Examining Health Anxiety and Anxiety About Fetal Health During Pregnancy

Abstract

Background: Health anxiety refers to excessive preoccupation or worry about one’s health. The experience of health anxiety during pregnancy is unclear. The limited existing research provides mixed results regarding the impact of pregnancy on health anxiety (e.g., Kowalyk, Hadjistavropoulos, & Jones, 2009; Savron et al., 1989). Purpose: The current investigation was designed to assess health anxiety in pregnant women, examine the relationship between health anxiety and fetal health anxiety, and examine the relationships between health anxiety, fetal health anxiety, associated constructs (i.e., general anxiety, depression, anxiety sensitivity, intolerance of uncertainty), and core health cognitions. In addition, inductive content analysis of open-ended questions facilitated a more comprehensive understanding of women’s experiences of fetal health anxiety. Methods: Participants comprised a sample of pregnant women (n = 100) and a sample of similarly aged non-pregnant women (n = 111) who completed a battery of measures to assess health anxiety, fetal health anxiety (pregnant women only), and additional constructs of interest. Results: Overall levels of health anxiety did not differ between the pregnant and non-pregnant women; in fact, scores for related subscales measuring perceived likelihood of having an illness and perceived negative consequences of having an illness were significantly lower in the pregnant sample suggesting that pregnancy may serve a protective function against some components of health anxiety. Significant, positive correlations between maternal health anxiety and measures of fetal health anxiety were observed. Significant, positive associations were also observed between health anxiety and the associated constructs (i.e., general anxiety, depression, anxiety sensitivity, intolerance of uncertainty) in both samples. General anxiety accounted for significant variance in health anxiety in the pregnant sample, and general anxiety and anxiety sensitive accounted for significant variance in health anxiety in the non-pregnant sample. The core health cognitions also accounted for significant variance in health anxiety, with differences observed between the samples. All four of the core health cognitions were uniquely related to health anxiety even when controlling for general anxiety and depression in both samples (with the exception of awfulness of illness in the non-pregnant sample). Significant, positive associations between fetal health anxiety and the associated constructs (with the exception of inhibitory intolerance of uncertainty and one measure of depression) were observed and general anxiety accounted for significant variance in fetal health anxiety. The core health cognitions accounted for significant variance in fetal health anxiety; however, only one of the four health cognitions (i.e., difficulty coping with illness) approached accounting for unique variance in fetal health anxiety when controlling for general anxiety and depression. Results from the inductive content analysis provided further information about pregnant women’s experiences of fetal health anxiety. Implications: The current investigation increases our knowledge of factors that may underlie elevated health anxiety during pregnancy. The results also extend our understanding of fetal health anxiety during pregnancy and the association between this construct and maternal health anxiety. The results support the cognitive-behavioural model of health anxiety and may have implications for assessment and treatment strategies for elevated health anxiety and fetal health anxiety during pregnancy.