Joint factor analysis and approximate equipercentile linking of common trait health anxiety measures: a cross-sectional study of the 14-, 18- and 64-item health anxiety inventory, the illness attitude scale, and the 14-item Whiteley Index

BMC Psychiatry

Research

Susanna Österman¹  Erland Axelsson²  Erik Hedman-Lagerlöf³ 

[1]Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden

[2]Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden

[3]Liljeholmen Primary Health Care Center, Region Stockholm, Liljeholmstorget 7, SE-117 94, Stockholm, Sweden

[4]Academic Primary Health Care Center, Region Stockholm, Stockholm, Sweden

[5]Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden

[6]Gustavsberg Primary Health Care Center, Region Stockholm, Stockholm, Sweden

关键词: Health anxiety;    Hypochondriasis;    Illness anxiety disorder;    Linking;    Somatic symptom disorder;   

DOI  :  10.1186/s12888-023-05151-7

 received in 2023-01-05, accepted in 2023-08-29,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundResearch on health anxiety has bloomed in recent years, but summaries of the literature are complicated by the use of dissimilar self-report questionnaires. Furthermore, these instruments have rarely been administered in parallel, and especially not in clinical samples. In this study, we aimed to investigate the relationship between five widespread health anxiety measures, and to draft guidelines for the conversion of different sum scores.MethodsClinical trial participants with principal pathological health anxiety (n = 335) and a sample of healthy volunteers (n = 88) completed the 14-item Whiteley Index (WI-14), the Illness Attitude Scale (IAS), and the 14-, 18-, and 64-item Health Anxiety Inventory (the HAI-64, HAI-18, and HAI-14). Cross-sectional data from all participants were pooled (N = 423) and we conducted a joint factor analysis and approximate equipercentile linking of the WI-14, IAS, HAI-64, HAI-18, and HAI-14.ResultsInter-scale correlations were high (rs ≥ 0.90 and ≥ 0.88 in adjusted analyses), and the scree plot of the joint factor analysis spoke for a unifactorial solution where 89/105 items (85%) had loadings ≥ 0.40. Most items at the core of this broad trait health anxiety factor pertained to the worry about health, the fear of having or developing a serious disease, and to some extent bodily preoccupation. We present a cross-walk table of observed equipercentile linked sum scores.ConclusionsThis study speaks clearly in favor of the WI-14, IAS, HAI-64, HAI-18, and HAI-14 all tapping into the same trait health anxiety construct, the core of which appears to concern the worry about health, the fear of having or developing a serious disease, and to some extent bodily preoccupation. Based on recently reported cut-offs for the HAI-14, a reasonable cutoff for pathological health anxiety in a psychiatric setting probably lies around 7–8 on the WI-14, 52–53 on the IAS, 82–83 on the HAI-64, and 26–27 on the HAI-18.Trial registrationClinicalTrials.gov NCT01966705, NCT02314065.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

Fig. 3