TY - JOUR
T1 - The impact of exposure-based cognitive behavior therapy for severe health anxiety on self-rated health
T2 - results from a randomized trial
AU - Hedman-Lagerlöf, Erik
AU - Axelsson, Erland
AU - Andersson, Erik
AU - Ljótsson, Brjánn
AU - Andreasson, Anna
AU - Lekander, Mats
PY - 2017/12/1
Y1 - 2017/12/1
N2 - Objective: Self-rated health (SRH) has been shown to be a stable predictor of illness and mortality. Improvement in SRH, even in the absence of change in objective health, predicts better health and reduced mortality. Severe health anxiety (SHA) is characterized by fear of illness and distorted health perception. The objective of the present study was to investigate if exposure-based cognitive behavior therapy (CBT) for SHA can lead to improvement in SRH and whether this improvement is mediated by reduced health anxiety. Methods: Data were collected from a randomized controlled trial where participants with SHA were allocated to 12 weeks of exposure-based CBT (n = 99) for SHA or to a no treatment control condition (n = 33). The mediation analysis was based on SRH- and health anxiety data collected weekly during the treatment phase. Results Linear mixed effects models analysis showed a significant interaction effect of group and time indicating superior improvements in SRH in exposure-based CBT compared to the control condition (Z = 2.69, p = 0.007). The controlled effect size was moderately large (d = 0.64) and improvements were stable at 1-year follow-up. Reduced health anxiety was a significant mediator of improvement in SRH. Conclusions: 12 weeks of exposure-based CBT for SHA can lead to significant improvements in SRH. Considering the previously established importance of SRH as a predictor for disease and mortality, exposure-based CBT for severe health anxiety may lead to improvements on several important health parameters, possibly even increasing the likelihood of longevity.
AB - Objective: Self-rated health (SRH) has been shown to be a stable predictor of illness and mortality. Improvement in SRH, even in the absence of change in objective health, predicts better health and reduced mortality. Severe health anxiety (SHA) is characterized by fear of illness and distorted health perception. The objective of the present study was to investigate if exposure-based cognitive behavior therapy (CBT) for SHA can lead to improvement in SRH and whether this improvement is mediated by reduced health anxiety. Methods: Data were collected from a randomized controlled trial where participants with SHA were allocated to 12 weeks of exposure-based CBT (n = 99) for SHA or to a no treatment control condition (n = 33). The mediation analysis was based on SRH- and health anxiety data collected weekly during the treatment phase. Results Linear mixed effects models analysis showed a significant interaction effect of group and time indicating superior improvements in SRH in exposure-based CBT compared to the control condition (Z = 2.69, p = 0.007). The controlled effect size was moderately large (d = 0.64) and improvements were stable at 1-year follow-up. Reduced health anxiety was a significant mediator of improvement in SRH. Conclusions: 12 weeks of exposure-based CBT for SHA can lead to significant improvements in SRH. Considering the previously established importance of SRH as a predictor for disease and mortality, exposure-based CBT for severe health anxiety may lead to improvements on several important health parameters, possibly even increasing the likelihood of longevity.
KW - exposure-based cognitive behavior therapy
KW - mediation
KW - randomized controlled trial
KW - self-rated health
KW - severe health anxiety
UR - http://www.scopus.com/inward/record.url?scp=85030774040&partnerID=8YFLogxK
U2 - 10.1016/j.jpsychores.2017.09.013
DO - 10.1016/j.jpsychores.2017.09.013
M3 - Article
C2 - 29167052
AN - SCOPUS:85030774040
SN - 0022-3999
VL - 103
SP - 9
EP - 14
JO - Journal of Psychosomatic Research
JF - Journal of Psychosomatic Research
ER -