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Date
Publisher
Philipps-Universität Marburg
Abstract
Severe health anxiety (HA) is characterized by excessive worry and anxiety about one’s health, often
accompanied by distressing intrusive imagery of signs of a serious illness or potentially receiving
bad news about having a life-threatening disease. However, the emotional responses to these
illness-related mental images in relation to HA have not been fully elucidated. Emotional responses
to mental imagery of 142 participants were assessed in a well-controlled script-driven imagery
task, systematically comparing emotional responses to illness-related imagery with neutral and
standard fear imagery. The results revealed that participants reported higher anxiety, aversion,
emotional arousal, and a stronger avoidance tendency during imagery of fear and illness-related
scenes compared to neutral scenes. Importantly, the emotional modulation varied by the level of
HA, indicating that individuals with higher HA experienced stronger emotional responses to illnessrelated
imagery. This association between HA and fearful imagery could not be better accounted for
by other psychological factors such as trait anxiety, anxiety sensitivity, somatic symptom severity,
or symptoms of depression and anxiety. Fearful responding to standard threat material was not
associated with HA. The present findings highlight the importance of considering fear responding to
mental imagery in understanding and addressing HA.