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Fear of Physical Sensations and Metacognitions About Health Anxiety Mediate the Relationship Between Negative Affect and Health Anxiety

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Abstract

High negative affect and low positive affect form a generalized vulnerability to emotional disorders, including health anxiety. The purpose of this study was to examine which specific vulnerabilities of anxiety sensitivity, somatosensory amplification, intolerance of uncertainty, and metacognitions about health anxiety mediate the pathways from negative affect and positive affect to health anxiety. Undergraduates (N = 564) completed self-report questionnaires. Mediational analyses demonstrated that the pathway from negative affect to health anxiety was mediated by anxiety sensitivity physical concerns, somatosensory amplification, and the metacognitions that thoughts can cause illness and that thoughts about illness are uncontrollable. In particular, the pathway from negative affect to health anxiety was primarily mediated by anxiety sensitivity physical concerns and the metacognition that thoughts about illness are uncontrollable. However, the specific vulnerabilities did not mediate the pathway from positive affect to health anxiety. These findings highlight that anxiety sensitivity physical concerns and metacognitions that thoughts about illness are uncontrollable play key roles in health anxiety.

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Data Availability

The data that support the findings of this study are available from the corresponding author, AMP, upon reasonable request.

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Funding

No funding was received for the completion of this study and the authors declare no competing interests.

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Authors and Affiliations

  1. Department of Psychology, MacEwan University, Edmonton, AB, T5J 4S2, Canada

    Tiffany D. Carmichael & Alexander M. Penney

Contributions

This manuscript is based on TDC’s undergraduate honours thesis, which was supervised by AMP within the Department of Psychology at MacEwan University. TDC and AMP designed the study, collected the data, and conducted the data cleaning, data analysis, and manuscript preparation. All authors contributed to and approved the final draft.

Corresponding author

Correspondence to Alexander M. Penney.

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Competing Interests

No funding was received for the completion of this study and the authors declare no competing interests.

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Cite this article

Carmichael, T.D., Penney, A.M. Fear of Physical Sensations and Metacognitions About Health Anxiety Mediate the Relationship Between Negative Affect and Health Anxiety. J Rat-Emo Cognitive-Behav Ther 43, 32 (2025). https://doi.org/10.1007/s10942-025-00603-3

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  • DOI https://doi.org/10.1007/s10942-025-00603-3

Keywords

  • Anxiety sensitivity
  • Intolerance of uncertainty
  • Somatosensory amplification
  • Neuroticism
  • Extraversion
  • Positive affect

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