Dysfunctional beliefs about health and illness: A family study

  • Sandra Arnáez Faculty of Psychology. University of Valencia.
  • Gemma García-Soriano Faculty of Psychology. University of Valencia.
  • Amparo Belloch Faculty of Psychology. University of Valencia.
Keywords: Hypochondriasis, Dysfunctional beliefs about illness, overestimation of threat, Intolerance of uncertainty, offspring


Cognitive models about hypochondriasis postulate that early experiences with illness can lead individuals to develop dysfunctional beliefs about having an illness. These beliefs can remain in a latent state and be triggered by a critical incident. Published studies have provided data partially supporting these assumptions. Considering that the primary family context shares experiences about illness, we examined the relationships between the dysfunctional beliefs that parents and their offsprings maintain about illness and thoughts, such as intolerance to uncertainty and over-estimation of threat, as well as the relationships between these beliefs with hypochondriacal and depressive symptoms. Forty university students and their parents (27 fathers and 36 mothers) completed self-reports on dysfunctional beliefs about illness, thoughts and symptoms of hypochondriasis and depression. Results indicated that the fathers’ dysfunctional beliefs about illness and overestimation of threat, but not those of mothers, were associated with their sons and daughters beliefs. Likewise, the dysfunctional beliefs of fathers, sons, and daughters were related to symptoms of hypochondriasis and depression.

Author Biographies

Sandra Arnáez, Faculty of Psychology. University of Valencia.
Aspirant (research fellow, enrolled in a Ph.D. degree). Department of Personality, Assessment and Psychological Treatments.
Gemma García-Soriano, Faculty of Psychology. University of Valencia.
Lecturer. Department of Personality, Assessment and Psychological Treatments.
Amparo Belloch, Faculty of Psychology. University of Valencia.
Professor. Department of Personality, Assessment and Psychological Treatments.


Abramowitz, J. S., Schwartz, S. A., y Whiteside, S. P. (2002, December). A contemporary conceptual model of hypochondriasis. Mayo Clinic Proceedings (Vol. 77, No. 12, pp. 1323-1330). Elsevier.

Abramowitz, J. S., y Braddock, A. (2008). Psychological treatment of health anxiety and hypochondriasis: A biopsychosocial approach. New York: Hogrefe publishing.

Abramowitz, J. S., y Moore, E. L. (2007). An experimental analysis of hypochondriasis. Behaviour Research and Therapy, 45(3), 413-424.

Alberts, N. M., Hadjistavropoulos, H. D., Sherry, S. B., y Stewart, S. H. (2016). Linking illness in parents to health anxiety in offspring: do beliefs about health play a role?. Behavioural and Cognitive Psychotherapy, 44(1), 18-29.

American Psychiatric Association. (2010). APA (2013). Diagnostic and Statistical Manual of Mental Disorders, (5th ed.). Arlington, VA: Author.

Barsky, A.J., Coeytaux, Remy, R., Sarnie, M.K., y Cleary, P.D. (1993). Hypochondriacal patients’ beliefs about good health. American Journal of Psychiatry, 150, 1085–1089.

Belloch, A. (2012). Propuestas para un enfoque transdiagnóstico de los trastornos mentales y del comportamiento: Evidencia, utilidad y limitaciones. Revista de Psicopatología y Psicología Clínica, 17(3), 295-311.

Belloch, A., Morillo, C., Luciano, J. V, García-Soriano, G., Cabedo, E., y Carrió, C. (2010). Dysfunctional belief domains related to obsessive-compulsive disorder: a further examination of their dimensionality and specificity. The Spanish Journal of Psychology, 13(1), 376–88.

Boelen, P. A., y Carleton, R. N. (2012). Intolerance of uncertainty, hypochondriacal concerns, obsessive-compulsive symptoms, and worry. The Journal of Nervous and Mental Disease, 200(3), 208-213.

Caballo, V. (2005). Manual para la evaluación clínica de los trastornos psicológicos. Ediciones Pirámide.

