Skip to main content
Top
Gepubliceerd in: Mindfulness 4/2016

05-04-2016 | ORIGINAL PAPER

Intolerance of Uncertainty as a Mediator of the Relationship between Mindfulness and Health Anxiety

Auteurs: Kristen M. Kraemer, Emily M. O’Bryan, Alison C. McLeish

Gepubliceerd in: Mindfulness | Uitgave 4/2016

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Abstract

Health anxiety is characterized by the misinterpretation of body sensations as signs of an illness, leading to health-related worry and increased healthcare utilization. Research has demonstrated the effectiveness of mindfulness-based interventions in the treatment of severe health anxiety, yet mechanisms of this association remain unexplored. Therefore, the present investigation sought to examine the indirect effect of mindfulness on health anxiety through intolerance of uncertainty (IU) or fear of the unknown. Undergraduate psychology students completed a series of online self-report measures for course credit. Bias-corrected bootstrapping (k = 10,000 samples) was used to generate a 95 % confidence interval to test the significance of the indirect effect. There was a significant indirect effect of greater levels of mindfulness on lower levels of health anxiety through decreases in intolerance of uncertainty. Higher levels of mindfulness may lead internal experiences to be perceived as less threatening, thereby increasing one’s ability to tolerate uncertainty and decreasing the need to worry and engage in safety behaviors that maintain health anxiety.
Literatuur
go back to reference Abramowitz, J. S., & Braddock, A. (2008). Psychological treatment of health anxiety and hypochondriasis: a biopsychosocial approach. Cambridge, MA: Hogrefe & Huber Publishing. Abramowitz, J. S., & Braddock, A. (2008). Psychological treatment of health anxiety and hypochondriasis: a biopsychosocial approach. Cambridge, MA: Hogrefe & Huber Publishing.
go back to reference Abramowitz, J. S., Deacon, B. J., & Valentiner, D. P. (2007). The short health anxiety inventory: psychometric properties and construct validity in a non-clinical sample. Cognitive Therapy and Research, 31, 871–883. doi:10.1007/s10608-006-9058-1.CrossRef Abramowitz, J. S., Deacon, B. J., & Valentiner, D. P. (2007). The short health anxiety inventory: psychometric properties and construct validity in a non-clinical sample. Cognitive Therapy and Research, 31, 871–883. doi:10.​1007/​s10608-006-9058-1.CrossRef
go back to reference Baer, R. A. (2003). Mindfulness training as a clinical intervention: a conceptual and empirical review. Clinical Psychology: Science and Practice, 10, 125–143. doi:10.1093/clipsy.bpg015. Baer, R. A. (2003). Mindfulness training as a clinical intervention: a conceptual and empirical review. Clinical Psychology: Science and Practice, 10, 125–143. doi:10.​1093/​clipsy.​bpg015.
go back to reference Barsky, A. J., Ettner, S. L., Horsky, J., & Bates, D. W. (2001). Resource utilization of patients with hypochondriacal health anxiety and somatization. Medical Care, 39, 705–715.CrossRefPubMed Barsky, A. J., Ettner, S. L., Horsky, J., & Bates, D. W. (2001). Resource utilization of patients with hypochondriacal health anxiety and somatization. Medical Care, 39, 705–715.CrossRefPubMed
go back to reference Carleton, R. N. (2012). The intolerance of uncertainty construct in the context of anxiety disorders: theoretical and practical perspectives. Expert Review of Neurotherapeutics, 12, 937–947. doi:10.1586/ern.12.82.CrossRefPubMed Carleton, R. N. (2012). The intolerance of uncertainty construct in the context of anxiety disorders: theoretical and practical perspectives. Expert Review of Neurotherapeutics, 12, 937–947. doi:10.​1586/​ern.​12.​82.CrossRefPubMed
