Efficacy of a transdiagnostic internet-based program for adolescents with emotional disorders: A randomized controlled trial.

OBJECTIVE: The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) is a well-established transdiagnostic cognitive-behavioral therapy (T-CBT) intervention. The aim of the present study was to examine the efficacy of the program Learn to Manage your Emotions [Aprende a Manejar tus Emociones] (AMtE), a self-applied transdiagnostic internet-delivered program based on the Spanish version of the UP-A. This is the first transdiagnostic internet-based program designed for the treatment of emotional disorders in adolescents. METHOD: A sample of Spanish adolescents with a primary diagnosis of an anxiety and/or depressive disorder (n = 58; age range = 12-18 years; 78.3% girls; 90% Caucasian) were randomly allocated to receive AMtE (n = 28) or the UP-A via videocall (n = 30). Pre-treatment, post-treatment and 3-month follow-up data were collected using self-reports and clinician-rated measures of anxiety, depression, positive and negative affect, anxiety sensitivity and emotional avoidance. RESULTS: Based on generalized estimating equations (GEE) models, both intervention programs were effective in significantly reducing self-reported anxiety and depressive disorder symptoms and clinician-rated severity of anxiety and depression, as well as self-reported transdiagnostic outcome variables. CONCLUSIONS: Data provide empirical support for the efficacy of AMtE as a transdiagnostic online CBT treatment for anxiety and depressive disorders in adolescents. No marked nor consistent differences were observed between the UP-A and AMtE, highlighting the potential usefulness of the online self-administered AMtE program.

Cognitive training via mobile app for addressing eating disorders' cognitions in adolescents: a randomized control trial protocol.

During adolescence, individuals are particularly vulnerable to developing eating disorders (EDs). To address the dysfunctional beliefs linked to these disorders, a new mobile app has been developed. This app, called GG eating disorders-Adolescents (GGED-AD), was created based on CBT to help adolescents work on their self-dialogue related to the core beliefs of eating disorders. The objective is to present the protocol for a randomized controlled trial to explore the efficacy of GGED-AD.Methods The study will be carried out in adolescents aged 13 to 16 from an educational center in the Valencian Community. The participants will be randomized into two groups: the experimental group will use the GGED-AD app during 14 consecutive days for approximately 5 min each day; and the control group will use a neutral app (GGNEUTRAL) during the same time. Both groups will complete instruments that assess dysfunctional beliefs related to eating disorders, eating symptoms, symptoms of depression and anxiety, body satisfaction and self-esteem before and after the intervention. A follow-up will be conducted one month later.Results A decrease in the degree of ascription to dysfunctional beliefs associated with eating disorders and eating symptomatology is expected, as well as an increase in body satisfaction and the self-esteem of the participants of the experimental group.Discussion The app in this study could help tackle and prevent ED-related symptoms in adolescents.Trial registration NCT06039514.

A mobile app to challenge obsessional beliefs in adolescents: a protocol of a two-armed, parallel randomized controlled trial.

BACKGROUND: Adolescence is a crucial stage for the development of OCD symptoms that, in most cases, persist into adulthood. This requires designing preventive strategies tailored to this population. Therefore, we aim to describe the study protocol that will be used to examine the effectiveness of a mobile health application to challenge obsessional beliefs in adolescents. METHODS: A two-armed randomized controlled trial will be conducted on an adolescent sample from the general population. The experimental group will use the intervention module (GGOC-AD) of a mobile app on the GGtude platform for 14 days whereas the control group will use a non-active module (GGN-AD) of said app. Primary outcome measures will be obsessional beliefs and obsessive-compulsive symptoms, and secondary measures will be self-esteem and emotional symptoms. Three assessment points will be conducted at baseline, post-intervention, and one-month follow-up. A linear multiple regression model with an intention to treat approach will be used. The expected total sample size will be 55 participants. DISCUSSION: We expect that the intervention group will show a reduction in obsessional beliefs and OCD-symptoms at post and follow-up in comparison with the control group. Additionally, we expect that the app will improve participants' self-esteem. This study could provide an accessible mobile health tool to prevent OCD-related symptoms in adolescents. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT06033391 . Registered September 4, 2023.

The Effectiveness of a Cell Phone eHealth App in Changing Knowledge, Stigmatizing Attitudes, and Intention to Seek Help Associated With Obsessive-Compulsive Disorder: Pilot Questionnaire Study.

