Hypochondriasis and Health Anxiety E-Book

Jonathan S. Abramowitz

• Herausgeber: Hogrefe Publishing
• Kategorie: Fachliteratur
• Serie: Advances in Psychotherapy - Evidence-Based Practice
• Sprache: Englisch

Seitenzahl: 186

Veröffentlichungsjahr: 2010

Beschreibung

Cognitive-behavioral therapy is now the treatment of choice for individuals with health anxiety and related problems. The latest research shows that it results in reductions in health-related worries, reassurance-seeking behavior, and phobic avoidance, as well as increases in life satisfaction and everyday functioning. This compact, easy to understand book by experts Jonathan S. Abramowitz and Autumn E. Braddock opens with an overview of the diagnostic issues and assessment of health anxiety, and delineates a research-based conceptual framework for understanding the development, maintenance, and treatment of this problem. The focus of the book is a highly practical guide to implementing treatment, packed with helpful clinical pearls, therapist-patient dialogues, illustrative case vignettes, and sample forms and handouts. Readers are equipped with skills for engaging reluctant patients in treatment and tailoring educational, cognitive, and behavioral techniques for health-related anxiety. The book, which also addresses common obstacles in treatment, represents an essential resource for anyone providing services for individuals with somatoform or anxiety disorders.

Leseprobe

Hypochondriasis and Health Anxiety

About the Authors

Jonathan S. Abramowitz, PhD, is Associate Chair of Psychology and Professor and Director of the Anxiety and Stress Disorders Clinic at the University of North Carolina at Chapel Hill. He has authored or edited ten books and over 100 research articles and book chapters on anxiety and related disorders. He serves as Associate Editor of two professional journals: Behavior Research and Therapy and the Journal of Cognitive Psychotherapy.

Autumn E. Braddock, PhD, is a clinical health psychologist within the Veterans Affairs Greater Los Angeles Healthcare System, specializing in behavioral medicine and cognitive-behavioral therapy for anxiety disorders. She has multiple publications and has presented her research, primarily addressing anxiety within medical populations, at national and international conferences.

Advances in Psychotherapy – Evidence-Based Practice

Danny Wedding; PhD, MPH, Prof., St. Louis, MO

(Series Editor)

Larry Beutler; PhD, Prof., Palo Alto, CA

Kenneth E. Freedland; PhD, Prof., St. Louis, MO

Linda C. Sobell; PhD, ABPP, Prof., Ft. Lauderdale, FL

David A. Wolfe; PhD, Prof., Toronto

(Associate Editors)

The basic objective of this series is to provide therapists with practical, evidence-based treatment guidance for the most common disorders seen in clinical practice – and to do so in a “reader-friendly” manner. Each book in the series is both a compact “how-to-do” reference on a particular disorder for use by professional clinicians in their daily work, as well as an ideal educational resource for students and for practice-oriented continuing education.

The most important feature of the books is that they are practical and “reader-friendly:” All are structured similarly and all provide a compact and easy-to-follow guide to all aspects that are relevant in real-life practice. Tables, boxed clinical “pearls”, marginal notes, and summary boxes assist orientation, while checklists provide tools for use in daily practice.

Hypochondriasis and Health Anxiety

Jonathan S. Abramowitz

University of North Carolina at Chapel Hill, NC

Autumn E. Braddock

Veterans Affairs of Greater Los Angeles Healthcare System, CA

Library of Congress Cataloging information for the print version of this book is available via the Library of Congress Marc Database

Cataloging data available from Library and Archives Canada

© 2011 by Hogrefe Publishing

http://www.hogrefe.com

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Copyright Information

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Format: EPUB

ISBN 978-1-61334-325-8

Dedication

To our respective families: Stacy, Emily, and Miriam; Eric, Alyxzandria, and Sienna. Your love puts everything in perspective.

Preface

This volume in the Advances in Psychotherapy: Evidence-Based Practice series describes the conceptualization, assessment, and psychological treatment of severe health anxiety, hypochondriasis, and related problems using empirically supported cognitive-behavioral therapy (CBT) techniques. The development of effective problem-focused treatments for severe health anxiety has created a growing need for the dissemination of treatment manuals, such as this one, to mental health professionals who want to know how to use these techniques with their patients.

