中国临床心理学杂志

灾难化解释对健康焦虑的影响:有调节的中介作用

作者：罗浩贤符仲芳李迪邢怡伦王建平

单位：1. 北京师范大学心理学部应用实验心理北京重点实验室北京 100875 2. 首都医科大学北京 100088

分类号：R395.2

出版年,卷(期):页码：2018,26(2):289-293

摘要：

目的：探讨灾难化解释、躯体警觉性、积极元认知对个体健康焦虑的影响。方法：采用问卷调查法对3个省份共510名大学生进行测查，使用多元依次回归检验灾难化解释对健康焦虑的影响中，躯体警觉性的中介效应和积极元认知有调节的中介效应。结果：①躯体警觉性对灾难化解释和健康焦虑的关系有部分中介效应。②积极元认知调节了中介过程的直接和前半路径。具体而言，相对于低积极元认知，高积极元认知能够减少灾难化解释对健康焦虑以及躯体警觉性的影响。结论：积极元认知调节了灾难化解释对健康焦虑的直接效应以及通过躯体警觉性影响健康焦虑的中介效应。

Objective:To explore the effect of catastrophic misinterpretation, body vigilance, positive metacognition and health anxiety. Methods:510 university students from 3 provinces in China were measured by questionnaire. The mediat-ing effect of body vigilance and the moderated mediating effect of positive metacognition were tested by stepped multiple lin-ear regression. Results:①Body vigilance played a partial mediating role in the relation between catastrophic misinterpreta-tion and health anxiety. ②The direct and mediation effect was moderated by positive metacognition. Compared to adults with low positive metacognition, adults with high positive metacognition showed buffering effect on direct and mediating paths. Conclusion:Positive metacognition moderats the direct effect between catastrophic misinterpretation and the media-tion effect of body vigilance in the relation between catastrophic misinterpretation and health anxiety.

