| Health anxiety refers to the fear and worry caused by inappropriate or excessive attention to one’s own health condition.Based on the comprehensive model of health anxiety,the development and maintenance of health anxiety is closely related to an individual’s interpretation bias(i.e.selective negative interpretation of ambiguous stimuli).However,empirical research evidence regarding the interpretation bias of health anxious individuals remains controversial.Therefore,current study aims to explore the relationship between health anxiety and interpretation bias from the perspectives of horizontal correlation,and further investigate the intervention effect of internet-based Cognitive Bias Modification-Interpretation(i CBM-I)training on health anxiety,catastrophizing interpretation,anxiety and depression symptoms and the mediating mechanism of catastrophizing interpretation from the perspectives of longitudinal intervention.In Study 1,a systematic review and meta-analysis were used to examine the relationship between health anxiety and interpretation bias,and subgroup analysis and meta-regression analysis were used to explore moderating variables affecting the relationship.Literature was searched in Chinese databases(CNKI,Wanfang and VIP),English databases(Web of Science,Pub Med,Psyc INFO and Scopus)and German databases(Psyndex and Pub Psych).Finally,33 articles(36 studies)were included in the systematic review,of which 29 articles(31 studies)were suitable for meta-analysis.The results of the meta-analysis showed that health anxiety was positively correlated with interpretation bias(g = 0.67,95%CI[0.51,0.83]).The measurement paradigm of interpretation bias was a significant moderator,while the moderating effects of stimulus type,clinical status,age,gender,year,culture and journal impact factor were not significant.Study 2 used a randomized controlled trial in which eligible participants(N = 228)with health anxiety(Short Health Anxiety Inventory [SHAI] scores ≥ 15)were randomly assigned to an intervention group(100% positive feedback i CBM-I intervention),a positive control group(50% positive and 50% negative feedback i CBM-I intervention),and a wait-list group.Participants were trained for 12 days(once every 3 days,a total of four times),and their health anxiety,catastrophizing interpretation,anxiety,and depression were measured at pre-treatment,post-treatment and 1-month follow-up to assess the immediate and follow-up effects of the i CBM-I program on health anxiety,and to explore the psychological mechanism of intervention effect.The generalized linear mixture model was used to analyze the intervention effect of the i CBM-I program,two-factor analysis of variance and hierarchical regression were used to analyze the moderating effect of demographic and symptom variables at baseline,and the latent growth curve model of the parallel development was used to analyze the longitudinal mediating effect of catastrophizing interpretation.The results found that: Compared with the wait-list group,the 100% positive feedback i CBM-I intervention group had significant immediate effect on the catastrophizing interpretation(d =-0.83,p < 0.001),anxiety(d =-0.62,p < 0.001)and depression(d =-0.94,p < 0.001)symptoms of healthy anxious individuals.There were significant effects of 1-month follow-up intervention on health anxiety(d =-0.59,p < 0.001),catastrophizing interpretation(d =-0.76,p < 0.01),anxiety(d =-0.56,p < 0.01)and depression(d =-0.77,p < 0.001).The marital status,baseline level of health anxiety symptoms and catastrophizing interpretation played a moderating role in the i CBM-I intervention of health anxiety symptoms,and catastrophizing interpretation played a longitudinal mediating role in the i CBM-I intervention of health anxiety symptoms.Current study developed an i CBM-I self-help intervention mini-program for health anxiety and investigated its feasibility,effect and psychological mechanism,providing new empirical research evidence for the cognitive theory of emotion and a new perspective for the networked intervention for health anxiety.In the future,researchers may consider the development of "top-down" and "bottom-up" combined intervention therapy,and investigate the effect and mechanism of intervention on health anxious individuals. |
