1. 1) Develop a supplementary psychoeducational resource focused on social support to accompany the WAC online program. Information discussed on the resource included fatigue, concentration and memory changes, pain, swelling, nervous system changes, low moods, anxious feelings, worries about cancer returning, feeling alone, benefits of social support, communication strategies, styles of communication, and sources of support.


2. 2) Conduct a preliminary evaluation of this resource. Assessing the face-validity of this resource is an important first step in adding educational materials to online programs like WAC.

Maternal Depression Online (MDO) was made available to Saskatchewan women from May 2012-Feburary 2014. The therapist-assisted Internet delivered Cognitive Behaviour Therapy program was designed specifically for the treatment of postpartum depression. MDO consisted of 7 interactive modules including text, graphics, animation, audio and video, and covered:(a) psychoeducation on maternal depression, (b) activity planning, (c) relaxation, (d) thinking styles, (e) cognitive restructuring, (f) problem solving, and (g) relapse prevention. Using a randomized control design, 50 women with mild to moderate postpartum depression either received MDO or waited for treatment.

Results were very promising. Symptoms of postpartum depression decreased more quickly for women participating in MDO when compared to those who waited for treatment. These results were maintained at four-week follow-up, providing preliminary support of the durability of the program. Participants who received MDO also demonstrated a reduction in symptoms of postnatal anxiety, general stress, and parental distress and an increase in quality of life when compared to participants who waited for the treatment. Participants reported high satisfaction with MDO and indicated that they enjoyed working with their Internet therapist. Discussion for future implementation of this program is underway.

Background:

Chronic pain is an important area of study given that 15 to 18% of the Canadian population will develop a chronic pain condition during their lifetime. One difficulty in the self-management of chronic pain is the lack of resources available for those who suffer from this condition. Although preliminary research has demonstrated Internet Cognitive Behaviour Therapy (ICBT) for chronic pain to be a viable treatment option, potential users' initial perceptions towards this mode of delivery may pose a barrier for participation in such programs. The purpose of the study was threefold:

To develop an ICBT perceptions questionnaire (ICBT-PQ) that captures the perceptions of potential users of the service

To examine variables that may predict early perceptions of ICBT (e.g., age, sex, computer self-efficacy)

To identify perceptions of what intervention features would be perceived by potential users as most desirable for ICBT

Methods:

Given the steps necessary to address the research questions, the overall project was divided into two studies. In study one, the ICBT-PQ was developed based on a comprehensive review of the literature and telephone interviews with 11 participants who had chronic pain. The preliminary version of the ICBT-PQ was then reviewed by researchers with ICBT experience and by a lay audience to ensure readability and acceptability.

In study two, a total of 129 people with chronic pain completed a web-based survey consisting of a demographic questionnaire, the finalized ICBT-PQ, and measures of computer self-efficacy and computer anxiety. Participants were predominantly female (82%), Caucasian (90%), middle-aged (average age = 47), and had chronic pain for an average of 12 years.

Results:

Through the factor analysis, the ICBT-PQ items were grouped into two categories: statements of potential ICBT strengtdhs and statements of potential ICBT limitations.

The majority of participants endorsed ICBT strength statements and disagreed with ICBT limitation statements.

ICBT strength statements that participants most agreed with

ICBT limitation statements that participants most disagreed with

Regressions indicated that female participants and participants high in computer self-efficacy were likely to endorse statements of ICBT strengths and disagree with statements of ICBT limitations.

Many participants indicated that they desired video content and group contact features in ICBT.

Conclusion:

Even though participants had no prior experience with ICBT, they generally had positive perceptions of ICBT such as accessibility and convenience. They did not perceive ICBT to have many negative limitations, such as computer concerns or concerns about the security of their personal information. The perceived strengths of ICBT outweighed the perceived limitations among study participants, which may indicate that ICBT may be well received if offered to Canadians with chronic pain.

