Should health anxiety be carved at the joint? A look at the health anxiety construct using factor mixture modeling in a non-clinical sample

• Published in: Journal of anxiety disorders Vol. 26; no. 1; pp. 246 - 251
• Main Authors: Asmundson, Gordon J.G., Taylor, Steven, Nicholas Carleton, R., Weeks, Justin W., Hadjstavropoulos, Heather D.
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ltd 01.01.2012; Elsevier
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Affectivity. Emotion; Anxiety; Anxiety - diagnosis; Anxiety - psychology; Attitude to Health; Biological and medical sciences; Conceptualization; Factor mixture modeling; Female; Fundamental and applied biological sciences. Psychology; Health; Health anxiety; Humans; Hypochondriasis; Hypochondriasis - diagnosis; Hypochondriasis - psychology; Illness Attitude Scales; Latent structures; Male; Medical sciences; Middle Aged; Mixtures; Models, Psychological; Nosology. Terminology. Diagnostic criteria; Personality. Affectivity; Psychiatric Status Rating Scales; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Psychometrics; Psychopathology. Psychiatry; Somatoform disorders. Psychosomatics; Surveys and Questionnaires; Symptoms; Techniques and methods; Illness Attitude Scales; Health anxiety; Hypochondriasis; Factor mixture modeling; Human; Affect affectivity; Factor analysis; Healthy subject; Health; Nosology; Latent variable model; Criterion; Dimensional analysis; Somatoform disorder; Young adult; Classification; Adult; Anxiety; Hypochondria; Diagnosis
• ISSN: 0887-6185; 1873-7897; 1873-7897
• DOI: 10.1016/j.janxdis.2011.11.009

► Contemporary cognitive-behavioral models conceptualize health anxiety as a construct that is continuous in nature; that is, one that varies in degree from low to high. ► The latent structure of the health anxiety construct was examined using factor mixture modeling in a large sample of non-clinical participants. ► Results contrast the contemporary conceptualization of health anxiety as well as findings of two prior studies, indicating that it is taxonic in nature; that is, it comprises several qualitatively distinct forms. Cognitive-behavioral models conceptualize health anxiety as a construct that varies in degree along a continuum rather than existing as nonpathological versus pathological classes or taxons. Only two studies have empirically evaluated the latent structure of health anxiety, both using taxometric statistical methods and both supporting its conceptualization as continuous ( Ferguson, 2009; Longley et al., 2010). We sought to further evaluate the latent structure of health anxiety using factor mixture modeling (FMM), which involved a combination of exploratory factor analysis (EFA) and mixture modeling that allowed comparison of models comprising one or more latent classes. Health anxiety symptom data were obtained from the Illness Attitude Scales (IAS) administered to 1768 university undergraduate students. Indicators of health anxiety, derived from EFA of IAS item data, included disease worry, disease conviction, health-related safety behaviors, fear of death, somatic focus, interference due to symptoms, and treatment seeking. FMM of these indicators suggested that health anxiety consists of two classes: (a) an “anxious” class comprising 81.4% of the sample and characterized primarily by somatic focus and interference due to symptoms, and (b) a “nonanxious” class comprising 18.6% of the sample with low scores on all indicators. Contrary to current conceptualizations and taxometric findings, the FMM results indicate the latent structure of health anxiety to be taxonic rather than continuous. Implications for the measurement and conceptualization of health anxiety are discussed and future research directions are highlighted.