go back to reference Craigie, M. A., Rees, C. S., Marsh, A., & Nathan, P. (2008). Mindfulness-based cognitive therapy for generalized anxiety disorder: a preliminary evaluation. Behavioural and Cognitive Psychotherapy, 36, 553–568. doi:10.1017/S135246580800458X.CrossRef Craigie, M. A., Rees, C. S., Marsh, A., & Nathan, P. (2008). Mindfulness-based cognitive therapy for generalized anxiety disorder: a preliminary evaluation. Behavioural and Cognitive Psychotherapy, 36, 553–568. doi:10.​1017/​S135246580800458​X.CrossRef
go back to reference Delgado, L. C., Guerra, P., Perakakis, P., Vera, M. N., del Paso, G. R., & Vila, J. (2010). Treating chronic worry: psychological and physiological effects of a training programme based on mindfulness. Behaviour Research and Therapy, 48, 873–882. doi:10.1016/j.brat.2010.05.012.CrossRefPubMed Delgado, L. C., Guerra, P., Perakakis, P., Vera, M. N., del Paso, G. R., & Vila, J. (2010). Treating chronic worry: psychological and physiological effects of a training programme based on mindfulness. Behaviour Research and Therapy, 48, 873–882. doi:10.​1016/​j.​brat.​2010.​05.​012.CrossRefPubMed
go back to reference Deyo, M., Wilson, K. A., Ong, J., & Koopman, C. (2009). Mindfulness and rumination: does mindfulness training lead to reductions in the ruminative thinking associated with depression? EXPLORE: The Journal of Science and Healing, 5, 265–271. doi:10.1016/j.explore.2009.06.005.CrossRef Deyo, M., Wilson, K. A., Ong, J., & Koopman, C. (2009). Mindfulness and rumination: does mindfulness training lead to reductions in the ruminative thinking associated with depression? EXPLORE: The Journal of Science and Healing, 5, 265–271. doi:10.​1016/​j.​explore.​2009.​06.​005.CrossRef
go back to reference Dugas, M. J., Gosselin, P., & Ladouceur, R. (2001). Intolerance of uncertainty and worry: investigating specificity in a nonclinical sample. Cognitive Therapy and Research, 25, 551–558. doi:10.1023/A:1005553414688.CrossRef Dugas, M. J., Gosselin, P., & Ladouceur, R. (2001). Intolerance of uncertainty and worry: investigating specificity in a nonclinical sample. Cognitive Therapy and Research, 25, 551–558. doi:10.​1023/​A:​1005553414688.CrossRef
go back to reference Feldman, G., Hayes, A., Kumar, S., Greeson, J., & Laurenceau, J. P. (2007). Mindfulness and emotion regulation: the development and initial validation of the Cognitive and Affective Mindfulness Scale-Revised (CAMS-R). Journal of Psychopathology and Behavioral Assessment, 29, 177–190. doi:10.1007/s10862-006-9035-8.CrossRef Feldman, G., Hayes, A., Kumar, S., Greeson, J., & Laurenceau, J. P. (2007). Mindfulness and emotion regulation: the development and initial validation of the Cognitive and Affective Mindfulness Scale-Revised (CAMS-R). Journal of Psychopathology and Behavioral Assessment, 29, 177–190. doi:10.​1007/​s10862-006-9035-8.CrossRef
go back to reference Fergus, T. A. (2013). Cyberchondria and intolerance of uncertainty: examining when individuals experience health anxiety in response to internet searches for medical information. Cyberpsychology, Behavior and Social Networking, 16, 735–739. doi:10.1089/cyber.2012.0671.CrossRefPubMed Fergus, T. A. (2013). Cyberchondria and intolerance of uncertainty: examining when individuals experience health anxiety in response to internet searches for medical information. Cyberpsychology, Behavior and Social Networking, 16, 735–739. doi:10.​1089/​cyber.​2012.​0671.CrossRefPubMed
go back to reference Fergus, T. A., & Bardeen, J. R. (2013). Anxiety sensitivity and intolerance of uncertainty: evidence of incremental specificity in relation to health anxiety. Personality and Individual Differences, 55, 640–644. doi:10.1016/j.paid.2013.05.016.CrossRef Fergus, T. A., & Bardeen, J. R. (2013). Anxiety sensitivity and intolerance of uncertainty: evidence of incremental specificity in relation to health anxiety. Personality and Individual Differences, 55, 640–644. doi:10.​1016/​j.​paid.​2013.​05.​016.CrossRef