Females participants and those with high computer self-efficacy were more likely to perceive ICBT favorably. Participants felt that it would be positive to include multimedia and group contact features in the ICBT program. Future research, however, needs to investigate whether these features are necessary and or improve the efficacy of ICBT.

Overall, the results of this study provide important information that could assist with future attempts to deliver ICBT to people with chronic pain.

Thank you to everyone for their participation in this research. The reserch findings have been submitted and accepted for publication in the academic journal Pain Research and Management.

Study Purpose:

The purpose of the current research was to study emotional adjustment to multiple sclerosis (MS) in a sample of Canadians.

Background:

Emotional adjustment to MS is most commonly studied by focusing on psychopathology symptoms, such as depression or anxiety. In the current study, emotional adjustment was measured as including both positive (i.e., quality of life, positive affect, satisfaction with life) and negative (i.e., depression and anxiety symptoms, negative affect) dimensions. To examine what factors contribute to emotional adjustment, two psychological models of emotional adjustment were evaluated and compared: Lazarus and Folkman's (1984) stress and coping model, and a model of Taylor's (1983) theory of cognitive adaptation

1. Stress and Coping Model: This model consists of appraising a stressor, such as stressors associated with MS, and then selecting ways of coping with the stressor. In the current study, appraisals included primary appraisals (i.e., evaluating the harm, threat, or loss associated with a stressor) and secondary appraisals (i.e., evaluating how much control a person feels over the stressor, and how much of a challenge the stressor will be to overcome). Coping strategies in the current study included: (a) problem-solving and cognitive restructuring coping, (b) emotional and social coping, and (c) escape and avoidance coping.


2. Theory of Cognitive Adaptation:
 This model consists of optimistic beliefs as a base in working towards achieving the interrelated tasks of searching for benefits or positive appraisals about life after a stressor, attempting to gain a sense of mastery over one's life, and efforts toward increasing self-esteem.

Study Findings:

1. Data were collected from 431 Canadians with MS who completed questionnaires online or through the mail.


2. For measures of emotional adjustment:
   
   1. Positive Adjustment
      1. Participants' satisfaction with life was similar to people with MS in other research; average scores were between "slightly dissatisfied" and "neutral".
      2. Participants' levels of positive affect were similar to other people with MS, but were lower than participants from a small non-medical Canadian sample.
      3. Participants' levels of different aspects of health-related quality of life were lower when compared to non-medical samples, but were similar to other people with MS for physical and psychological health-related quality of life
   
   
   1. Negative Adjustment
      1. Over one-third of study participants (37.5%) scored above the recommended clinical cut-off for depression symptoms and almost two-thirds of participants (59.6%) scored above the recommended clinical cut-off for anxiety symptoms. Depression scores in the current study were either similar to, or higher than, other MS research in Canada. Anxiety scores in the current study were higher than participants in other MS studies in Canada.
      2. Participants' levels of negative affect were similar to both another study of people with MS and to a small, non-medical Canadian sample.


3. The Stress and Coping Model described above was able to be statistically tested for its contribution to predicting negative adjustment outcomes, but not positive adjustment outcomes. For negative adjustment outcomes, the model was mostly supported in its fit to the data. The strongest predictor of negative adjustment outcomes was the use of escape-avoidance coping strategies, as well as using primary appraisals of stress. Cognitive restructuring and problem-solving coping helped to mediate (i.e., explain some of the relationship) between appraisals and negative adjustment.


4. The Theory of Cognitive Adaptation model described above was able to be statistically tested for its contribution to predicting both positive and negative adjustment outcomes. Optimism was tested by itself first, and it was found that optimism alone was a better predictor of lower negative adjustment outcomes than it was of higher positive adjustment outcomes. When the other variables were added to the model, including mastery, self-esteem, and benefit-finding, the results were that the model was mostly supported in its fit to the data for both of the adjustment outcomes. For positive adjustment outcomes, self-esteem was the greatest direct predictor, followed by having a sense of mastery, optimism, and a smaller relationship with benefit-finding. For negative adjustment outcomes, again the strongest predictors were lower self-esteem and a lower sense of mastery.


