Health anxiety and older adults : a cross sectional study comparing predictors of health anxiety between an older and younger cohort : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Clinical Psychology at Massey University, Albany, New Zealand

Abstract

Health anxiety is a universal experience ranging from adaptive concerns about physical health to debilitating worry that may merit clinical diagnosis. Little is known about health anxiety in older adults and the overall objective of this study was to contribute to the nascent literature in this subject. The present study was conducted within a cognitive framework that emphasises the perception of bodily sensations in the origin and maintenance of health anxiety. The research comprised three interrelated studies. The principal investigation examined body perception (anxiety sensitivity, body vigilance and somatosensory amplification) variables as predictors of health anxiety across two cohorts. These findings were supported by assessment of the factor structure of measures of health anxiety and body perception in the older cohort. Finally, a measure of attention to bodily sensations in health anxiety (BVS-H) was trialled. The study was a self-report survey measuring demographic, physical health, current distress, body perception and health anxiety variables, which was administered to 221 adults over 65 and a comparison group of 177 adults aged 18 – 30. Regression analyses showed that consistent with the cognitive model, body perception predicted health anxiety. Body vigilance predicted health anxiety in both groups. The amplification of bodily sensations was a more important predictor of health anxiety for older adults. Inter-relationships between anxiety sensitivity, body vigilance and health anxiety in the older cohort, differed from expectations and warrant further study. The effects of control variables varied between groups with worry emerging as a predictor only for the older cohort. Physical health predicted health anxiety, but contributing variables differed between cohorts. Pain was a predictor for both groups, but physical illness was a predictor only for the younger cohort. Consistent with prior studies, older adults reported lower levels of health anxiety than the younger cohort. Factor analyses supported the structure of health anxiety, body vigilance and somatosensory amplification measures. Factor analysis of the anxiety sensitivity measure was inconclusive. BVS-H measure gave satisfactory results. These findings support the cognitive theory of health anxiety as an explanatory model of health anxiety in older adults and highlight cohort differences in variables contributing to health anxiety.