Swipe om te navigeren naar een ander artikel
Recent research has shown that mindfulness-based cognitive therapy (MBCT) could be a useful alternative approach to the treatment of health anxiety and deserves further investigation. In this paper, we outline the rationale for using MBCT in the treatment of this condition, namely its hypothesised impact on the underlying mechanisms which maintain health anxiety, such as rumination and avoidance, hypervigilance to body sensations and misinterpretation of such sensations. We also describe some of the adaptations which were made to the MBCT protocol for recurrent depression in this trial and discuss the rationale for these adaptations. We use a case example from the trial to illustrate how MBCT was implemented and outline the experience of one of the participants who took part in an 8-week MBCT course. Finally, we detail some of the more general experiences of participants and discuss the advantages and possible limitations of this approach for this population, as well as considering what might be useful avenues to explore in future research.
Beck, A.T. (1976). Cognitive therapy and the emotional disorders. Oxford: International Universities Press.
Borkovec, T. D., & Sharpless, B. (2004). Generalized anxiety disorder: bringing cognitive-behavioral therapy into the valued present. In S. C. Hayes, V. M. Follette, & M. M. Linehan (Eds.), Mindfulness and acceptance: expanding the cognitive-behavioral tradition (pp. 209–242). New York: Guilford Press.
Butler, G., Fennell, M., & Hackmann, A. (2008). Cognitive behavioural therapy for anxiety disorders: mastering clinical challenges. New York: Guilford Press.
Greeven, A., Van Balkom, A. J., Visser, S., Merkelbach, J. W., Van Rood, Y. R., Van Dyck, R., et al. (2007). Cognitive behavior therapy and paroxetine in the treatment of hypochondriasis: a randomized controlled trial. American Journal of Psychiatry, 164, 91–99. doi: 10.1176/appi.ajp.164.1.91. CrossRefPubMed
Kabat-Zinn, J. (1990). Full catastrophe living: using the wisdom of your body and mind to face stress, pain and illness. New York: Bantam Dell.
McManus, F., Surawy, C., Muse, K., Vazquez-Montez, 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), 817–828. doi: 10.1037/a0028782. CrossRefPubMedCentralPubMed
Orsillo, S. M., & Roemer, L. (2011). The mindful way through anxiety. New York: Guilford Press.
Raes, F., Dewulf, D., Heeringen, C. V., & Williams, J. M. G. (2009). Mindfulness and reduced cognitive reactivity to sad mood: evidence from a correlational study and a non-randomized waiting list controlled study. Behaviour Research and Therapy, 47, 623–627. doi: 10.1016/j.brat.2009.03.007. CrossRefPubMed
Salkovskis, P., & Warwick, H. (2001). Making sense of hypochondriasis: a cognitive theory of health anxiety. In G. Asmundson, S. Taylor, & B. J. Cox (Eds.), Health anxiety: clinical and research perspectives on hypochondriasis and related conditions (pp. 46–64). New York: Wiley.
Salkovskis, P., 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.
Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: a new approach to preventing relapse. London: Guildford Press.
Sorensen, P., Birket-Smith, M., Wattar, U., Buemann, I., Salkovskis, P.M. (2011). A randomised clinical trial of cognitive behavioural therapy versus short term psychodynamic psychotherapy versus no intervention for patients with hypochondriasis. Psychological Medicine, 41, 431–441.
Teasdale, J. D., Segal, Z. V., & Williams, J. M. G. (2003). Mindfulness training and problem formulation. Clinical Psychology: Science and Practice, 10, 157–160.
Thomson, A. B., & Page, L. A. (2007). Psychotherapies for hypochondriasis. Cochrane Database of Systematic Reviews, 4, 1–43. doi: 10.1002/14651858.CD006520.pub2.
Wattar, U., Sorensen, P., Buemann, I., Birket-Smith, M., Salkovskis, P. M., Albertsen, M., et al. (2005). Outcome of cognitive-behavioural treatment for health anxiety (hypochondriasis) in a routine clinical setting. Behavioural and Cognitive Psychotherapy, 33, 165–175. doi: 10.1017/S1352465804002000. CrossRef
Way, B.M., Creswell, J.D., Eisenberger, N.I., Lieberman, M.D. (2010). Dispositional mindfulness and depressive symptomatology: correlations with limbic and self referential neural activity during rest. Emotion, 10(1), 12–24.
Wells, A. (1997). Hypochondriasis and health anxiety. In A. Wells (Ed.), Cognitive therapy of anxiety disorders. Chichester: Wiley.
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.2044-8260.2010.02000.x. CrossRefPubMed
- Mindfulness-Based Cognitive Therapy (MBCT) for Health Anxiety (Hypochondriasis): Rationale, Implementation and Case Illustration
J. Mark G. Williams
- Springer US