Master of Science
Sandra E. Gramling
Hypochondriasis is a disorder that may affect ten percent of all individuals seeking medical care. This places a great burden on the health care resources that are currently available. Unfortunately, very few of these individuals come to the attention of mental health professionals.
Various models have attempted to conceptualize hypochondriasis. These include the psychiatric model, the psychodynamic model, the social learning and the perceptual or cognitive abnormality model.
The perceptual or cognitive abnormality model suggests that individuals who are hypochondriacal misinterpret and/or amplify normal bodily sensations. These processes lead the individuals to believe they are suffering from a serious disease. Few empirical studies have been conducted to confirm this model, and no research has been conducted testing this model using psychophysiological measures to test whether or not these indices are indeed different for non-hypochondriacal persons.
Pain is a symptom often reported by hypochondriacs and this is what usually brings them into contact with the health care system. Being able to measure how hypochondriacs react to the experience of pain would give insight into whether or not they react more strongly to pain than do non-hypochondriacal persons. Although the objective measurement of pain has been considered difficult in the past, recent work by researchers using visual analogue scales have shown them to be valid and reliable instruments for measuring both the sensory and affective dimensions of the pain experience.
The present study tested the perceptual and cognitive abnormality model of hypochondriasis using painful physical stimuli (heat stimulation and a cold pressor task) to measure subjects' pain tolerance and to rate their experience of pain. Subjects rated their pain experience on both sensory (intensity) and affective (unpleasantness) dimensions using visual analogue scales. The model was also tested using a psychological stressor, a visualization task which incorporated everyday life events. The psychophysiological measure heart rate was continuously recorded to assess subjects' physiological activity to stress. It was hypothesized that hypochondriacal individuals would withdraw their feet from the cold water bath, before being instructed to, at a significantly higher rate than the control group. It was also hypothesized that visual analogue scale ratings of intensity and unpleasantness would be significantly higher for the hypochondriacal group than for the control group for both cold pressor and thermal radiant heat. Further, it was hypothesized that the hypochondriacal group would exhibit increased heart rate, as well as a longer return to baseline time compared to the control group.
In general, the data offered little support for the hypotheses used to test the amplification/misinterpretation components of the perceptual and cognitive abnormality model. Methodological problems with the study were discussed and improvements suggested. Also, problems and advantages of the present model were noted.
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