This book builds upon psychological principles of behavior change. As such, it assumes that the reader has basic knowledge and some training in psychotherapeutic intervention. It is written for psychologists, psychiatrists, physicians, nurses, physician aides, social workers, students and trainees, and other health care practitioners who encounter patients with unexplained physical complaints.

The book is divided into five chapters. The first chapter describes the clinical phenomenon of health anxiety and related problems, and describes empirically supported diagnostic and assessment procedures. Chapter 2 reviews what is known about the leading theoretical models of health anxiety and their implications for successful treatment. In Chapter 3, we present a framework for conducting an initial assessment and for deciding whether a patient is a candidate for the psychological treatment program outlined in Chapter 4. Methods for discussing the psychological (as opposed to medical) aspects of treatment, and strategies for getting the patient to “buy in” to a psychological approach are also incorporated in Chapter 3. Chapter 4 presents the nuts and bolts of psychological treatment techniques for health anxiety. It also reviews scientific evidence for the efficacy of this program and describes a number of common obstacles to successful treatment. Finally, Chapter 5 includes a case example of the treatment of severe health anxiety. A variety of forms and patient handouts for use in treatment appear in the appendix.

Health anxiety is a heterogeneous clinical condition. Some patients experience fears of dying a slow death due to cancer, while others have recurring, anxiety-evoking doubts that their unexplained pain or other bodily sensations are symptoms of a rare or previously undiscovered disease. At the time of this writing, the DSM-V Task Force on Somatoform Disorders is considering a new diagnosis, Complex Somatic Symptom Disorder, which would be even more heterogeneous and subsume a number of DSM-IV-TR conditions, such as hypochondriasis, somatization disorder, pain disorders, and undifferentiated somatoform disorder.

Although a systematic and multicomponent treatment approach is advocated in this book, we do not intend it to be a “cookbook.” Rather, it guides the clinician in tailoring specific treatment components to individual patients’ needs. It provides a practical and structured approach with supporting didactic materials for both clinicians and patients.

Acknowledgments

We are indebted to many people, including series editor Danny Wedding, associate editor Ken Freedland, and Robert Dimbleby of Hogrefe Publishing, for their invaluable guidance and suggestions. We also appreciate Kristy Gura’s hard work in helping us prepare this book for publication. The pages of this volume echo clinical insights we acquired during our work at the Mayo Clinic in Rochester, Minnesota. We are grateful for the support of terrific colleagues including Stephen Whiteside, Sarah Kalsy, Brett Deacon, Katherine Moore, Kristi Dahlman, and Jill Snuggerud.

Dr. Braddock acknowledges the professional mentorship of Gary Wolfe, PhD, and Lisa Altman, MD, who have given unwavering support of primary care psychology and patient-centered care within the VA of Greater Los Angeles Healthcare System. She also thanks her colleagues Kellie Condon, PhD; Leigh Anne Selby, PsyD; and Mike Young, LCSW, and the numerous primary care providers, for their ongoing collaboration, guidance, and friendship.

Jointly, we dedicate this book to the brave patients who came to us – sometimes unwillingly – when their search for a medical explanation for their bodily complaints turned up empty. Not knowing what to expect, they courageously challenged themselves to embrace a psychological perspective on their complaints. They accepted their bodily sensations as benign, confronted their fears, and defeated their anxiety. They believed in us, confided in us, challenged us, and educated us. We thank them for their willingness to open their minds to our approach.

Table of Contents

 Dedication

Preface

Acknowledgments

1         Description of Health Anxiety

1.1      Terminology

1.2      Definition

1.3      Epidemiology

1.4      Course and Prognosis

1.5      Differential Diagnoses

1.5.1   Somatization Disorder

1.5.2   Somatic Delusions

1.5.3   Illness or Disease Phobia

1.5.4   Panic Disorder

1.5.5   Obsessive-Compulsive Disorder

1.5.6   Generalized Anxiety Disorder

1.5.7   Pain Disorder

1.6      Comorbidity

1.7      Diagnostic Procedures and Documentation

1.7.1   Structured Diagnostic Interviews

1.7.2   Semi-Structured Symptom Interviews

1.7.3   Self-Report Inventories

1.7.4   Documenting Changes in Symptom Levels

2        Theories and Models of Health Anxiety

2.1      Development of Health Anxiety

2.1.1   The Human Body Is “Noisy”