Bodily signals and worries about health

B Bodily difficulties need to be understood from both medical and functional perspectives, which can be relevant at the same time. The study did not establish what caused the participants’ bodily symptoms or whether medical assessment was needed. The results therefore cannot be used to determine the cause of an individual’s difficulties.

Acute symptoms should be assessed by healthcare services, and new or clearly changed symptoms may need medical assessment. In parallel, it can be important to examine how attention, interpretations, worrying and checking affect daily life.

Who took part and what was measured?

The study was based on online self-reports from 564 university students in Canada. Their mean age was 21.8 years and 72.3 per cent were women. This was a young, non-clinical student sample. Participants had not been recruited because they were seeking care for health anxiety.

The study’s own measures used the term bodily symptoms. At a single time point, participants answered questions about such symptoms during the preceding four weeks, health anxiety, anxiety sensitivity and metacognitive beliefs about health-related thinking.

In the study, anxiety sensitivity referred to fear of what bodily signals might mean or lead to, for example interpreting palpitations as a sign of serious illness. The metacognitive questions concerned, among other things, beliefs that negative thinking or worrying can be useful or protective and that positive thinking can be risky.

Because all the measures were self-reports collected at the same time, the study can show how the responses were associated, but not what came first or what caused anything else. The results apply to this sample and cannot readily be generalised to people seeking care or treatment.

What did the study show?

In the group, more reported bodily symptoms were associated with greater health anxiety. Greater health anxiety also occurred alongside greater fear of what bodily signals might mean and stronger beliefs that worrying can be useful or protective. This shows associations between participants’ responses, not what caused the health anxiety.

The researchers then compared the association between bodily symptoms and health anxiety at different levels of fear of bodily signals. No clear difference was apparent.

A small difference emerged only when beliefs about the usefulness of worrying were also taken into account. At higher scores on that measure, bodily symptoms and health anxiety were more strongly associated among participants who were also more afraid of what bodily signals might mean.

The pattern was apparent above a calculated level that roughly 27 per cent of participants exceeded. It explained an additional 0.62 per cent of the variation in health anxiety, a very small increment.

The result raises a question about how bodily signals, fear of their possible meaning and beliefs about worrying may be associated. It does not answer why an individual has health anxiety or what helps that particular person.

When health worries take up space

Health worries can mean attention being drawn to the body again and again, and to the question of what a signal means. For some, self-monitoring becomes part of their health worries. This may involve repeatedly tuning in to the body and following its signals. Worrying, checking and attempts to gain certainty can be other parts of the same pattern. They may begin automatically and need not be conscious choices. None of this establishes what causes a bodily signal.

In this study, participants answered questions at a single time point about bodily symptoms, fear of bodily signals, health anxiety and beliefs that worrying or negative thinking can help or protect. Their responses were associated, but the study cannot show what influences what over time. Self-monitoring, the act of worrying and checking behaviours were not examined separately.

In our sessions, we can explore whether any of this is relevant to you. What happens to your attention when you feel something in your body? Do you notice yourself starting to tune in to your body, worry or check more? Is there a sense that worrying helps you to be prepared or protects you? These are questions we explore together. I do not assume the answers in advance.

In MCT, we can work with how you relate to thoughts, where attention is directed and what you do when worry arises. The medical and functional perspectives need to stand side by side. Medical conditions need to be assessed and, where necessary, investigated. At the same time, functional processes need the same attention.