Does Metacognition Make a Unique Contribution to Health Anxiety When Controlling for Neuroticism, Illness Cognition, and Somatosensory Amplification?

Abstract

Somatosensory amplification (e.g., Barsky, 1992), illness cognition (e.g., Salkovskis & Warwick, 1986), and neuroticism (e.g., Noyes et al., 2003) have all been linked to health anxiety. The first two factors are disorder specific; however, neuroticism is a general vulnerability connected to a range of disorders. In the metacognitive model (Wells, 2009), beliefs about thinking have been implicated in the development of psychopathologies, but little is known about the contribution of individual differences in metacognition to health anxiety, specifically. A cross-sectional design was employed with convenience sampling used for participant selection. Participants (N = 351) completed a questionnaire battery and the following hypotheses were tested: (a) metacognition will show a significant positive correlation with health anxiety and (b) the relationship between metacognition and health anxiety will remain significant after controlling for variables normally associated with health anxiety (i.e., neuroticism, somatosensory amplification, and illness cognition). Hierarchical multiple regression analysis were run to test hypotheses and determine the best independent metacognitive predictors. The results supported each of the hypotheses and revealed three independent metacognitive predictors of health anxiety: “negative metacognitive beliefs about uncontrollability and danger,” “beliefs about the need for thought control,” and “cognitive confidence.” Overall, this study indicates that metacognition may have an important role in health anxiety, and the clinical implications are discussed.