Interpretation bias in health anxiety: a systematic review and meta-analysis
Interpretation bias (i.e. the selective negative interpretation of ambiguous stimuli) may contribute to the development and maintenance of health anxiety. However, the strength of the empirical evidence for this association remains a topic of debate. This study aimed to estimate the association betw...
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| Veröffentlicht in: | Psychological medicine 2023-01, Vol.53 (1), p.34-45 |
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| creator | Du, Xiayu Witthöft, Michael Zhang, Tao Shi, Congrong Ren, Zhihong |
| description | Interpretation bias (i.e. the selective negative interpretation of ambiguous stimuli) may contribute to the development and maintenance of health anxiety. However, the strength of the empirical evidence for this association remains a topic of debate. This study aimed to estimate the association between health anxiety and interpretation bias and to identify potential moderators of this association. Chinese-language databases (CNKI, VIP, and Wanfang), English-language databases (Web of Science, PubMed, PsycINFO, and Scopus), and German-language databases (Psyndex and PubPsych) were searched for relevant studies. There were 36 articles (39 studies) identified by this search (N = 8984), of which 32 articles (34 studies) were included in the meta-analysis (N = 8602). Results revealed a medium overall effect size (g = 0.67). Statistically equivalent effect sizes were observed for patients diagnosed with clinical health anxiety (g = 0.58) and subclinical health anxiety (g = 0.72). The effect sizes for threat stimuli that were health related (g = 0.68) and not health related (g = 0.63) did not differ significantly. The effect size for studies using an offline paradigm (g = 0.75) was significantly higher than that for studies using an online paradigm (g = 0.50). It is concluded that health anxiety is significantly and robustly associated with interpretation bias. These findings are of central importance for the advancement of models and treatment of health anxiety. |
| doi_str_mv | 10.1017/S0033291722003427 |
| format | Article |
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However, the strength of the empirical evidence for this association remains a topic of debate. This study aimed to estimate the association between health anxiety and interpretation bias and to identify potential moderators of this association. Chinese-language databases (CNKI, VIP, and Wanfang), English-language databases (Web of Science, PubMed, PsycINFO, and Scopus), and German-language databases (Psyndex and PubPsych) were searched for relevant studies. There were 36 articles (39 studies) identified by this search (N = 8984), of which 32 articles (34 studies) were included in the meta-analysis (N = 8602). Results revealed a medium overall effect size (g = 0.67). Statistically equivalent effect sizes were observed for patients diagnosed with clinical health anxiety (g = 0.58) and subclinical health anxiety (g = 0.72). The effect sizes for threat stimuli that were health related (g = 0.68) and not health related (g = 0.63) did not differ significantly. The effect size for studies using an offline paradigm (g = 0.75) was significantly higher than that for studies using an online paradigm (g = 0.50). It is concluded that health anxiety is significantly and robustly associated with interpretation bias. These findings are of central importance for the advancement of models and treatment of health anxiety.</description><identifier>ISSN: 0033-2917</identifier><identifier>EISSN: 1469-8978</identifier><identifier>DOI: 10.1017/S0033291722003427</identifier><identifier>PMID: 36349699</identifier><language>eng</language><publisher>Cambridge, UK: Cambridge University Press</publisher><subject>Ambiguity ; Ambiguous stimulus ; Anxiety ; Anxiety - therapy ; Anxiety Disorders - therapy ; Bias ; Chinese languages ; Coronaviruses ; COVID-19 ; Fear & phobias ; Health care ; Health problems ; Humans ; Illnesses ; Information processing ; Language ; Medical research ; Meta-analysis ; Moderators ; Pandemics ; Paradigms ; Systematic review</subject><ispartof>Psychological medicine, 2023-01, Vol.53 (1), p.34-45</ispartof><rights>Copyright © The Author(s), 2022. Published by Cambridge University Press</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c427t-b16560c94a3e5b5c9925a37bd2d26fa9438873fb6a0616317e01b734e067f70f3</citedby><cites>FETCH-LOGICAL-c427t-b16560c94a3e5b5c9925a37bd2d26fa9438873fb6a0616317e01b734e067f70f3</cites><orcidid>0000-0002-1870-9216 ; 0000-0002-4632-4874 ; 0000-0002-4928-4222 ; 0000-0001-7161-0728 ; 0000-0002-3753-6242</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.cambridge.org/core/product/identifier/S0033291722003427/type/journal_article$$EHTML$$P50$$Gcambridge$$H</linktohtml><link.rule.ids>164,314,776,780,12826,27903,27904,30978,55606</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36349699$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Du, Xiayu</creatorcontrib><creatorcontrib>Witthöft, Michael</creatorcontrib><creatorcontrib>Zhang, Tao</creatorcontrib><creatorcontrib>Shi, Congrong</creatorcontrib><creatorcontrib>Ren, Zhihong</creatorcontrib><title>Interpretation bias in health anxiety: a systematic review and meta-analysis</title><title>Psychological medicine</title><addtitle>Psychol. Med</addtitle><description>Interpretation bias (i.e. the selective negative interpretation of ambiguous stimuli) may contribute to the development and maintenance of health