Joint factor analysis and approximate equipercentile linking of common trait health anxiety measures: a cross-sectional study of the 14-, 18- and 64-item health anxiety inventory, the illness attitude scale, and the 14-item Whiteley Index
Abstract Background Research on health anxiety has bloomed in recent years, but summaries of the literature are complicated by the use of dissimilar self-report questionnaires. Furthermore, these instruments have rarely been administered in parallel, and especially not in clinical samples. In this s...
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | BMC Psychiatry |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12888-023-05151-7 |
| _version_ | 1797451852957089792 |
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| author | Erland Axelsson Susanna Österman Erik Hedman-Lagerlöf |
| author_facet | Erland Axelsson Susanna Österman Erik Hedman-Lagerlöf |
| author_sort | Erland Axelsson |
| collection | DOAJ |
| description | Abstract Background Research on health anxiety has bloomed in recent years, but summaries of the literature are complicated by the use of dissimilar self-report questionnaires. Furthermore, these instruments have rarely been administered in parallel, and especially not in clinical samples. In this study, we aimed to investigate the relationship between five widespread health anxiety measures, and to draft guidelines for the conversion of different sum scores. Methods Clinical trial participants with principal pathological health anxiety (n = 335) and a sample of healthy volunteers (n = 88) completed the 14-item Whiteley Index (WI-14), the Illness Attitude Scale (IAS), and the 14-, 18-, and 64-item Health Anxiety Inventory (the HAI-64, HAI-18, and HAI-14). Cross-sectional data from all participants were pooled (N = 423) and we conducted a joint factor analysis and approximate equipercentile linking of the WI-14, IAS, HAI-64, HAI-18, and HAI-14. Results Inter-scale correlations were high (rs ≥ 0.90 and ≥ 0.88 in adjusted analyses), and the scree plot of the joint factor analysis spoke for a unifactorial solution where 89/105 items (85%) had loadings ≥ 0.40. Most items at the core of this broad trait health anxiety factor pertained to the worry about health, the fear of having or developing a serious disease, and to some extent bodily preoccupation. We present a cross-walk table of observed equipercentile linked sum scores. Conclusions This study speaks clearly in favor of the WI-14, IAS, HAI-64, HAI-18, and HAI-14 all tapping into the same trait health anxiety construct, the core of which appears to concern the worry about health, the fear of having or developing a serious disease, and to some extent bodily preoccupation. Based on recently reported cut-offs for the HAI-14, a reasonable cutoff for pathological health anxiety in a psychiatric setting probably lies around 7–8 on the WI-14, 52–53 on the IAS, 82–83 on the HAI-64, and 26–27 on the HAI-18. Trial registration ClinicalTrials.gov NCT01966705, NCT02314065. |
| first_indexed | 2024-03-09T15:00:21Z |
| format | Article |
| id | doaj.art-d472846b59644ac8bbfae598b6f50768 |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2024-03-09T15:00:21Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj.art-d472846b59644ac8bbfae598b6f507682023-11-26T13:56:52ZengBMCBMC Psychiatry1471-244X2023-09-0123111310.1186/s12888-023-05151-7Joint factor analysis and approximate equipercentile linking of common trait health anxiety measures: a cross-sectional study of the 14-, 18- and 64-item health anxiety inventory, the illness attitude scale, and the 14-item Whiteley IndexErland Axelsson0Susanna Österman1Erik Hedman-Lagerlöf2Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska InstitutetCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska InstitutetDivision of Psychology, Department of Clinical Neuroscience, Karolinska InstitutetAbstract Background Research on health anxiety has bloomed in recent years, but summaries of the literature are complicated by the use of dissimilar self-report questionnaires. Furthermore, these instruments have rarely been administered in parallel, and especially not in clinical samples. In this study, we aimed to investigate the relationship between five widespread health anxiety measures, and to draft guidelines for the conversion of different sum scores. Methods Clinical trial participants with principal pathological health anxiety (n = 335) and a sample of healthy volunteers (n = 88) completed the 14-item Whiteley Index (WI-14), the Illness Attitude Scale (IAS), and the 14-, 18-, and 64-item Health Anxiety Inventory (the HAI-64, HAI-18, and HAI-14). Cross-sectional data from all participants were pooled (N = 423) and we conducted a joint factor analysis and approximate equipercentile linking of the WI-14, IAS, HAI-64, HAI-18, and HAI-14. Results Inter-scale correlations were high (rs ≥ 0.90 and ≥ 0.88 in adjusted analyses), and the scree plot of the joint factor analysis spoke for a unifactorial solution where 89/105 items (85%) had loadings ≥ 0.40. Most items at the core of this broad trait health anxiety factor pertained to the worry about health, the fear of having or developing a serious disease, and to some extent bodily preoccupation. We present a cross-walk table of observed equipercentile linked sum scores. Conclusions This study speaks clearly in favor of the WI-14, IAS, HAI-64, HAI-18, and HAI-14 all tapping into the same trait health anxiety construct, the core of which appears to concern the worry about health, the fear of having or developing a serious disease, and to some extent bodily preoccupation. Based on recently reported cut-offs for the HAI-14, a reasonable cutoff for pathological health anxiety in a psychiatric setting probably lies around 7–8 on the WI-14, 52–53 on the IAS, 82–83 on the HAI-64, and 26–27 on the HAI-18. Trial registration ClinicalTrials.gov NCT01966705, NCT02314065.https://doi.org/10.1186/s12888-023-05151-7Health anxietyHypochondriasisIllness anxiety disorderLinkingSomatic symptom disorder |
| spellingShingle | Erland Axelsson Susanna Österman Erik Hedman-Lagerlöf Joint factor analysis and approximate equipercentile linking of common trait health anxiety measures: a cross-sectional study of the 14-, 18- and 64-item health anxiety inventory, the illness attitude scale, and the 14-item Whiteley Index BMC Psychiatry Health anxiety Hypochondriasis Illness anxiety disorder Linking Somatic symptom disorder |
| title | Joint factor analysis and approximate equipercentile linking of common trait health anxiety measures: a cross-sectional study of the 14-, 18- and 64-item health anxiety inventory, the illness attitude scale, and the 14-item Whiteley Index |
| title_full | Joint factor analysis and approximate equipercentile linking of common trait health anxiety measures: a cross-sectional study of the 14-, 18- and 64-item health anxiety inventory, the illness attitude scale, and the 14-item Whiteley Index |
| title_fullStr | Joint factor analysis and approximate equipercentile linking of common trait health anxiety measures: a cross-sectional study of the 14-, 18- and 64-item health anxiety inventory, the illness attitude scale, and the 14-item Whiteley Index |
| title_full_unstemmed | Joint factor analysis and approximate equipercentile linking of common trait health anxiety measures: a cross-sectional study of the 14-, 18- and 64-item health anxiety inventory, the illness attitude scale, and the 14-item Whiteley Index |
| title_short | Joint factor analysis and approximate equipercentile linking of common trait health anxiety measures: a cross-sectional study of the 14-, 18- and 64-item health anxiety inventory, the illness attitude scale, and the 14-item Whiteley Index |
| title_sort | joint factor analysis and approximate equipercentile linking of common trait health anxiety measures a cross sectional study of the 14 18 and 64 item health anxiety inventory the illness attitude scale and the 14 item whiteley index |
| topic | Health anxiety Hypochondriasis Illness anxiety disorder Linking Somatic symptom disorder |
| url | https://doi.org/10.1186/s12888-023-05151-7 |
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