BACKGROUND: Obsessive-compulsive disorder (OCD) is a disabling disorder associated with high interference in people's lives. However, patients with OCD either do not seek help or delay seeking help. Research suggests that this could be explained by poor mental health literacy about the disorder and the associated stigma. OBJECTIVE: This study aims to evaluate the feasibility, acceptability, and preliminary effectiveness of a mental health mobile app, esTOCma, developed to improve knowledge about OCD and its treatment, increase help-seeking intention, and reduce stigmatizing attitudes and social distance associated with OCD. METHODS: We used preintervention, postintervention, and 3-month follow-up assessments in this single-arm pilot intervention. Overall, 90 participants were recruited from the community using the snowball sampling method. We used esTOCma to defeat the "stigma monster" over the course of 10 missions. The participants completed the sociodemographic information and Obsessive-Compulsive Inventory-Revised at preassessment and an acceptability questionnaire at postassessment. All other measures were completed at the preassessment, postassessment, and 3-month follow-up (ie, the Spanish Mental Illness Stigma Attribution Questionnaire-27, the General Help-Seeking Questionnaire, the Social Distance Scale, and the Mental Health Literacy Questionnaire). RESULTS: Of the 90 participants from the community that were assessed for eligibility, 86% (n=78) were allocated to intervention. Of these 78 participants, 79% (n=62) completed the game and answered the postintervention assessment (completer group). Overall, 69% (43/62) of the participants also completed the 3-month follow-up assessment. The participants completing the study were older (P=.003) and had a higher baseline knowledge of OCD (P=.05). The participants took an average of 13.64 (SD 10.50) days to complete the intervention, including the pre- and postassessments. The participants spent an average of 4.56 (SD 3.33) days completing the 10 missions included in the app. Each mission took a mean of between 2 (SD 3.01) and 9.35 (SD 3.06) minutes. The app was rated as useful or very useful by the vast majority of participants 90% (56/62). Moreover, 90% (56/62) of the participants reported that they had learned or learned a lot, and 98% (61/62) of the participants reported that they would recommend the app to a friend. Repeated measures ANOVA (43/62, 69%) showed that after the intervention participants showed an increased knowledge of mental health and intention to seek help as well as fewer stigmatizing attitudes and less social distance. CONCLUSIONS: Preliminary data show that esTOCma is a feasible and acceptable app, and after completing its 10 missions, there is an increase in the understanding of OCD and help-seeking intention along with a decrease in the social stigma and social distance associated with OCD that lasts for at least 3 months. The results support the potential of technology-based interventions to increase the intention to seek help and reduce the stigma associated with OCD. A larger, community-controlled study is also recommended.

Can an app increase health literacy and reduce the stigma associated with obsessive-compulsive disorder? A crossover randomized controlled trial.

BACKGROUND: Obsessive-compulsive disorder (OCD) is a disabling condition with a high delay in seeking treatment. esTOCma is an app developed to increase mental health literacy (MHL) about OCD, reduce stigma, and increase the intention to seek professional treatment. It is a serious game and participants are asked to fight against the "OCD stigma monster" by accomplishing 10 missions. The aim of this study is to evaluate the effectiveness of this app in a community sample. METHODS: A randomized controlled trial with a crossover design was carried out. Participants were randomized to two groups: immediate use (iApp, n = 102) and delayed use (dApp, n = 106) of esTOCma. The iApp group started using the app at baseline until the game was over. The dApp group initiated at 10-days until the game finished. Participants were requested to complete a set of questionnaires at baseline and 10-day, 20-day and 3-month follow-ups. RESULTS: The Time×Group interaction effect was significant for the primary outcome measures: there was an increase in MHL and intention to seek help, and a decrease in stigma and OC symptoms, with large effect sizes, only after using the app. Changes were maintained (or increased) at follow-up. LIMITATIONS: The study did not include an active control group and some of the scales showed low internal consistency or a ceiling effect. CONCLUSIONS: This study provides first evidence for the effectiveness of esTOCma as a promising intervention to fight stigma and reduce the treatment gap in OCD. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04777292. Registered February 23, 2021, https://clinicaltrials.gov/ct2/show/NCT04777292.

