ABSTRACT
Interpretation bias (i.e. the selective negative interpretation of ambiguous stimuli) may contribute to the development and maintenance of health anxiety. However, the strength of the empirical evidence for this association remains a topic of debate. This study aimed to estimate the association between health anxiety and interpretation bias and to identify potential moderators of this association. Chinese-language databases (CNKI, VIP, and Wanfang), English-language databases (Web of Science, PubMed, PsycINFO, and Scopus), and German-language databases (Psyndex and PubPsych) were searched for relevant studies. There were 36 articles (39 studies) identified by this search (N = 8984), of which 32 articles (34 studies) were included in the meta-analysis (N = 8602). Results revealed a medium overall effect size (g = 0.67). Statistically equivalent effect sizes were observed for patients diagnosed with clinical health anxiety (g = 0.58) and subclinical health anxiety (g = 0.72). The effect sizes for threat stimuli that were health related (g = 0.68) and not health related (g = 0.63) did not differ significantly. The effect size for studies using an offline paradigm (g = 0.75) was significantly higher than that for studies using an online paradigm (g = 0.50). It is concluded that health anxiety is significantly and robustly associated with interpretation bias. These findings are of central importance for the advancement of models and treatment of health anxiety.
ABSTRACT
Attentional bias toward health-threat may theoretically contribute to the development and maintenance of health anxiety, but the empirical findings have been controversial. This study aimed to synthesize and explore the heterogeneity in a health-threat related attentional bias of health-anxious individuals, and to determine the theoretical model that better represents the pattern of attentional bias in health anxiety. Four databases (Web of Science, PubMed, PsycINFO, and Scopus) were searched for relevant studies, with 17 articles (N = 1546) included for a qualitative review and 16 articles (18 studies) for a three-level meta-analysis (N = 1490). The meta-analytic results indicated that the health anxiety group, compared to the control group, showed significantly greater attentional bias toward health-threat (g = 0.256). Further analyses revealed that attentional bias type, paradigm, and stimuli type were significant moderators. Additionally, compared to the controls, health-anxious individuals displayed significantly greater attention maintenance (g = 0.327) but nonsignificant attention vigilance to health-threat (g = -0.116). Our results provide evidence for the attention maintenance model in health-anxious individuals. The implications for further research and treatment of elevated health anxiety in the context of coronavirus disease-2019 (COVID-19) were also discussed.
Subject(s)
Attentional Bias , COVID-19 , Anxiety , Anxiety Disorders , HumansABSTRACT
Background: Estimating the prevalence of depressive and anxiety symptoms among older adults with different health conditions can inform mental health services for this population during the corona virus disease-2019 (COVID-19) pandemic. Method: A search of 12 scientific databases identified 17 studies with 11,237 Chinese older adults who were infected by COVID-19, were generally healthy, or had chronic illnesses. Meta-analysis was used to estimate the overall prevalence of depressive and anxiety symptoms in these three groups. Assessment criteria, region, and time phase of the pandemic were tested as sources of heterogeneity. Results: With an average risk of bias score of 6.71 (range = 6-8), the majority of included studies employed appropriate statistical methods, used validated measurement tools, and had adequate response rates; however, they might have deficiencies in sample frame, sampling method, and sample size. Within the COVID-19, general, and chronic illness groups, the prevalence of depressive symptoms was 27%, 26%, and 61%, respectively, and the prevalence of anxiety symptoms was 14%, 23%, and 85%, respectively. Among generally healthy older adults, anxiety was more prevalent during the Phase 2 (March-April 2020) of the pandemic compared with other time phases. Conclusions: The results have implications for addressing the mental health problems of Chinese older adults, especially those with chronic illnesses, during the COVID-19 pandemic.