| Health anxiety is a dimensional concept ranging from minor concerns about bodily sensations and health at one end of a continuum to clinically significant health-related fears and constant worry about sensations, combined with disease conviction, at the other end (Salkovskis & Warwick, 1986). To date, subjective instruments (i.e., self-report) have been considered the only practical methods of assessing health anxiety. These measures are, however, susceptible to distortion and demand effects (particularly given the negative stereotype surrounding one form of health anxiety, hypochondriasis). Research suggests that relative colour-naming latencies as assessed by the Modified Stroop Paradigm (MSP) may represent a powerful assessment technique. This technique focuses on attentional bias towards health information by asking participants to look at a series of words, to ignore the meaning of the words, and to state the colour the words are written in. An inability to keep one's attention away from relevant words (e.g., cancer) is demonstrated by an increase in the amount of time taken to name the colour it has been presented in. This bias, to pay excessive attention to information about health and illness, is predicted by the cognitive-behavioural model of health anxiety and has received empirical support.;One purpose of this investigation was to create preliminary normative MSP tables and provide psychometric support for the Modified Stroop Paradigm-Health Anxiety Screen (MSP-HAS) as unique tool to assess health anxiety. A second purpose was to provide evidence in support of the cognitive-behavioural model of health anxiety. Three studies were completed employing 33 Student participants, 45 Psychiatric participants, and 16 Medical participants; preliminary normative values for these groups are offered. As expected, Student participants did not demonstrate significant elevations in health anxiety or MSP-HAS scores. Psychiatric participants with high health anxiety displayed elevations in Illness colour-word naming latencies as compared to those without high health anxiety. MSP-HAS scores for Psychiatric participants without elevated health anxiety were similar to those found in the non-clinical Student group. Pre-surgical Medical participants demonstrated elevations in Illness colour-word naming latencies despite denying health anxious thoughts as typically measured by self-report instruments. Sensitivity to change was also demonstrated; MSP-HAS scores dropped significantly from pre-surgery to successful post-surgery. Test-retest reliability, internal consistency, convergent validity, construct validity, and content validity of the MSP-HAS were supported. By employing the MSP-HAS alongside more conventional questionnaire measures of health anxiety, important information was collected about the three main categories of individuals studied, the cognitive-behavioural model of anxiety, and the dimensional conceptualization of health anxiety. The use of the MSP-HAS as a potential objective measure of health anxiety was supported, with the potential to decrease clinicians' reliance on client self-report. Additional clinical implications are discussed. |