Estigma asociado a los problemas de salud mental en población universitaria española / Stigma associated with mental health problems in the Spanish university population

El conocimiento sobre los problemas de salud mental y el contacto previo son variables clave en la lucha contra el estigma. Los objetivos del estudio fueron: (1) explorar el nivel de estigma asociado a los trastornos mentales en estudiantes de diferentes Grados universitarios y (2) analizar la evolución del estigma en estudiantes de Psicología. Dos grupos completaron el “Cuestionario de atribución” (AQ-27). El grupo 1 compuesto por 392 estudiantes de primer curso de los diferentes grados evaluados (Medad= 18,59 años; DT= 1,29; 60% mujeres), y el grupo 2 por 152 estudiantes de tercer curso de Psicología (Medad= 24,35 años; DT= 8,97; 73,4% mujeres). Los estudiantes del grupo 1 con contacto previo con trastornos mentales mostraron actitudes menos estigmatizantes. Se observaron diferencias en función del Grado cursado. El grupo 2 mostró menores niveles de estigma a lo largo del curso académico. Los resultados apoyan la eficacia que la formación en salud mental y las intervenciones de sensibilización mediante el contacto con personas con problemas de salud mental, pueden tener en la reducción del estigma. (AU)

Knowledge about mental health problems and previous contact are key variables in the fight against stigma. The aims of the study were: (1) to explore the level of stigma associated with mental disorders in students of different university degrees, and (2) to analyse the evolution of stigma in psychology students. Two groups completed the Attribution Questionnaire (AQ-27). Group 1 consisted of 392 first-year students of the different degrees evaluated (Mage= 18.59 years, SD=1.29, 60% female), and group 2 consisted of 152 third-year Psychology undergraduates (Mage= 24.35 years, SD= 8.97, 73.4% female). Group 1 students with previous contact with mental disorders showed less stigmatising attitudes. Differences were observed according to grade level. Group 2 showed lower levels of stigma throughout the academic year. The results support the effectiveness that mental health education and awareness-raising interventions through contact with people with mental health problems can have in reducing stigma. (AU)

Enhancing mental health literacy in obsessive-compulsive disorder and reducing stigma via smartphone: A randomized controlled trial protocol.

Background: Obsessive-compulsive disorder (OCD) is a disabling disorder that can be successfully treated. However, individuals with OCD do not seek or delay seeking treatment. This delay may be explained by poor mental health literacy and stigmatizing attitudes toward OCD in community. In order to work on these variables, a gamified mental health mobile application (app) called esTOCma has been developed. The purpose of this study is to describe the protocol for a study to test the efficacy of esTOCma, increasing mental health literacy and help-seeking intention, reducing the stigmatizing attitudes and social distance suffered by people with OCD, as well as the distress associated with obsessive-compulsive symptoms. Methods: A randomized controlled trial with a crossover design with two conditions (immediate-use App group versus delayed-use App group) will be conducted on a non-clinical adult sample of the community of a minimum size of 200 participants. Participants in the immediate-use App group will start using the app at baseline until completion (10 days); whereas participants in the delayed-use App group will wait 10 days, and then start using the app until completion (10 days). The outcomes will be measured at four assessment points (baseline; 10 days from baseline; and 20 days from baseline; and after 3 months). The following instruments will be administered: Attribution Questionnaire, General Help-Seeking Questionnaire, Social Distance Scale, Mental Health Literacy, Psychoeducation Questionnaire, Social Desirability Scale, Single-Item Self-esteem Scale, and Obsessive-Compulsive Inventory-Revised. Discussion: This protocol presents the first study to describe a randomized control trial of a mental health app focused on changing mental health literacy, stigmatizing attitudes, social distance and help-seeking intention associated with OCD. An app intervention of these characteristics is especially relevant nowadays as the COVID-19 pandemic has increased obsessive-compulsive symptoms and severity. An improvement in general knowledge about OCD and a reduction in stigma could be associated with earlier OCD detection and an increase in help-seeking intention, which could result in greater wellbeing. Moreover, normalizing intrusions and knowledge about the cognitive OCD model could serve as a protective variable in vulnerable individuals. Trial registration: ClinicalTrials.gov identifier: NCT04777292. Registered February 23, 2021, https://clinicaltrials.gov/ct2/show/NCT04777292.

Prevention of Depression and Anxiety in Subclinical Adolescents: Effects of a Transdiagnostic Internet-Delivered CBT Program.

Anxiety and depressive symptoms are common problems in adolescence that could be addressed by means of preventive interventions. Even though transdiagnostic cognitive behavior therapy (T-CBT) is potentially an ideal strategy to deal with anxiety and depression, it has rarely been used for preventive purposes. In addition, so far, no study has used internet-delivered T-CBT to prevent anxiety and depression in adolescents. This study aimed to examine the utility of AMTE, an internet-delivered T-CBT program, for the indicated prevention of anxiety and depression in adolescents. AMTE was applied to 30 adolescents (56.7% females, age range = 12-18 years, Mage = 14.00, SDage = 1.89) who showed subclinical symptoms of anxiety and/or depression. Participants were assessed at pre- and post-treatment and follow-up (3 months). We found that after the program, the symptoms of self-reported anxiety and depression, clinician-rated symptom severity, and self-reported and parent-reported severity of the main problems had significantly improved. In addition, there were significant improvements in anxiety sensitivity and emotional avoidance. Finally, we found high feasibility and acceptability of the program. AMTE is feasible and potentially effective for the indicated prevention of anxiety and depression as well as of clinical transdiagnostic factors, in adolescents.

