title: A diary-based modification of symptom attributions in pathological health anxiety: effects on symptom report and cognitive biases.
abstract: OBJECTIVE
  To examine whether a 2-week attribution modification training (AMT) changes symptom severity, emotional evaluation of health-threatening stimuli, and cognitive biases in pathological health anxiety.
  
  
  METHODS
  We randomized 85 patients with pathological health anxiety into an electronic diary-based AMT group (AMTG; n = 42) and a control group without AMT (CG; n = 43). Self-report symptom measures, emotional evaluation, attentional bias, and memory bias toward symptom and illness words were assessed with an emotional Stroop task, a recognition task, and an emotional rating task for valence and arousal.
  
  
  RESULTS
  After the 2-week period, the AMTG compared with the CG reported lower symptoms of pathological health anxiety, F(1, 82) = 10.94, p < .01, η2p = .12, rated symptom, F(1, 82) = 5.56, p = .02, η2p = .06, and illness words, F(1, 82) = 4.13, p = .045, η2p = .05, as less arousing, and revealed a smaller memory response bias toward symptom words in the recognition task F(1, 82) = 12.32, p < .01, η2p = .13. However, no specific AMT effect was observed for the attentional bias.
  
  
  CONCLUSIONS
  The results support the efficacy of a comparatively short cognitive intervention in pathological health anxiety as a possible add-on intervention to existing treatment approaches to reduce symptom severity, as well as abnormalities in health-related emotional evaluation and memory processes.
authors.affiliation: Department of Clinical Psychology, University of Heidelberg.
authors.forename: Tobias
authors.initials: T
authors.lastname: Kerstner
authors.affiliation: Department of Clinical Psychology, Johannes Gutenberg University of Mainz.
authors.forename: Michael
authors.initials: M
authors.lastname: Witthöft
authors.affiliation: Department of Clinical Psychology, University of Heidelberg.
authors.forename: Daniela
authors.initials: D
authors.lastname: Mier
authors.affiliation: Department of Cognitive and Clinical Neuroscience, Institute of Mental Health, Medical Faculty of Manheim, University of Heidelberg.
authors.forename: Carsten
authors.initials: C
authors.lastname: Diener
authors.affiliation: Department of Clinical Psychology, University of Heidelberg.
authors.forename: Fred
authors.initials: F
authors.lastname: Rist
authors.affiliation: Department of Clinical Psychology, University of Heidelberg.
authors.forename: Josef
authors.initials: J
authors.lastname: Bailer
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology / Q000628:therapy*; D001008:Anxiety Disorders / Q000523:psychology / Q000628:therapy*; D001143:Arousal / Q000502:physiology; D001288:Attention / Q000502:physiology*; D001521:Behavior Therapy; D003071:Cognition / Q000502:physiology*; D004644:Emotions / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D057566:Self Report; D012938:Social Perception; D016896:Treatment Outcome