go back to reference Fetzner, M. G., Asmundson, G. J., Carey, C., Thibodeau, M. A., Brandt, C., Zvolensky, M. J., & Carleton, R. N. (2014). How do elements of a reduced capacity to withstand uncertainty relate to the severity of health anxiety? Cognitive Behaviour Therapy, 43, 262–274. doi:10.1080/16506073.2014.929170.CrossRefPubMed Fetzner, M. G., Asmundson, G. J., Carey, C., Thibodeau, M. A., Brandt, C., Zvolensky, M. J., & Carleton, R. N. (2014). How do elements of a reduced capacity to withstand uncertainty relate to the severity of health anxiety? Cognitive Behaviour Therapy, 43, 262–274. doi:10.​1080/​16506073.​2014.​929170.CrossRefPubMed
go back to reference Grossman, P., & Van Dam, N. T. (2011). Mindfulness, by any other name …: trials and tribulations of sati in western psychology and science. Contemporary Buddhism, 12, 219–239.CrossRef Grossman, P., & Van Dam, N. T. (2011). Mindfulness, by any other name …: trials and tribulations of sati in western psychology and science. Contemporary Buddhism, 12, 219–239.CrossRef
go back to reference Haenen, M. A., de Jong, P. J., Schmidt, A. J., Stevens, S., & Visser, L. (2000). Hypochondriacs’ estimation of negative outcomes: domain-specificity and responsiveness to reassuring and alarming information. Behaviour Research and Therapy, 38, 819–833. doi:10.1016/S0005-7967(99)00128-X.CrossRefPubMed Haenen, M. A., de Jong, P. J., Schmidt, A. J., Stevens, S., & Visser, L. (2000). Hypochondriacs’ estimation of negative outcomes: domain-specificity and responsiveness to reassuring and alarming information. Behaviour Research and Therapy, 38, 819–833. doi:10.​1016/​S0005-7967(99)00128-X.CrossRefPubMed
go back to reference Harris, P. A., Taylor, R., Thielke, R., Payne, J., Gonzalez, N., & Conde, J. G. (2009). Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. Journal of Biomedical Informatics, 42, 377–381. doi:10.1016/j.jbi.2008.08.010.CrossRefPubMed Harris, P. A., Taylor, R., Thielke, R., Payne, J., Gonzalez, N., & Conde, J. G. (2009). Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. Journal of Biomedical Informatics, 42, 377–381. doi:10.​1016/​j.​jbi.​2008.​08.​010.CrossRefPubMed
go back to reference Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. New York: The Guilford Press. Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. New York: The Guilford Press.
go back to reference Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: past, present, and future. Clinical Psychology: Science and Practice, 10, 144–156. Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: past, present, and future. Clinical Psychology: Science and Practice, 10, 144–156.
go back to reference MacSwain, K. L. H., Sherry, S. B., Stewart, S. H., Watt, M. C., Hadjistavropoulos, H. D., & Graham, A. R. (2009). Gender differences in health anxiety: an investigation of the interpersonal model of health anxiety. Personality and Individual Differences, 47, 938–943. doi:10.1016/j.paid.2009.07.020.CrossRef MacSwain, K. L. H., Sherry, S. B., Stewart, S. H., Watt, M. C., Hadjistavropoulos, H. D., & Graham, A. R. (2009). Gender differences in health anxiety: an investigation of the interpersonal model of health anxiety. Personality and Individual Differences, 47, 938–943. doi:10.​1016/​j.​paid.​2009.​07.​020.CrossRef
go back to reference McManus, F., Surawy, C., Muse, K., Vazquez-Montes, M., & Williams, J. M. G. (2012). A randomized clinical trial of mindfulness-based cognitive therapy versus unrestricted services for health anxiety (hypochondriasis). Journal of Consulting and Clinical Psychology, 80(5), 817. doi:10.1037/a0028782.CrossRefPubMedPubMedCentral McManus, F., Surawy, C., Muse, K., Vazquez-Montes, M., & Williams, J. M. G. (2012). A randomized clinical trial of mindfulness-based cognitive therapy versus unrestricted services for health anxiety (hypochondriasis). Journal of Consulting and Clinical Psychology, 80(5), 817. doi:10.​1037/​a0028782.CrossRefPubMedPubMedCentral