Factores asociados al impacto emocional de la pandemia por Covid-19 en profesionales sanitarios / [Factors associated with the emotional impact of the Covid-19 pandemic on health professionals]

El objetivo de este trabajo fue explorar el impacto emocional de la Covid-19 en profesionales sanitarios del Hospital Clínico Universitario de Valencia, e identificar las variables asociadas. Participaron 228 profesionales que cumplimentaron en mayo de 2020 una encuesta online elaborada ad hoc. Los profesionales sanitarios experimentaron síntomas de estrés (32%), depresión (26%), ansiedad (14%) y recuerdos intrusos (7,5%). Se observó mayor frecuencia de tristeza y ansiedad en mujeres y en profesionales que habían presentado síntomas de Covid-19. La categoría profesional con síntomas emocionales más frecuentes fue el de auxiliar de enfermería, y para estrés también enfermeros y residentes. Las unidades con mayor afectación fueron las de primera línea. Las variables psicológicas que se asociaron negativamente con la frecuencia de todas las manifestaciones sintomáticas fueron: autocuidado, autoestima, resiliencia y uso de estrategias de afrontamiento activas, junto a autoeficacia y apoyo social para estrés y depresión. Pese a las limitaciones del estudio, los resultados pueden contribuir a orientar programas preventivos para profesionales sanitarios en futuras crisis sanitarias.

The aim of this study was to explore the emotional impact of Covid-19 on healthcare professionals at the Clinical and University Hospital of Valencia (Spain), and to identify the associated variables. A total of 228 professionals completed an ad hoc online survey in May 2020. The healthcare professionals experienced symptoms of stress (32%), depression (26%), anxiety (14%) and intrusive memories (7.5%). A higher frequency of sadness and anxiety was observed in women and in professionals who had presented Covid-19 symptoms. The professional category with the most frequent emotional symptoms was that of auxiliary nurses, and for stress also nurses and residents. The most affected were the first line units. The psychological variables that were negatively associated with the frequency of all symptomatic manifestations were: self-care, self-esteem, resilience and use of active coping strategies, together with self-efficacy and social support for stress and depression. Despite the limitations of the study, the results may contribute to guide preventive programs for health professionals in future health crises.

The relationship between obsessions and the self: Feared and actual self-descriptions in a clinical obsessive-compulsive disorder sample.

Cognitive models of obsessive-compulsive disorder (OCD) posit the relevance of the self in OCD, although the nature of this association is still unclear. We aimed to explore actual and feared selves and its association with obsessions and intrusions in a group of OCD patients. A group of 58 patients with OCD identified their most upsetting obsession and intrusion (non-clinical obsession) experienced in the past 3 months. These cognitions were classified as either moral-based or autogenous (obsessions n = 32; intrusions n = 26) or non-moral-based or reactive, depending on their content. Next, patients described their actual self and their feared self, that is, the person they feared being or becoming, and whether they believed these descriptions were associated with their obsessions/intrusions. Results indicate that individuals with OCD described themselves as insecure, anxious and fearful, but also as good and nice. They particularly feared a selfish, aggressive, bad, liar, coward, insecure and arrogant self. Two-thirds of the patients believed that their obsessions said something about their actual self (65.52%) and that their obsessions brought them closer to the person they do not want to be (62.06%). A third of patients believed their intrusions said something about their actual self (actual self: 30.35%; feared self: 25%), which was a significantly lower percentage than for obsessions. These associations existed independent from the content of the obsession and/or intrusion, although patients with obsessions with moral-based contents more often tended to believe that their obsessions brought them closer to the person they do not want to be. Results suggest the relevance of the real and feared selves in the maintenance of obsessions.

Effects of Coronavirus Fears on Anxiety and Depressive Disorder Symptoms in Clinical and Subclinical Adolescents: The Role of Negative Affect, Intolerance of Uncertainty, and Emotion Regulation Strategies.