基金项目：

作者简介：

参考文献：

1 Abramowitz JS, Olatunji BO, Deacon BJ. Health anxiety, hypochondriasis, and the anxiety disorders. Behavior Therapy, 2007, 38(1):86-94
2 Ferguson E. A taxometric analysis of health anxiety. Psychological Medicine, 2009, 39(2):277-285
3 Lee S, Creed FH, Ma YL, Leung CM. Somatic symptom burden and health anxiety in the population and their correlates. Journal of Psychosomatic Research, 2015, 78(1):71-76
4 Olatunji BO, Kauffman BY, Meltzer S, et al. Cognitivebehavioral therapy for hypochondriasis/health anxiety:a meta-analysis of treatment outcome and moderators. Behaviour Research & Therapy, 2014, 58(4):65-74
5 Weck F, Gropalis M, Hiller W, Bleichhardt G. Effectiveness of cognitive-behavioral group therapy for patients with hypochondriasis(health anxiety). Journal of Anxiety Disorders, 2015, 30:1-7
6 Rachman S. Health anxiety disorders:a cognitive construal. Behaviour Research & Therapy, 2012, 50(7-8):502-512.
7 Gellatly R, Beck AT. Catastrophic thinking:a transdiagnostic process across psychiatric disorders. Cognitive Therapy & Research, 2016, 40(4):1-12
8 Norris AL, Marcus DK. Cognition in health anxiety and hypochondriasis:recent advances. Current Psychiatry Reviews, 2014, 10(1):44-49
9 Bailey R, Wells A. Metacognitive beliefs moderate the relationship between catastrophic misinterpretation and health anxiety. Journal of Anxiety Disorders, 2015, 34:8-14
10 Witthöft M, Kerstner T, Ofer J, et al. Cognitive biases in pathological health anxiety:the contribution of attention, memory, and evaluation processes. Clinical Psychological Science, 2015, 4(3):464-479
11 Lee HJ, Goetz AR, Turkel JE,Siwiec SG. Computerized attention retraining for individuals with elevated health anxiety. Anxiety Stress & Coping, 2015, 28(2):226-237
12 Shields C, Murphy K. Selective attention and health anxiety:ill-health stimuli are distracting for everyone. Cognitive Therapy & Research, 2011, 35(3):241-252
13 Olatunji BO, Deacon BJ, Abramowitz JS, Valentiner DP. Body vigilance in nonclinical and anxiety disorder samples:structure, correlates, and prediction of health concerns. Behavior Therapy, 2007, 38(4):392-401
14 Esteve MR, Camacho L. Anxiety sensitivity, body vigilance and fear of pain. Behaviour Research & Therapy, 2008, 46 (6):715-27
15 Vlaeyen JW, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain:a state of the art. Pain, 2000, 85(3):317-332
16 Wong WS, Lam HM, Chow YF, et al. The effects of anxiety sensitivity, pain hypervigilance, and pain catastrophizing on quality of life outcomes of patients with chronic pain:a preliminary, cross-sectional analysis. Quality of Life Research, 2014, 23(8):2333-2341
17 Melli G, Carraresi C, Poli A, Bailey R. The role of metacognitive beliefs in health anxiety. Personality & Individual Differences, 2016, 89:80-85
18 Bailey R, Wells A. Is metacognition a causal moderator of the relationship between catastrophic misinterpretation and health anxiety? a prospective study. Behaviour Research & Therapy, 2016, 78:43-50
19 Halvorsen M, Hagen R, Hjemdal O, et al. Metacognitions and thought control strategies in unipolar major depression:a comparison of currently depressed, previously depressed, and never-depressed individuals. Cognitive Therapy & Research, 2014, 39(1):31-40
20 Rief W, Hiller W, Margraf J. Cognitive aspects of hypochondriasis and the somatization syndrome. Journal of Abnormal Psychology, 1998, 107(4):587-595
21 符仲芳. 癌症患者躯体症状敏感性和复发恐惧的关系:有调节的中介效应. 硕士论文. 北京:北京师范大学硕士学位论文, 2016
22 Schmidt NB, Lerew DR, Trakowski JH. Body vigilance in panic disorder:evaluating attention to bodily perturbations. Journal of Consulting & Clinical Psychology, 1997, 65(2):214-20
23 Salkovskis PK, Warwick HM. The health anxiety inventory:development and validation of scales for the measurement of health anxiety and hypochondriasis. Psychological Medicine, 2002, 32(5):843-853
24 Zhang Y, Liu R, Li G, Mao S, Yuan Y. The reliability and validity of a chinese-version short health anxiety inventory:an investigation of university students. Neuropsychiatric Disease & Treatment, 2015, 11:1739-1747
25 Wells A, Cartwright-Hatton S. A short form of the metacognitions questionnaire:properties of the mcq-30. Behaviour Research & Therapy, 2004, 42(4):385
26 范文超, 符仲芳, 徐慰, 等. 元认知问卷在中国大学生中的修订. 中国临床心理学杂志, 2017, 25(3):448-452
27 熊红星, 张璟, 叶宝娟, 等. 共同方法变异的影响及其统计控制途径的模型分析. 心理科学进展, 2012, 20(5):757-769
28 温忠麟, 叶宝娟. 中介效应分析:方法和模型发展. 心理科学进展, 2014, 22(5):731-745
29 Hayes AF. Introduction to mediation, moderation, and conditional process analysis:a regression-based approach. Journal of Educational Measurement, 2013, 51(3):335-337
30 温忠麟, 叶宝娟. 有调节的中介模型检验方法:竞争还是替补?. 心理学报, 2014, 46(5):714-726
31 Bailey R, Wells A. Development and initial validation of a measure of metacognitive beliefs in health anxiety:the mcqha. Psychiatry Research, 2015, 230(3):871-877
32 周怡, 戴利莎, 邓云龙. 健康焦虑元认知量表中文版在医学生中的信度与效度. 中国临床心理学杂志, 2017, 25(3):471-474

服务与反馈：

【文章下载】【加入收藏】