This study will compare the efficacy of cognitive therapy and exposure therapy for treating hypochondriasis.
Hypochondriasis is defined as a preoccupation with the fear of having a serious disease based on the person's misinterpretation of bodily symptoms (APA). For a long time hypochondriasis was seen as difficult to treat. Meanwhile effective psychological treatment for hypochondriasis exists. Psychotherapies using cognitive therapy (CT), cognitive behavioral therapy (CBT), exposure therapy (ET) or behavioral stress management approaches are effective in reducing symptoms of hypochondriasis. However, few studies compare different types of psychotherapy. In addition, in these studies numbers of participants were small, no differences between different treatments were found, and one third of the participants showed no satisfactory change. This study will compare the efficacy of CT and ET in a larger sample of 84 participants. Participants in this randomized controlled trial (RCT) will first undergo baseline assessment. Then they will be randomly assigned to either CT, ET or a waiting list (WL), all conditions are for the duration of 12 weeks. CT includes psychoeducation, attention training, cognitive restructuring, behavioral experiments, imagery rescripting and relapse prevention. ET includes change of safety behavior, exposition (in sensu and in vivo), and relapse prevention. Both treatment trials contain the identical number of sessions. Treatment response will be assessed at week 12 and additionally one and three years after treatment. Participants of the WL will be assigned to CT or ET after the waiting period.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
84
weekly 50-minute sessions for 12 weeks
Department of Clinical Psychology and Psychotherapy of the Wolfgang Goethe University
Frankfurt am Main, Hesse, Germany
Hypochondriasis Yale-Brown Obsessive-Compulsive Scale (H-YBOCS)
clinician-rated measure that assesses hypochondriacal obsessions, compulsions and avoidance
Time frame: 3 months
Illness Attitude Scales (IAS)
self-report measure that assesses attitudes, fears, and beliefs associated with the psychopathology of hypochondriasis and that of abnormal illness behavior
Time frame: 3 months
Beck-Depression Inventory II (BDI-II)
self-report measure that assesses depressive symptoms
Time frame: 3 months
Beck Anxiety Inventory (BAI)
self-report measure that asessses anxiety symptoms
Time frame: 3 months
Brief Symptom Inventory (BSI)
self-report measure that assesses aspects of general psychopathology
Time frame: 3 months
Scale for the Assessment of Illness Behavior (SAIB)
self-report measure that focuses on illness behavior
Time frame: 3 months
Health-related quality of life (SF-12)
self-report measure the assesses the health-related quality of life
Time frame: 3 months
Cognitions About Body and Health Questionnaire (CABAH)
self-rated measure that focuses on attitudes related to the cognitive concept of hypochondriasis
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Time frame: 3 months