anxiety. However, the strength of the empirical evidence for this association remains a topic of debate. This study aimed to estimate the association between health anxiety and interpretation bias and to identify potential moderators of this association. Chinese-language databases (CNKI, VIP, and Wanfang), English-language databases (Web of Science, PubMed, PsycINFO, and Scopus), and German-language databases (Psyndex and PubPsych) were searched for relevant studies. There were 36 articles (39 studies) identified by this search (N = 8984), of which 32 articles (34 studies) were included in the meta-analysis (N = 8602). Results revealed a medium overall effect size (g = 0.67). Statistically equivalent effect sizes were observed for patients diagnosed with clinical health anxiety (g = 0.58) and subclinical health anxiety (g = 0.72). The effect sizes for threat stimuli that were health related (g = 0.68) and not health related (g = 0.63) did not differ significantly. The effect size for studies using an offline paradigm (g = 0.75) was significantly higher than that for studies using an online paradigm (g = 0.50). It is concluded that health anxiety is significantly and robustly associated with interpretation bias. These findings are of central importance for the advancement of models and treatment of health anxiety.</description><subject>Ambiguity</subject><subject>Ambiguous stimulus</subject><subject>Anxiety</subject><subject>Anxiety - therapy</subject><subject>Anxiety Disorders - therapy</subject><subject>Bias</subject><subject>Chinese languages</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>Fear & phobias</subject><subject>Health care</subject><subject>Health problems</subject><subject>Humans</subject><subject>Illnesses</subject><subject>Information processing</subject><subject>Language</subject><subject>Medical research</subject><subject>Meta-analysis</subject><subject>Moderators</subject><subject>Pandemics</subject><subject>Paradigms</subject><subject>Systematic review</subject><issn>0033-2917</issn><issn>1469-8978</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp1kEtLxDAUhYMozvj4AW6k4MZNNY82adzJ4GNgwIW6Lkl762ToY0xStf_elBkVFFf3wvnOuZeD0AnBFwQTcfmIMWNUEkFp2BIqdtCUJFzGmRTZLpqOcjzqE3Tg3ApjwkhC99GEcZZILuUULeatB7u24JU3XRtpo1xk2mgJqvbLSLUfBvxwFanIDc5DE6gisvBm4D2IZdQEY6xaVQ_OuCO0V6nawfF2HqLn25un2X28eLibz64XcRF-9LEmPOW4kIlikOq0kJKmigld0pLySsmEZZlgleYKc8IZEYCJFiwBzEUlcMUO0fkmd2271x6czxvjCqhr1ULXu5wGmBOWShLQs1_oqutt-HekeMZpFvIDRTZUYTvnLFT52ppG2SEnOB-rzv9UHTyn2-ReN1B-O766DQDbhqpGW1O-wM_t_2M_AfUJhpE</recordid><startdate>20230101</startdate><enddate>20230101</enddate><creator>Du, Xiayu</creator><creator>Witthöft, Michael</creator><creator>Zhang, Tao</creator><creator>Shi, Congrong</creator><creator>Ren, Zhihong</creator><general>Cambridge University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7QJ</scope><scope>7QP</scope><scope>7QR</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HEHIP</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2S</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1870-9216</orcidid><orcidid>https://orcid.org/0000-0002-4632-4874</orcidid><orcidid>https://orcid.org/0000-0002-4928-4222</orcidid><orcidid>https://orcid.org/0000-0001-7161-0728</orcidid><orcidid>https://orcid.org/0000-0002-3753-6242</orcidid></search><sort><creationdate>20230101</creationdate><title>Interpretation bias in health anxiety: a systematic review and meta-analysis</title><author>Du, Xiayu ; 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Med</addtitle><date>2023-01-01</date><risdate>2023</risdate><volume>53</volume><issue>1</issue><spage>34</spage><epage>45</epage><pages>34-45</pages><issn>0033-2917</issn><eissn>1469-8978</eissn><abstract>Interpretation bias (i.e. the selective negative interpretation of ambiguous stimuli) may contribute to the development and maintenance of health anxiety. However, the strength of the empirical evidence for this association remains a topic of debate. This study aimed to estimate the association between health anxiety and interpretation bias and to identify potential moderators of this association. Chinese-language databases (CNKI, VIP, and Wanfang), English-language databases (Web of Science, PubMed, PsycINFO, and Scopus), and German-language databases (Psyndex and PubPsych) were searched for relevant studies. There were 36 articles (39 studies) identified by this search (N = 8984), of which 32 articles (34 studies) were included in the meta-analysis (N = 8602). Results revealed a medium overall effect size (g = 0.67). Statistically equivalent effect sizes were observed for patients diagnosed with clinical health anxiety (g = 0.58) and subclinical health anxiety (g = 0.72). The effect sizes for threat stimuli that were health related (g = 0.68) and not health related (g = 0.63) did not differ significantly. The effect size for studies using an offline paradigm (g = 0.75) was significantly higher than that for studies using an online paradigm (g = 0.50). It is concluded that health anxiety is significantly and robustly associated with interpretation bias. 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| subjects | Ambiguity Ambiguous stimulus Anxiety Anxiety - therapy Anxiety Disorders - therapy Bias Chinese languages Coronaviruses COVID-19 Fear & phobias Health care Health problems Humans Illnesses Information processing Language Medical research Meta-analysis Moderators Pandemics Paradigms Systematic review |
| title | Interpretation bias in health anxiety: a systematic review and meta-analysis |
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