Fears related to COVID-19 ("coronavirus fears") have emerged as a new psychological effect of the current COVID-19 pandemic and have been associated with psychological distress and impairment. Other adverse effects include an increase in anxiety and depression symptoms and the respective disorders. The purpose of the current study was to examine the incremental validity of coronavirus fears and transdiagnostic factors in the prediction of the severity of anxiety and depressive disorder symptoms. A sample of 144 adolescents [aged 12-18 years, 55 boys (38.2%) and 89 girls (61.8%)] most of whom showed elevated levels of anxiety and depressive disorder symptoms completed several self-report measures online assessing coronavirus fears, transdiagnostic vulnerability and protective factors, and emotion regulation strategies. Results based on a series of hierarchical multiple regression analyses revealed that coronavirus fears, negative affect, intolerance of uncertainty, acceptance/tolerance, rumination and suppression explained unique variance in the severity of anxiety and depressive disorder symptoms. Path analysis demonstrated that acceptance/tolerance, rumination and suppression mediated the association between higher level transdiagnostic factors and the severity of major depressive disorder symptoms. Findings provide support for the hierarchical transdiagnostic model of emotional disorders and suggest that clinicians should be aware of coronavirus fears. Also, the results warrant the need to consider transdiagnostic vulnerability and protective processes in the new protocols for the treatment of emotional disorders.

Teachers' Knowledge and Stigmatizing Attitudes Associated With Obsessive-Compulsive Disorder: Effectiveness of a Brief Educational Intervention.

Because children and adolescents are vulnerable to developing obsessive-compulsive disorder (OCD), classroom teachers play an important role in the early identification and intervention in students with OCD. The present study aims to explore the recognition of OCD, general knowledge about this disorder, implications in the classroom, and stigmatizing attitudes among teachers, as well as the effectiveness of a brief educational intervention about OCD. Participants (n = 95; mean age = 43. 29 years old; 64.3% female) were primary and secondary school teachers who were randomly assigned to an experimental group or a control group. All of them completed a set of self-report questionnaires, read an educational fact sheet (either about OCD in the experimental group or about a healthy diet in the control group), and again completed the questionnaires. Results show that prior to the intervention, most of the teachers identified the contamination and order OCD symptoms described in a vignette as specific to OCD (82.1%) and would recommend talking about the problem (98.9%) and seeking help (94.7%). However, only a few (36.8%) knew about the most effective OCD treatments or identified compulsions as a main OCD symptom (33%). Moreover, only about half of the teachers correctly identified OCD's possible interference in classroom routines, such as delays to achieve perfection or concentration problems, and strategies for dealing with OCD, such as continuing with the class rhythm. Stigma levels were from low to moderate. After the brief educational intervention, participants in the experimental group increased their knowledge about OCD, improved their strategies for managing a student with OCD symptoms, and had fewer stigmatizing attitudes associated with pity (p < 0.05). These changes were not observed in the control group. We can conclude that this brief and easy-to-administer intervention is an effective educational intervention to significantly improve teachers' knowledge and attitudes, at least in the short-term. These results are especially relevant because OCD is associated with high interference and long delays in seeking treatment, and teachers have a unique opportunity to help with prevention, early identification, and recommending an adequate intervention for OCD.

Illness-related intrusive thoughts and illness anxiety disorder.

INTRODUCTION: Intrusive thoughts about health threats (illness-ITs) are a potential cognitive risk factor for the development and maintenance of illness anxiety disorder (IAD). This study analyzes the dimensionality of illness-ITs from normalcy to psychopathology, and it evaluates whether the appraisals instigated by the Its mediate between these thoughts and IAD symptoms. METHODS: Two groups of individuals participated in the study and completed the Illness Intrusive Thoughts Inventory and the Whiteley Index. The first group was composed of 446 non-clinical community participants. Of them, 264 individuals (68.6% women; Mage  = 30.03 [SD = 13.83]) reported having experienced an upsetting illness-IT in the past three months and were then included in the main analyses. The second group included 31 patients with a current main diagnosis of IAD based on DSM-5 criteria (51.6% women; Mage  = 32.74 [SD = 9.69]). Their severity was assessed with the Hypochondriasis Yale-Brown Obsessive-Compulsive Scale -Modified version, with scores ranging from 15 to 58 (M = 46.12, SD = 9.41). RESULTS: Illness-ITs are common in both non-clinical individuals and in patients with IAD, and they instigate dysfunctional emotional, cognitive, and behavioral consequences, although with greater intensity in patients than in non-clinical individuals. The relationship between illness-ITs and IAD is mediated by overestimation of threat and thought-action fusion-probability appraisals. CONCLUSION: Illness-ITs are a dimensional cognitive experience. The way they are appraised facilitates their escalation into symptoms of IAD. PRACTITIONER POINTS: Provides support for the cognitive explanatory model of IAD and its usefulness in clinical practice. Indicates that the way people interpret and react to naturally occurring intrusive thoughts about illness seems to be a vulnerability marker for developing an illness anxiety disorder. Emphasizes that the meaning that patients with IAD ascribe to their intrusive thoughts about illnesses must be a main target in the cognitive-behavioral treatment of IAD. Suggests that the importance of intrusive thoughts in IAD does not lie in the frequency with which they are experienced, but in the way, they are appraised/interpreted, which is what determines whether they become a clinically significant symptom. Indicates that the relationship between illness intrusive thoughts and IAD symptoms in non-clinical individuals is based on: overestimating the negative consequences of experiencing an illness intrusive thought; and the appraisal that having such a thought would increase its likelihood of coming true. Shows that the frequency of illness-related intrusive cognitions is associated with worse cognitive and behavioral consequences.