go back to reference Norton, P. J., Sexton, K. A., Walker, J. R., & Ron Norton, G. (2005). Hierarchical model of vulnerabilities for anxiety: replication and extension with a clinical sample. Cognitive Behaviour Therapy, 34, 50–63. doi:10.1080/16506070410005401.CrossRefPubMed Norton, P. J., Sexton, K. A., Walker, J. R., & Ron Norton, G. (2005). Hierarchical model of vulnerabilities for anxiety: replication and extension with a clinical sample. Cognitive Behaviour Therapy, 34, 50–63. doi:10.​1080/​1650607041000540​1.CrossRefPubMed
go back to reference Preacher, K. J., & Hayes, A. F. (2004). SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods, Instruments, & Computers, 36, 717–731. doi:10.3758/BF03206553.CrossRef Preacher, K. J., & Hayes, A. F. (2004). SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods, Instruments, & Computers, 36, 717–731. doi:10.​3758/​BF03206553.CrossRef
go back to reference Salkovskis, P. M., Rimes, K. A., Warwick, H. M. C., & Clark, D. M. (2002). The health anxiety inventory: development and validation of scales for the measurement of health anxiety and hypochondriasis. Psychological Medicine, 32, 843–853. doi:10.1017/S0033291702005822.CrossRefPubMed Salkovskis, P. M., Rimes, K. A., Warwick, H. M. C., & Clark, D. M. (2002). The health anxiety inventory: development and validation of scales for the measurement of health anxiety and hypochondriasis. Psychological Medicine, 32, 843–853. doi:10.​1017/​S003329170200582​2.CrossRefPubMed
go back to reference Surawy, C., McManus, F., Muse, K., & Williams, J. M. G. (2015). Mindfulness-based cognitive therapy (MBCT) for health anxiety (hypochondriasis): rationale, implementation and case illustration. Mindfulness, 6, 382–392. doi:10.1007/s12671-013-0271-1 Surawy, C., McManus, F., Muse, K., & Williams, J. M. G. (2015). Mindfulness-based cognitive therapy (MBCT) for health anxiety (hypochondriasis): rationale, implementation and case illustration. Mindfulness, 6, 382–392. doi:10.​1007/​s12671-013-0271-1
go back to reference Taylor, S., & Asmundson, G. J. G. (2004). Treating health anxiety: a cognitive–behavioral approach. New York, NY: Guilford. Taylor, S., & Asmundson, G. J. G. (2004). Treating health anxiety: a cognitive–behavioral approach. New York, NY: Guilford.
go back to reference Watson, D. (2000). Mood and temperament. New York: Guildford Press. Watson, D. (2000). Mood and temperament. New York: Guildford Press.
go back to reference Williams, M. J., McManus, F., Muse, K., & Williams, J. M. G. (2011). Mindfulness-based cognitive therapy for severe health anxiety (hypochondriasis): an interpretative phenomenological analysis of patients’ experiences. British Journal of Clinical Psychology, 50, 379–397. doi:10.1111/j.2044-8260.2010.0200.CrossRefPubMed Williams, M. J., McManus, F., Muse, K., & Williams, J. M. G. (2011). Mindfulness-based cognitive therapy for severe health anxiety (hypochondriasis): an interpretative phenomenological analysis of patients’ experiences. British Journal of Clinical Psychology, 50, 379–397. doi:10.​1111/​j.​2044-8260.​2010.​0200.CrossRefPubMed
Metagegevens
Titel
Intolerance of Uncertainty as a Mediator of the Relationship between Mindfulness and Health Anxiety
Auteurs
Kristen M. Kraemer
Emily M. O’Bryan
Alison C. McLeish
Publicatiedatum
05-04-2016
Uitgeverij
Springer US
Gepubliceerd in
Mindfulness / Uitgave 4/2016
Print ISSN: 1868-8527
Elektronisch ISSN: 1868-8535
DOI
https://doi.org/10.1007/s12671-016-0524-x

Andere artikelen Uitgave 4/2016

Mindfulness 4/2016 Naar de uitgave