5. Variables from the two models were also combined to determine whether a more comprehensive model would help to predict adjustment outcomes. Statistically, the models were not able to be tested.

Usefulness of the Findings:

1. This study provides useful information for clinicians who work with people with MS.


2. High levels of depression symptoms and, in particular, anxiety symptoms were identified. Few participants in the current study were receiving psychological interventions (17%) or medication for psychological conditions (43%).


3. It will be important to monitor, over time, both depression and anxiety symptoms in people with MS in order to identify people in need of treatment. Finding treatment options that are accessible, such as internet- or telephone-administered cognitive-behavioural therapy, may also be helpful.


4. Coping strategies, particularly using escape-avoidance coping strategies, will also be useful to evaluate. Interventions to reduce reliance on escape-avoidance coping strategies may be helpful to improve emotional adjustment.


5. The appraisal of stressors as being associated with harm, loss, and threats was also associated with poorer adjustment. Interventions targeting how people appraise stressors in their lives may be helpful.


6. Enhancing optimism, self-esteem, mastery, and (to a lesser extent) benefit-finding would all contribute to improvements in positive adjustment outcomes. Enhancing self-esteem and mastery would also contribute to improving negative adjustment outcomes.

Thank you to all respondents for your participation in this research. The next step is to inform other researchers and clinicians of the study findings.

Study Purpose:

Depression and anxiety are the most commonly experienced mental health conditions in Canada. Research has shown that one of the significant factors in the under-treatment of mental health conditions is a lack of access to providers. Researchers have begun to create novel ways to address the problem of a lack of access to mental health services, such as offering Therapist-Assisted Internet Cognitive Behaviour Therapy (TAICBT). This involves clients reviewing psychoeducational information on the use of cognitive and behavioural strategies for coping with a mental health condition over the Internet. This is combined with communicating with a therapist who provides support in the application of the material, typically over email or the phone. TAICBT has been shown to be more accessible and inexpensive, than traditional therapy. The four objectives of this study were to (1) Document the implementation process of TAICBT with clinical psychology students, (2) Investigate positive and negative experiences of student therapists using TAICBT, (3) Understand students' perceptions of facilitators and barriers of providing TAICBT, and (4) Generate practical recommendations for training students in TAICBT.

Study Methodology:

The 12 participants were Ph.D. students at the University of Regina. All participants had to have completed at minimum a 600 hour practicum, the TAICBT workshop, and have provided the TAICBT program to at least one client. Participants were recruited through an email to eligible Online Therapy USER student therapists at the University of Regina. Participants completed a 45-60 minute semi-structured interview. All interviews were recorded and transcribed. Thematic content analysis was completed by two coders and reviewed by an additional researcher and supervisor.

Study Results:

There were six major content areas that were generated from the interviews. Within each content area there were several themes that were identified. Below is a breakdown of some of the results.

Positive Aspects of Graduate Students experience with TAICBT

1. Themes:
1. TAICBT training workshop was instructive and educational
2. TAICBT beneficial to clinical training
3. Email communication conducive to training novice therapists
4. Exceptional supervision and support from staff members
5. TAICBT overall was a valuable service to clients with less time commitment from the therapist

Challenges and Weaknesses of TAICBT

1. Themes:
1. Challenges working with some clients
2. Challenges in deciding what to write to clients
3. Challenges with some of the policies and procedures
4. Challenges with perceived obligation to take on clients

Facilitators of the Graduate Students Experience with TAICBT

1. Themes:
1. High-quality supervision and support from staff members
2. Therapist comfort with technology
3. Flexibility in location, day, and time emails could be written
4. Ease of use of the program Online Therapy USER website

Barriers of the Graduate Students Experience with TAICBT

1. Themes:
1. Students had many other demands on their time
2. Some aspects of the program were inconvenient
3. Learning a new program was a significant time investment
4. Clients behaviour can act as a barrier

