关键词: 健康焦虑, 解释偏向矫正, 随机对照试验, 潜在增长曲线模型, 纵向中介

Abstract: Health anxiety refers to the fear and worry caused by inappropriate or excessive attention to one's own health condition. Based on the comprehensive model of health anxiety, the development and maintenance of health anxiety is closely related to an individual's interpretation bias. Moreover, the study found that the interpretation of health anxiety tends to show the characteristics of catastrophizing interpretation, and alleviating catastrophizing interpretation can help reduce the symptoms of health anxiety. Therefore, current study aims to investigate the intervention effect of cognitive bias modification of interpretation training on health anxiety, catastrophizing interpretation, anxiety and depression symptoms and the longitudinal mediating mechanism of catastrophizing interpretation, in order to provide new ideas for internet-based intervention of health anxiety. Study used a randomized controlled trial in which eligible participants (N = 228) with health anxiety (Short Health Anxiety Inventory [SHAI] scores ≥ 15) were randomly assigned to an iCBM-I group (100% positive feedback, N = 76) , an attention control group (50% positive and 50% negative feedback, N = 76), and a wait-list control group (N = 76). Participants in iCBM-I group and attention control group finished internet-based tasks for 12 days (one session every 3 days, a total of four sessions). The health anxiety, catastrophizing interpretation, anxiety, and depression were measured at pre-treatment, post-treatment and 1-month follow-up to assess the immediate and follow-up effects of the iCBM-I program on health anxiety, and to explore the psychological mechanism of intervention effect. Based on the principle of intent to treat, the generalized linear mixture model was used to analyze the intervention effect of the iCBM-I program, two-factor analysis of variance and hierarchical regression were used to analyze the moderating effect of demographic and symptom variables at baseline, and the latent growth curve model of the parallel development was used to analyze the longitudinal mediating effect of catastrophizing interpretation. The results found that: Compared with the wait-list group, the 100% positive feedback iCBM-I intervention group had significant immediate effect on the catastrophizing interpretation, anxiety and depression symptoms of healthy anxious individuals. There were significant effects of 1-month follow-up intervention on health anxiety, catastrophizing interpretation, anxiety and depression. The marital status, baseline level of health anxiety symptoms and catastrophizing interpretation played a moderating role in the iCBM-I intervention of health anxiety symptoms, and catastrophizing interpretation played a longitudinal mediating role in the iCBM-I intervention of health anxiety symptoms. Current study developed an iCBM-I self-help intervention mini-program for health anxiety and investigated its feasibility, effect and psychological mechanism, providing new empirical research evidence for the cognitive theory of emotion and a new perspective for the networked intervention for health anxiety. In the future, researchers may consider the development of "top-down" and "bottom-up" combined intervention therapy, and investigate the effect and mechanism of intervention on health anxious individuals.

Key words: Health anxiety, cognitive bias modification of interpretation, randomized controlled trials, latent growth curve model, longitudinal mediation