title: Exposure therapy changes dysfunctional evaluations of somatic symptoms in patients with hypochondriasis (health anxiety). A randomized controlled trial.
abstract: Dysfunctional evaluations of somatic symptoms are considered a central factor in maintaining hypochondriasis. The aim of the current study was to investigate whether exposure therapy (ET) without cognitive restructuring is sufficient to change dysfunctional evaluations of somatic symptoms. The current study was based on a randomized controlled trial and compared patients with hypochondriasis (N=73) receiving ET or cognitive therapy (CT) to a wait list (WL) control group. In both the ET and CT groups, dysfunctional symptom evaluations changed significantly compared with the WL group. No differences between the ET and CT groups emerged. The relationship between the treatment condition (active treatment vs. WL) and reductions in health anxiety was mediated by changes in somatic symptom evaluations only in a specific card sorting procedure. We conclude that addressing dysfunctional symptom evaluations is a necessary precondition for the effective treatment of hypochondriasis. However, the results indicate that ET and CT appear to change those processes to a similar degree.
authors.affiliation: Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes Gutenberg University of Mainz, Wallstraße 3, D-55122 Mainz, Germany. Electronic address: flweck@uni-mainz.de.
authors.forename: Florian
authors.initials: F
authors.lastname: Weck
authors.affiliation: Department of Clinical Psychology and Psychotherapy, Goethe University, Varrentrappstraße 40-42, D-60486 Frankfurt am Main, Germany. Electronic address: neng@psych.uni-frankfurt.de.
authors.forename: Julia M B
authors.initials: JM
authors.lastname: Neng
authors.affiliation: Department of Clinical Psychology and Psychotherapy, Goethe University, Varrentrappstraße 40-42, D-60486 Frankfurt am Main, Germany. Electronic address: schwind@psych.uni-frankfurt.de.
authors.forename: Julia
authors.initials: J
authors.lastname: Schwind
authors.affiliation: Department of Clinical Psychology and Psychotherapy, Goethe University, Varrentrappstraße 40-42, D-60486 Frankfurt am Main, Germany. Electronic address: v.hoefling@psych.uni-frankfurt.de.
authors.forename: Volkmar
authors.initials: V
authors.lastname: Höfling
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001008:Anxiety Disorders / Q000628:therapy; D001294:Attitude to Health; D015928:Cognitive Behavioral Therapy / Q000379:methods; D005260:Female; D006801:Humans; D006998:Hypochondriasis / Q000523:psychology / Q000628:therapy*; D007171:Implosive Therapy / Q000379:methods*; D008297:Male; D011569:Psychiatric Status Rating Scales; D011615:Psychotherapy, Group / Q000379:methods; D016896:Treatment Outcome
keywords: Cognitive therapy; Exposure therapy; Health anxiety; Hypochondriasis; Illness anxiety disorder