Future Utilization of TAICBT

1. Theme:
1. Therapists are open to future usage of TAICBT as professionals

Suggested Improvements to TAICBT

1. Themes:
1. Improvements to the TAICBT training workshop
2. Improvements to the screening and set-up of clients on the system
3. Suggested improvements to modules
4. Improvements to the website
5. Modifications to the policy and procedures

Recommendations for future TAICBT training Programs:

It was evident that students saw considerable value in learning TAICBT. Drawing on the perceived strengths and challenges of our program, others who develop a TAICBT training program should consider several points including:

1. More in-depth training workshop
2. Formalizing students' role in the form of practicum
3. Make students aware of client variability
4. Flexibility in client document review
5. High level of commitment from staff and supervisors
6. Formalize peer supervision

At the present time, we are working to inform clinicians and other researchers of these findings through publications and presentations at conferences. Thank you again for your participation in our research. Should you have any questions, please feel free to contact Dr. Heather Hadjistavropoulos at 585-5133.

Background:

Breast cancer has been classified as the most prevalent type of cancer affecting Canadian women. Recent research suggests that a proportion of women diagnosed with breast cancer experience elevated health anxiety, as well as generalized anxiety and depression. However, further research is needed in order to understand the implications of health anxiety among women with breast cancer. To date, it is unknown whether health anxiety is associated with increased body vigilance and reduced reassurability among this population. Furthermore, it is unclear whether health anxiety uniquely predicts quality of life over and above other factors such as general negative affect (i.e., depression and anxiety), cancer-specific anxiety, or, alternatively, vulnerability factors that are associated with other anxiety disorders (i.e., intolerance of uncertainty and anxiety sensitivity). Given the multiple constructs that can be assessed by psychologists, it is important to identify those constructs that are unique and provide valuable information to understanding the emotional experience of women who have been diagnosed with breast cancer.

Results:

Participants were Canadian women who were diagnosed with breast cancer within the past ten years (n = 198) whom completed a series of online questionnaires. The results illustrated that:

1. Individuals with elevated health anxiety also reported being more preoccupied with bodily sensations, less reassured by medical personnel, and had poorer physical quality of life than those with lower health anxiety


2. Health anxiety was a significant factor over and above other health-related and cancer-related variables


3. The longer time that had elapsed since diagnosis the better the individual's physical quality of life

Conclusion:

The results of the study are important because they provide unique information about the relationship between health anxiety, body vigilance, reassurability, and quality of life in women with breast cancer. It also added to the literature supporting the cognitive-behavioral model of health anxiety and demonstrates how the model is applicable to women with a history of breast cancer. This study provides direction for researchers who have an interest in studying the psychological well-being of women with breast cancer by establishing the importance of health anxiety in this population. Above all, the knowledge gained from this project may aid clinicians in understanding which constructs are important to assess when treating women with a history of breast cancer.

Your participation in this study is greatly appreciated. If you have any questions about the study findings, please contact Kirsten Gullickson at gullickk@uregina.ca.

Individuals with a medically ill parent are at increased risk for psychological distress. However, it is not known whether they may also be at risk for developing health anxiety. The interpersonal model of hypochondriasis (Stuart & Noyes, 1999) proposes that parental illness and insecure attachment styles may contribute to increased levels of health anxiety in adults. The cognitive- behavioural model of health anxiety (Salkovskis & Warwick, 2001) predicts that exposure to parental illness may increase dysfunctional core beliefs regarding health (e.g., perceived increase in risk of illness) which could increase health anxiety. This study explored the relationship between parental health status (i.e., ill or healthy), adult attachment style, dysfunctional health beliefs, and health anxiety in 328 emerging adults with healthy parents and 116 emerging adults with ill parents. Participants completed measures of health anxiety, adult attachment style, and health beliefs. Those with an ill parent answered additional questions designed to assess illness-related variables such as perceptions of illness severity and age at diagnosis. The primary results were as follows:

1. Emerging adults in the ill parent group reported higher levels of health anxiety than those in the healthy parent group.
2. In support of the cognitive-behavioural model, the relationship between parental illness and health anxiety was also shown to be dependent upon the formation of beliefs regarding the likelihood of illness.
3. As predicted by the interpersonal model, emerging adults with an insecure attachment style reported higher levels of health anxiety as compared to those with the secure attachment style. Contrary to our predictions, this relationship was not stronger in the ill parent group.
4. In directly comparing the ability of the interpersonal and cognitive-behavioural models to predict health anxiety, perceptions of the likelihood of illness, difficulty coping with illness, and the parent's ability to cope with their illness were all significant unique predictors of health anxiety, while attachment style was not.