Is context a crucial factor in distinguishing between intrusions and obsessions in patients with obsessive-compulsive disorder?

OBJECTIVE: Some cognitive models of obsessive-compulsive disorder (OCD) posit that intrusions exist on a continuum with obsessions; others consider that they may be unrelated phenomena that differ in the context where they occur. We aimed to examine and compare, at two different moments, the context of the occurrence of intrusions and obsessions. METHOD: Sixty-eight patients with OCD completed an interview appraising their most upsetting obsession and intrusion. RESULTS: At their onset, the obsessions/intrusions were associated with experiencing negative emotional states and life events, and they were more likely to appear in "inappropriate" contexts. The context of the obsessions/intrusions differed the last time they were experienced. Autogenous obsessions/intrusions occurred more frequently in contexts with an indirect link. CONCLUSIONS: The context distinguishes between intrusions and obsessions, not when they emerge, but when the obsession is already established. The results support that there is a continuum or progression from intrusions to obsessions.

Recent Insights Into Cyberchondria.

PURPOSE OF REVIEW: The construct of cyberchondria was introduced relatively recently. This article aims to review the conceptualization, theoretical basis and correlates of cyberchondria, as well as its prevention and management. RECENT FINDINGS: Although there is no consensus, most definitions of cyberchondria emphasize online health research associated with heightened distress or anxiety. The two theoretical models of cyberchondria involve reassurance seeking and specific metacognitive beliefs. Cyberchondria has relationships with health anxiety, problematic Internet use and symptoms of obsessive-compulsive disorder, with public health implications pertaining to functional impairment and altered healthcare utilization. Suggestions about prevention and management of cyberchondria have been put forward, but not tested yet. Research interest in cyberchondria has steadily increased. It is uncertain whether cyberchondria can be considered a distinct entity. Future research should aim to clarify the conceptual status of cyberchondria, quantify its impact and develop evidence-based approaches for a better control of cyberchondria.

Dysfunctional beliefs as mediators between illness-related intrusive thoughts and health anxiety symptoms.

BACKGROUND: Cognitive behavioural models of hypochondriasis assume that dysfunctional illness-related beliefs are involved in the genesis and maintenance of the disorder. The role that other more general dysfunctional beliefs about thoughts play in this disorder has also been highlighted. Internal triggers such as illness-related intrusive thoughts could activate these beliefs. AIM: The present paper examines whether general dysfunctional beliefs about distressing thoughts, such as intolerance of uncertainty, over-estimation of threat, and thought-action fusion-likelihood, mediate between illness-related intrusive thoughts and health anxiety symptoms. METHOD: A group of participants composed of individuals with hypochondriasis (n = 31; 51.5% women; mean age = 32.74 years, SD = 9.96) and community individuals (n = 219; 54.3% women; mean age = 39.56 years, SD = 15.20) completed a series of questionnaires to assess illness-related intrusive thoughts (INPIE), dysfunctional beliefs about thoughts (OBSI-R), and health anxiety symptoms (SHAI). RESULTS: Results from a multiple parallel mediation analysis indicate that over-estimation of threat partially mediated the relationship between illness-related intrusive thoughts and health anxiety symptoms. CONCLUSIONS: The results support the importance of the tendency to over-estimate the threat in the relationship between intrusive thoughts related to illness contents and health anxiety. Conceptual and clinical implications of these results are discussed.

The Spanish validation of the Short Health Anxiety Inventory: Psychometric properties and clinical utility.

