the correlation of health anxiety with the cognitive distortions examined.
Furthermore, the metacognitive beliefs relating to the uncontrollability and interference of the thoughts of illness have been significant predatory of the hypochondriac symptoms, while keeping other interfering variables such as anxiety and depression under control.
Finally, the cognitive beliefs relating to the uncontrollability proved to be capable of mediating the relationship between the hypochondriac symptoms and anxiety sensitivity, a well -known predisposing factor in health anxiety (Abrahamowitz et al., 2007).
From the results of this Italian investigation and another previous English study (Bailey & Wells, 2015), Anxiety sensitivity would become an important factor of predisposition to hypochondriac symptoms only in the presence of metacognitive beliefs such as the uncontrollability and interference of illness thoughts.
In conclusion, the data of the literature in our possession on role of metacognition in health anxiety disorderalbeit relatively recent and in need of further insights, they suggest without a shadow of a doubt the need to insert metacognitive variables within the conceptualization and treatment of hypochondria.