These results have important theoretical and clinical implications. As support was provided for both models of health anxiety, future research should focus on integrating these two models. An integrated model would recognize parental medical illness, attachment style, and dysfunctional health beliefs as necessary for providing a more comprehensive account of the development of health anxiety in emerging adults. In terms of clinical implications, increased awareness of perceptions of the likelihood of illness could lead to better identification of early health anxiety and improved treatment for clients who present with elevated health anxiety. Moreover, the current findings suggest that treatment focused directly on addressing attachment problems may be beneficial for clients.

Thank you to all for their participation in this research. The findings will be reported in a manuscript and soon submitted for publication to an academic journal.

Study Purpose:

To investigate beliefs and emotions that may influence health behaviours (treatment activities), such as diet, exercise, medication use, and blood glucose monitoring in individuals with diabetes.

Background:

In this study, we were interested in examining whether there is evidence to support two models of health behaviour - the Theory of Planned Behaviour and Protection Motivation Theory. Both models suggest that how we think influences our health behaviours. The models have different ideas, however, about the thoughts or beliefs that influence health behaviours. The key beliefs and attitudes are listed below:

Theory of Planned Behaviour: This theory suggests the following beliefs/attitudes influence health behaviour:
1. Attitudes: Belief about the health behaviour (for example, how beneficial and valuable participation in each health behaviour is)
2. Subjective Norms: Belief about how much other people, such as family and friends, would like the individual to participate in the health behaviour
3. Perceived Behavioural Control: Belief about the individual's ability to engage in each health behaviour
4. Response Efficacy: Belief about how effective engaging in each health behaviour is

Protection Motivation Theory: This theory suggests the following beliefs/attitudes influence health behaviour:
1. Perceived Vulnerability: Belief about how likely the individual is to experience complications from diabetes
2. Perceived Severity: Belief about how serious not participating in each of the health behaviours is and how serious potential complications are
3. Response Costs: Beliefs about barriers towards participating in each health behaviour (interference with life, discomfort, pain, embarrassment, etc.)
4. Self-Efficacy: Belief about the individual's ability to engage in each health behaviour

Study Findings:

1. Participants varied in their engagement in the health behaviours:
1. 88.1% of participants took their medications the number of times recommended daily;
2. 66.4% engaged in at least 30 minutes of physical activity or a specific exercise session at least 3 days of the week;
3. 52.8% tested their blood sugars the recommended number of times daily;
4. 28.2% participated in a healthy eating plan for the majority of each day

1. Anxiety was related to health behaviours:
1. Individuals with Type 1 and Type 2 diabetes who had higher anxiety about their health were less likely to follow dietary guidelines
2. Those who were anxious about health also had lower participation in exercise activities - this was mostly true of individuals with Type 1 diabetes
3. Those who were anxious about their health were more likely to monitor their blood glucose levels - this was mostly true of individuals with Type 1 diabetes

1. Certain beliefs related to anxiety about health were also found to influence participation in the health behaviours. Individuals were less likely to participate in the health behaviours if they believed:
1. coping with diabetes was difficult
2. medical services are inadequate
3. they are vulnerable to illness
4. diabetes is awful

1. The Theory of Planned Behaviour described above was supported overall. That is, the more favorable the individuals' attitudes towards the health behaviours, the more confidence in performing the health behaviours and the less anxious they were, the more individuals intended to and actually participated in each of the health behaviours.
2. The Protection Motivation Theory described above was also supported. Specifically, findings suggested that the more vulnerable to complications the individual believed they were, the more effective each of the health behaviours was believed to be, the fewer barriers towards participation in the health behaviours, the more confident in performing the health behaviours and the less anxious they were, the higher the individual's intention to and actual participation in each of the health behaviours.

