Conocimiento E Interes

Health Psychology 2002, Vol. 21, No. 2, 147–156

Copyright 2002 by the American Psychological Association, Inc. 0278-6133/02/$5.00 DOI: 10.1037//0278-6133.21.2.147

Perceptual Consequences of an Illness-Concern Induction and Its Relation to Hypochondriacal Tendencies
Len Lecci and Dale J. Cohen
University of North Carolina at Wilmington
This article examines the perceptual consequences ofactivating illness concern as a function of hypochondriacal tendencies. In 2 independent samples, hypochondriacal tendencies were associated with slower reaction times on a modified emotional Stroop task when the stimulus words were illness related, but only when illness concern was activated. Moreover, these findings emerged when hypochondriacal tendencies were defined as a sensitivity to bodilysensations. When defined as illness preoccupation and fear, hypochondriacal tendencies were associated with a generalized pattern of perseveration to all stimuli when health concern was activated. Finally, the results persisted even after statistically controlling for state anxiety. Findings are discussed within the context of an activation hypothesis and highlight the importance of theoperational definition and assessment of hypochondriacal tendencies when examining perceptual biases. Key words: perceptual bias, Stroop, hypochondriasis, activation

I have a tumor in my head the size of a basketball. I can feel it when I blink. —Woody Allen, Hannah and Her Sisters

Numerous and complex consequences are associated with having exaggerated or unfounded symptoms and illness concerns. Inthe clinical population, such beliefs can manifest themselves in the form of hypochondriasis, which has been defined as illness preoccupation and worry due to the misinterpretation of bodily symptoms (Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association, 1994; Kellner, 1986; Kenyon, 1978; Warwick & Salkovskis, 1989). Despite the somatic emphasis, such experiencesare presumed to be largely psychological in their origin and are subsumed by the somatoform disorders. Epidemiological data suggest that only 4%–5% of the general population exhibits somatoform symptoms (e.g., Escobar, Burnam, Karno, Forsythe, & Golding, 1987), yet these individuals make extensive use of medical care services (Monson & Smith, 1983; Wagner & Curran, 1984) and account for upwards of50% of adult ambulatory health care costs (Collyer, 1979). Individuals in the nonclinical population generally show bias toward believing they are healthy unless confronted with overLen Lecci and Dale J. Cohen, Department of Psychology, University of North Carolina at Wilmington. This research was supported in part by a Cahill Grant from the University of North Carolina at Wilmington. Specialthanks go to Ashley Neighbors, Holly Williamson, Aimee Boner, Laura Lupton, and Michele Mathis for their assistance with data collection, coding, and data entry. Portions of this article were presented at the 10th annual convention of the American Psychological Society, Washington, DC, June 1998, and at the 12th annual convention of the American Psychological Society, Miami, Florida, June 2000.Correspondence concerning this article should be addressed to Len Lecci, Department of Psychology, University of North Carolina at Wilmington, 601 South College Road, Wilmington, North Carolina 284035612. E-mail: leccil@uncwil.edu 147

whelming evidence to the contrary. Weinstein (1984, 1987), for example, has shown that most people assess their risk for illness as lower than average. Indeed, when“normal” individuals have a health fear activated, they often avoid actions that may facilitate the detection of a health threat and may be temporarily unwilling to undertake protective acts (e.g., Leventhal & Watts, 1966; Millar & Millar, 1995). In contrast, individuals exhibiting subclinical forms of hypochondriasis, hereafter referred to as hypochondriacal tendencies,1 evidence a strong bias...