Castañeiras, C. (2001). Avances en psicopatología y clínica de la hipocondría. Tesis doctoral. Universidad de Valencia.

Chorot y Martínez-Narváez (2012). Trastornos somatoformes. En Belloch, A., Sandín, B., y Ramos, F. (Ed.), Manual de psicopatología (pp. 177-212). Madrid, España: McGraw-Hill.

Christensen, A. J., Moran, P. J., y Wiebe, J. S. (1999). Assessment of irrational health beliefs: relation to health practices and medical regimen adherence. Health Psychology, 18(2), 169.

Deacon, B., y Abramowitz, J. S. (2008). Is hypochondriasis related to obsessive-compulsive disorder, panic disorder, or both? An empirical evaluation. Journal of Cognitive Psychotherapy, 22(2), 115-127.

Fergus, T. A. (2014). Health‐related dysfunctional beliefs and health anxiety: Further evidence of cognitive specificity. Journal of Clinical Psychology, 70(3), 248-259.

Fergus, T. A., y Valentiner, D. P. (2011). Intolerance of uncertainty moderates the relationship between catastrophic health appraisals and health anxiety. Cognitive Therapy and Research, 35(6), 560-565.

Ferguson, E. (2000). Hypochondriacal concerns and the five factor model of personality. Journal of Personality, 68(4), 705-724.

Fulton, J. J., Marcus, D. K., y Merkey, T. (2011). Irrational health beliefs and health anxiety. Journal of Clinical Psychology, 67(6), 527-538.

Gellatly, R., y Beck, A. T. (2016). Catastrophic thinking: A transdiagnostic process across psychiatric disorders. Cognitive Therapy and Research, 40(4), 441-452.

Hadjistavropoulos, H. D., Craig, K. D., y Hadjistavropoulos, T. (1998). Cognitive and behavioral responses to illness information: the role of health anxiety. Behaviour Research and Therapy, 36(2), 149-164.

Hadjistavropoulos, H. D., Janzen, J. A., Kehler, M. D., Leclerc, J. A., Sharpe, D., y Bourgault-Fagnou, M. D. (2012). Core cognitions related to health anxiety in self-reported medical and non-medical samples. Journal of Behavioral Medicine, 35(2), 167-178.

Haenen, M. A., de Jong, P. J., Schmidt, A. J., Stevens, S., y Visser, L. (2000). Hypochondriacs' estimation of negative outcomes: domain-specificity and responsiveness to reassuring and alarming information. Behaviour Research and Therapy, 38(8), 819-833.

Kellner, R. (1985). Functional somatic symptoms and hypochondriasis: a survey of empirical studies. Archives of General Psychiatry, 42(8), 821-833.

Kellner, R. (1989). Hypochondriasis and body dysmorphic disorder. Treatments of psychiatric disorders: a task force report of the American Psychiatric Association, 3, 2138-2146.

Marcus, D. K. (1999). The cognitive-behavioral model of hypochondriasis: misinformation and triggers. Journal of Psychosomatic Research, 47(1), 79-91.

Marcus, D. K., Gurley, J. R., Marchi, M. M., y Bauer, C. (2007). Cognitive and perceptual variables in hypochondriasis and health anxiety: A systematic review. Clinical Psychology Review, 27(2), 127-139.

Marcus, D. K., y Church, S. E. (2003). Are dysfunctional beliefs about illness unique to hypochondriasis?. Journal of Psychosomatic Research, 54(6), 543-547.

McEvoy, P. M., y Mahoney, A. E. (2012). To be sure, to be sure: Intolerance of uncertainty mediates symptoms of various anxiety disorders and depression. Behavior Therapy, 43(3), 533-545.

Noyes, R., Carney, C. P., Hillis, S. L., Jones, L. E., y Langbehn, D. R. (2005). Prevalence and correlates of illness worry in the general population. Psychosomatics, 46(6), 529-539.

Noyes, R., Happel, R. L., y Yagla, S. J. (1999). Correlates of hypochondriasis in a nonclinical population. Psychosomatics, 40(6), 461-469.