Usefulness of the Findings:

1. The information that was gathered from this study can be used in the future to develop strategies to help people who are having difficulties with participation in each of the health behaviours.
2. It appears that helping people change their beliefs and emotions could help them change their adherence to treatment guidelines.
3. Some specific recommendations include providing information:


1. on risks of not participating in each health behaviour,
2. on the effectiveness of each health behaviour in managing diabetes,
3. instruction on how to properly engage in the health behaviours by an expert and role model, and
4. spending time examining and solving barriers involved in each health behaviour on an individual basis

Thank you again for your participation in this research. Our next step is to work towards informing other researchers and clinicians of the study findings.

Background:

Although caring for individuals with dementia is known to result in increased burden and depression among caregivers, little research has investigated caregiver's anxiety or concern about eventually developing dementia themselves. This is referred to as dementia anxiety. Existing research has reported mixed findings regarding factors that predict dementia anxiety among caregivers and non-caregivers. Potential relationships among caregiver burden, depression and dementia anxiety have not been extensively examined. This study explored caregiver and care recipient factors as predictors of dementia anxiety in older adult caregivers.

Methods:

A sample of 116 older adult caregivers answered demographic/background questions and completed a series of self-report measures assessing dementia anxiety, caregiver burden, depression, and the physical disability of the care recipient.

Results:

The majority of caregivers were female, Caucasian, and reported caring for a spouse. Analyses revealed that background variables were generally not related to dementia anxiety, while depression and caregiver burden were significantly associated. Using linear regression analysis, it was found that a diagnosis of dementia in the care recipient and caregiver depression were both significant predictors of caregiver dementia anxiety.

Conclusion:

Health care providers should be aware that dementia anxiety is associated with caring for individuals with dementia as well as with depression. Dementia anxiety may place additional strain on caregivers of individuals who have dementia and are suffering from depression and thus should be the focus of future research.

Study Purpose & Method:

The purpose of our research was to further understand the relationship between posttraumatic stress disorder (PTSD) symptoms in individuals diagnosed with multiple sclerosis (MS). Research supports the idea that PTSD is more prevalent in individuals with chronic health conditions, but PTSD symptoms amongst individuals with MS have not been widely studied. Thus, we sought to examine the extent to which MS-related disability, MS type, and time since diagnosis contributed to symptoms of PTSD. Participants with MS, another health condition (e.g., arthritis, chronic pain), or no health conditions (controls) completed an Internet survey with questions regarding demographics, chronic health conditions, anxiety, depression, PTSD, and MS disability (MS group only).

Study Results:

When participants were asked to rate the extent to which they perceive having MS to be a traumatic experience, almost a quarter of the sample found their disability to be considerably or extremely traumatic.

Based on our regression analyses, time since diagnosis of MS, MS type, and the perception of MS as traumatic were not significant predictors of PTSD symptoms. However, MS-related disability, and having another chronic health condition were found to significantly predict PTSD symptoms. Using PTSD diagnosis criteria assessed based on the Internet survey, 22.2% of the MS group and 22.9% of the non-MS health conditions group were likely to have PTSD, compared to only 11.9% of the control sample.

Our results support the notion that individuals with chronic health conditions such as MS, may be at an increased risk for developing PTSD symptoms. These findings underscore the need for physicians or care providers to tailor treatment regimes to specific individuals, and assess the amount of distress caused by the experience of having MS and other chronic health conditions. As there is limited research regarding MS and PTSD, replication of our results and further examination of PTSD in MS is important.

We are currently in the process of informing clinicians and others researchers about the study findings through publications and presentations at conferences.

Thank you again for your participation in our research. If you have any questions regarding this research, please free to contact Dr. Heather Hadjistavropoulos at 585-5133.