BACKGROUND/OBJECTIVE: The Short Health Anxiety Inventory (SHAI) is a widely used self-report instrument to evaluate health anxiety. To assess the SHAI's factor structure, psychometric properties, and accuracy in differentiating Spanish non-clinical individuals from patients with severe health anxiety or hypochondriasis. METHOD: A total of 342 community participants (61.6% women; M age = 34.60, SD = 14.91) and 31 hypochondriacal patients (51.6% women; M age = 32.74, SD = 9.69) completed the SHAI and other self-reports assessing symptoms of hypochondriasis, depression, anxiety sensitivity, worry, and obsessive-compulsive. RESULTS: The original two-factor structure was selected as the best structure, based on its parsimony and empirical support (Factor 1: Illness likelihood; Factor 2: Negative consequences of illness). Moreover, the Spanish version of the SHAI demonstrated good construct and concurrent and discriminant validity, and internal consistency. A cutoff of 40.5 (total score) accurately distinguished non-clinical individuals from patients with severe health anxiety or hypochondriasis. CONCLUSIONS: The SHAI is an adequate screening instrument to measure health anxiety in Spanish-speaking community adults.

INTRODUCCIÓN/OBJETIVO: El Inventario Breve de Ansiedad por la Salud (SHAI, por sus iniciales en inglés) es un autoinforme ampliamente empleado para evaluar ansiedad por la salud. El objetivo es evaluar la estructura factorial del SHAI, sus propiedades psicométricas, y exactitud diferenciando entre población española no clínica y pacientes con hipocondría. MÉTODO: Un total de 342 participantes extraídos de la población general (66% mujeres, M edad  = 35, DT = 14,91) y 31 pacientes con hipocondría (51,6% mujeres; M edad  = 32,74, DT = 9,69 completaron el SHAI y otros autoinformes de síntomas hipocondriacos, depresión, sensibilidad a la ansiedad, preocupaciones y obsesivo-compulsivos. RESULTADOS: La estructura de dos factores propuesta originalmente fue seleccionada como la mejor estructura debido a su parsimonia y soporte empírico (Factor 1: Probabilidad de enfermar; Factor 2: Consecuencias negativas enfermedad). La versión española del SHAI muestra una buena consistencia interna, y validez de constructo, concurrente y discriminante. El punto de corte de 40,5 (puntuación total) permite distinguir entre los individuos no clínicos y los pacientes con elevada ansiedad por la salud o hipocondría. CONCLUSIONES: El SHAI es un instrumento adecuado para la detección de ansiedad por la salud en población adulta hispano hablante.

The Spanish validation of the Short Health Anxiety Inventory: Psychometric properties and clinical utility / Validación española del Inventario Breve de Ansiedad por la Salud: propiedades psicométricas y utilidad clínica

Background/Objective: The Short Health Anxiety Inventory (SHAI) is a widely used self-report instrument to evaluate health anxiety. To assess the SHAI's factor structure, psychometric properties, and accuracy in differentiating Spanish non-clinical individuals from patients with severe health anxiety or hypochondriasis. Method: A total of 342 community participants (61.6% women; Mage = 34.60, SD = 14.91) and 31 hypochondriacal patients (51.6% women; Mage = 32.74, SD = 9.69) completed the SHAI and other self-reports assessing symptoms of hypochondriasis, depression, anxiety sensitivity, worry, and obsessive-compulsive. Results: The original two-factor structure was selected as the best structure, based on its parsimony and empirical support (Factor 1: Illness likelihood; Factor 2: Negative consequences of illness). Moreover, the Spanish version of the SHAI demonstrated good construct and concurrent and discriminant validity, and internal consistency. A cutoff of 40.5 (total score) accurately distinguished non-clinical individuals from patients with severe health anxiety or hypochondriasis. Conclusions: The SHAI is an adequate screening instrument to measure health anxiety in Spanish-speaking community adults

