The Impact of Exposure Therapy on Cancer-Related Future Cognitions in Severe Health Anxiety

• Published in: Cognitive and behavioral practice 2023-09
• Main Authors: Brier, Nora, Brown, Lily A.
• Format: Article
• Language: English
• Subjects: exposure therapy; health anxiety; inhibitory learning; somatic symptoms
• ISSN: 1077-7229; 1878-187X
• DOI: 10.1016/j.cbpra.2023.07.001

•Illness anxiety disorder (IAD) involves several treatment-interfering behaviors.•Traditional habituation model may not be sufficient for long-term maintenance of treatment gains.•Individuals with IAD formed conditioned fear associations between benign fear cues.•Inhibitory learning theory states exposure therapy should optimize expectation violation.•This paper describes exposure therapy for IAD from an inhibitory learning theory perspective. Individuals with illness anxiety disorder (IAD) experience a preoccupation with having or acquiring a serious illness despite having mild or absent physical symptoms. Formerly hypochondriasis, individuals with IAD experience high rates of disability, contribute to elevated annual health care costs, and experience multiple comorbidities. IAD has been historically difficult to treat for both medical and mental health providers. Research suggests cognitive behavior therapy has mixed results for individuals with IAD. In this fictitious case presentation, we describe a course of successful exposure therapy for IAD drawing on the principals of inhibitory learning theory. Thus, through this example we demonstrate how to overcome common obstacles to successful treatment for IAD, such as willingness to participation, comorbid depression, and therapeutic alliance.