Health anxiety (HA) refers to a preoccupation and fear about acquiring or having a serious disease. The fear results from the negative misinterpretation of harmless bodily sensations. While past research has found that individuals who worry about their health commonly engage in distinctive maladaptive behaviours (e.g., seeking repeated reassurance from physicians, excessively scanning their bodies), the relationship between HA and wellness behaviour, such as physical activity, has not been adequately examined. Furthermore, the extent to which HA may be associated with other maladaptive behaviours, such as the tendency to use excess medication, has not yet been addressed. The goal of this study was to clarify the relationships between HA, thoughts about health, maladaptive behaviours, and physical activity. Undergraduate participants (N =144) completed an online questionnaire. The primary results of this study are as follows:

1. HA was not significantly related to general physical activity.
2. Students who tend to focus on their body were more inclined to engage in extreme physical activity, and reported symptoms of exercise tolerance and exercise withdrawal.
3. Students with HA were more likely to engage in a variety of maladaptive behaviours including body scanning, medication use, and diagnostic verification.
4. When students reported negative thoughts about their health (e.g., the belief that they are at risk of becoming sick) they were more likely to engage in maladaptive behaviours.

The results of this study have two important implications. First, the relationship between HA and a variety of maladaptive behaviours was expanded upon. For instance, students who worry about their health were more likely to use medication and seek out medical treatment. Second, students who tend to focus on their body may be at risk of engaging in extreme physical activity. As this research only investigated the experiences reported by university students, future research should determine if similar relationships are found in other samples. While this study had its limitations, including using self-report measures, the results clarify that HA is more related to maladaptive behaviour than wellness behaviour, such as physical activity.

The Short Health Anxiety Inventory (SHAI; Salkovskis, Rimes, Warwick, & Clark, 2002) is a self-report measure designed to assess health anxiety in individuals with medical illnesses as well as individuals who are healthy. In this psychometric study, we examined data from a community sample with no serious medical conditions (n = 232) and a medical sample with multiple sclerosis (n = 245). In addition to other measures, both samples completed the SHAI. Factor analysis found the same two-factor solution for both samples, with the two factors labelled: 1) Thought Intrusion, and 2) Fear of Illness. Comparable item loadings were found for both samples, but the two factors were more strongly related in the non-medical sample. There was also a very large difference in scores between patients who had MS and those who did not have MS on the Thought Intrusion scale, and only a small difference between these groups on the Fear of Illness scale. These differences indicate that the experience of health anxiety in patients with MS appears to be different from the experience of health anxiety in individuals who do not have MS.

Lab Project

Study Purpose

This study was conducted to obtain a better understanding of health anxiety in individuals with and without medical conditions or emotional concerns. Health anxiety is worry you may experience due to bodily sensations or anxiety about health related information. By obtaining a better understanding of health anxiety, we believe that clinicians who work with individuals with health anxiety will be better able to effectively assess and treat such individuals.

Study Findings

Results from this study indicated that individuals who are health anxious hold four primary thoughts that contribute to health anxiety. These include: 1) thoughts concerning how likely it is they will develop or experience worsening of an illness; 2) thoughts concerning how awful the illness would be; 3) thoughts regarding their ability to cope with the illness; and 4) thoughts about the ability of medical services to assist them in dealing with their illness.

We were also able to examine differences in the presentation of health anxiety between individuals with and without a medical condition or emotional difficulty. Results revealed that health anxiety is increased in individuals who have a health condition or a history of anxiety and depression.

We also sought to examine the differences in the four primary thoughts (identified above) between individuals who have a medical condition and those who do not. We found that all four of the thoughts related to health anxiety in individuals with medical conditions. In individuals who did not have a medical condition, however, health anxiety was most strongly related to thoughts about how likely it is they would develop an illness and their inability to cope with the illness. These findings are important for clinicians working with individuals with health anxiety as they show that health anxiety may present slightly differently in individuals with and without a medical condition. Knowledge of such differences will assist clinicians in identifying increased health anxiety and developing treatment strategies to reduce the amount of health related thoughts and worries an individual may have.