Introducción/Objetivo: El Inventario Breve de Ansiedad por la Salud (SHAI, por sus iniciales en inglés) es un autoinforme ampliamente empleado para evaluar ansiedad por la salud. El objetivo es evaluar la estructura factorial del SHAI, sus propiedades psicométricas, y exactitud diferenciando entre población española no clínica y pacientes con hipocondría. Método: Un total de 342 participantes extraídos de la población general (66% mujeres, Medad = 35, DT = 14,91) y 31 pacientes con hipocondría (51,6% mujeres; Medad = 32,74, DT = 9,69 completaron el SHAI y otros autoinformes de síntomas hipocondriacos, depresión, sensibilidad a la ansiedad, preocupaciones y obsesivo-compulsivos. Resultados: La estructura de dos factores propuesta originalmente fue seleccionada como la mejor estructura debido a su parsimonia y soporte empírico (Factor 1: Probabilidad de enfermar; Factor 2: Consecuencias negativas enfermedad). La versión española del SHAI muestra una buena consistencia interna, y validez de constructo, concurrente y discriminante. El punto de corte de 40,5 (puntuación total) permite distinguir entre los individuos no clínicos y los pacientes con elevada ansiedad por la salud o hipocondría. Conclusiones: El SHAI es un instrumento adecuado para la detección de ansiedad por la salud en población adulta hispano hablante

Creencias disfuncionales sobre la salud y la enfermedad: Un estudio familiar / Dysfunctional beliefs about health and illness: A family study

Los modelos cognitivos sobre la hipocondría postulan que las experiencias tempranas con la enfermedad promueven el desarrollo de creencias disfuncionales sobre la enfermedad. Estas creencias pueden permanecer latentes y activarse ante un incidente crítico. Los estudios publicados aportan datos que avalan de manera indirecta estos planteamientos. Teniendo en cuenta que en el núcleo familiar primario se comparten experiencias sobre la enfermedad, examinamos la relación entre las creencias disfuncionales que los progenitores y sus descendientes mantienen sobre la enfermedad y los pensamientos, tales como la intolerancia a la incertidumbre y la sobreestimación de la amenaza, y las relaciones entre dichas creencias, la sintomatología hipocondríaca y depresiva. Cuarenta estudiantes universitarios y sus progenitores (27 padres y 36 madres) completaron auto-informes sobre creencias disfuncionales acerca de la enfermedad, los pensamientos y síntomas hipocondríacos y depresivos. Los resultados mostraron que las creencias disfuncionales sobre la enfermedad y la sobrestimación de la amenaza de los padres, pero no de las madres, se asociaban con las de sus hijos e hijas. Asimismo, las creencias disfuncionales de padres, hijos, e hijas, se relacionaron con síntomas de hipocondría y depresión

Cognitive models about hypochondriasis postulate that early experiences with illness can lead individuals to develop dysfunctional beliefs about having an illness. These beliefs can remain in a latent state and be triggered by a critical incident. Published studies have provided data partially supporting these assumptions. Considering that the primary family context shares experiences about illness, we examined the relationships between the dysfunctional beliefs that parents and their offsprings maintain about illness and thoughts, such as intolerance to uncertainty and over-estimation of threat, as well as the relationships between these beliefs with hypochondriacal and depressive symptoms. Forty university students and their parents (27 fathers and 36 mothers) completed self-reports on dysfunctional beliefs about illness, thoughts and symptoms of hypochondriasis and depression. Results indicated that the fathers' dysfunctional beliefs about illness and overestimation of threat, but not those of mothers, were associated with their sons and daughters beliefs. Likewise, the dysfunctional beliefs of fathers, sons, and daughters were related to symptoms of hypochondriasis and depression

The relationships between health anxiety, online health information seeking, and cyberchondria: Systematic review and meta-analysis.

BACKGROUND: Cyberchondria refers to an abnormal behavioral pattern in which excessive or repeated online searches for health-related information are distressing or anxiety-provoking. Health anxiety has been found to be associated with both online health information seeking and cyberchondria. The aims of the present systematic review and meta-analysis were to examine the magnitude of these associations and identify any moderator variables. METHODS: A systematic literature search was performed across several databases (PsycINFO, PubMed, Embase) and reference lists of included studies. RESULTS: Twenty studies were included across two independent meta-analyses, with 7373 participants. Random effects meta-analyses showed that there was a positive correlation between health anxiety and online health information seeking [r = 0.34, 95% CI (0.20, 0.48), p < .0001], and between health anxiety and cyberchondria [r = 0.62, 95% CI (0.52, 0.71), p < .0001]. A meta-regression indicated that the age of study participants [Q(1) = 4.58, p = .03] was partly responsible for the heterogeneity found for the relationship between health anxiety and cyberchondria. LIMITATIONS: The generalizability and validity of our findings are restricted by the methodological limitations of the primary studies, namely, an over-reliance on a single measure of cyberchondria, the Cyberchondria Severity Scale. CONCLUSIONS: Our review found a positive correlation between health anxiety and online health information seeking, and between health anxiety and cyberchondria. Further research should aim to explore the contexts for these associations as well as address the identified limitations of the extant literature.