Noyes, R., Stuart, S., Langbehn, D. R., Happel, R. L., Longley, S. L., y Yagla, S. J. (2002). Childhood antecedents of hypochondriasis. Psychosomatics, 43(4), 282-289.

Olatunji, B. O., Deacon, B. J., y Abramowitz, J. S. (2009). Is health anxiety an anxiety disorder? British Journal of Psychiatry, 194, 481–482.

Rachman, S. (2012). Health anxiety disorders: a cognitive construal. Behaviour Research and Therapy, 50(7), 502-512.

Reuman, L., Jacoby, R. J., Blakey, S. M., Riemann, B. C., Leonard, R. C., y Abramowitz, J. S. (2017). Predictors of illness anxiety symptoms in patients with obsessive compulsive disorder. Psychiatry Research, 256, 417-422.

Rief, W., Hiller, W., y Margraf, J. (1998). Cognitive aspects of hypochondriasis and the somatization syndrome. Journal of Abnormal Psychology, 107(4), 587.

Riskind, J. H., Sica, C., Bottesi, G., Ghisi, M., y Kashdan, T. B. (2017). Cognitive vulnerabilities in parents as a potential risk factor for anxiety symptoms in young adult offspring: An exploration of looming cognitive style. Journal of Behavior Therapy and Experimental Psychiatry, 54, 229-238.

Robbins, J. M., y Kirmayer, L. J. (1996). Transient and persistent hypochondriacal worry in primary care. Psychological Medicine, 26(3), 575-589.

Robichaud, M., Dugas, M. J., y Conway, M. (2003). Gender differences in worry and associated cognitive-behavioral variables. Journal of Anxiety Disorders, 17(5), 501-516.

Salkovskis, P. M. & Warwick, H. M. C. (1986). Morbid preoccupations, health anxiety and reassurance: a cognitive behavioural approach to hypochondriasis. Behaviour Research and Therapy, 24, 597–602.

Sanz, J., Perdigón, A. L., y Vázquez, C. (2003). Adaptación española del Inventario para la Depresión de Beck-II (BDI-II): 2. Propiedades psicométricas en población general. Clínica y Salud, 14(3).

Scarella, T. M., Laferton, J. A., Ahern, D. K., Fallon, B. A., y Barsky, A. (2016). The relationship of hypochondriasis to anxiety, depressive, and somatoform disorders. Psychosomatics, 57(2), 200-207.

Sica, C., Caudek, C., Bottesi, G., De Fazio, E., Ghisi, M., Marchetti, I., y Orsucci, A. (2013). Fathers'“not just right experiences” predict obsessive–compulsive symptoms in their sons: Family study of a non-clinical Italian sample. Journal of Obsessive-Compulsive and Related Disorders, 2(3), 263-272.

Taylor, S., y Asmundson, G. (2004). Treating health anxiety: A cognitive-behavioral Approach. New York: Guilford.

Weck, F., Bleichhardt, G., y Hiller, W. (2009). The factor structure of the Illness Attitude Scales in a German population. International Journal of Behavioral Medicine, 16(2), 164-171.

Weck, F., Harms, G., Neng, J. M., y Stangier, U. (2011). Hypochondrische Merkmale bei Patienten einer psychotherapeutischen Ambulanz. Zeitschrift für Klinische Psychologie und Psychotherapie.

Wheaton, M. G., Berman, N. C., Franklin, J. C., y Abramowitz, J. S. (2010). Health anxiety: Latent structure and associations with anxiety-related psychological processes in a student sample. Journal of Psychopathology and Behavioral Assessment, 32(4), 565-574.

How to Cite
Arnáez, S., García-Soriano, G., & Belloch, A. (2018). Dysfunctional beliefs about health and illness: A family study. Anales De Psicología / Annals of Psychology, 35(1), 19-25. https://doi.org/10.6018/analesps.35.1.317501
Clinical and Health Psychology