At the present time, we are working to inform clinicians and other researchers of these findings through publications and presentations at conferences.

Thank you again for your participation in our research. Should you have any questions, please feel free to contact Dr. Heather Hadjistavropoulos at 585-5133.

Women commonly experience anxiety and depression following a breast cancer diagnosis; however, less is known about health anxiety in this population. Persons with health anxiety may have excessive fear or worries about illness or disease, hold strong beliefs that one is ill, pay close attention to bodily sensations, and seek reassurance repeatedly from family, friends, and medical personnel that they are healthy. Health anxiety is important to study in women previously diagnosed with breast cancer because severe forms of health anxiety can contribute to significant disability, is associated with other types of anxiety and depression, and can result in reduced health-related quality of life.

It is also recognized that having adequate social support is associated with positive outcomes after a diagnosis of breast cancer, such as better psychological health and immune function. However, some research reports how even well-intentioned people may respond in unhelpful or distressing ways to women diagnosed with breast cancer. Given that reduced social support and negative responses by social network members is associated with increased anxiety and depression, this study sought to investigate whether similar relationships would be observed between health anxiety and social factors.

Canadian women previously diagnosed with early-stage breast cancer (stages 0, I, or II) were recruited across to participate in an internet-based survey. One-hundred sixty-six women were included in the final analyses. The findings that are reported in a manuscript recently submitted for publication in an academic journal are reported below:

1. Roughly one-third of the sample reported elevated health anxiety
2. Health anxiety was higher amongst women more recently diagnosed and treated for breast cancer
3. On average, health anxiety was lower amongst women with breast cancer as compared to samples of patients with chronic pain and multiple sclerosis (based on previously published data); yet, health anxiety in women with breast cancer was higher than that reported by community and control samples
4. Women who perceived that their support system was adequate also tended to report seeking support to alleviate their health worries
5. Women who reported receiving unsupportive responses from social network members also reported being more excessively health anxious and holding health anxious beliefs (e.g., the belief that others were not taking their health concerns seriously)

The results of this study have important implications for our theoretical understanding of health anxiety in a medical sample. In particular, social factors have been neglected in the cognitive-behavioral model of health anxiety, and this research suggests a need for such variables to be taken into account. Clinically, this research underscores the need for practitioners to obtain information regarding a breast cancer patient's social network should she present with health anxiety. Future research might attempt to better understand the links among unsupportive social network behaviours and health anxiety.

Study Purpose:

The purpose of this project was to obtain a better understanding of the relationship between health anxiety, obesity, and binge eating. Obesity is a growing concern in our society that is associated with increased health problems. Individuals who suffer from both obesity and binge eating have a greater risk of increased health problems as well as depression and anxiety. Thus, due to the potential increased risk of health problems it is possible individuals who are overweight, and engage in binge eating may also worry and interpret bodily sensations as a sign of illness or experience anxiety when exposed to health- related information.

Study Findings:

Surprisingly, findings from this study revealed that individuals with elevated body weight (i.e., overweight or obese) were not more likely to have increased health anxiety.

However, we did find that individuals who binge eat have increased health anxiety and increased thoughts associated with health anxiety such as thoughts about how likely it is that they will develop an illness, thoughts about how awful it would be to experience and illness, thoughts about their ability to cope with an illness, as well as thoughts about the ability or inability of medical services to assist them in dealing with their illness. These results were also shown after we accounted for individuals who had a chronic medical condition at the time of completing the study.

As this was the first study to examine body weight, binge eating and health anxiety it will be important for future research to examine how binge eating may contribute to the development and maintenance of health anxiety, or alternatively the extent to which health anxiety may be a risk factor for binge eating.

We are currently in the process of informing clinicians and others researchers about the study findings through publications and presentations at conferences.

Thank you again for your participation in our research. If you have any questions regarding this research, please free to contact Dr. Heather Hadjistavropoulos at 585-5133.