Health anxiety cognitive model — MRCPsych Paper A MCQ

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EasyPsychologyHealth anxiety cognitive modelMRCPsych Paper A

A 43-year-old man has persistent health anxiety. After a brief, mild headache that resolves spontaneously, he becomes convinced that it indicates a brain tumour, despite a normal neurological examination. In the cognitive-behavioural model of health anxiety, which process is most directly illustrated?

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Correct answer: C — Catastrophic misinterpretation of bodily sensations

The correct answer is C. Catastrophic misinterpretation occurs when a benign or transient bodily sensation is appraised as evidence of serious disease. Here, a mild, self-limiting headache is interpreted as indicating a brain tumour despite a normal examination. Selective attention may increase awareness of physical sensations, but the vignette specifically demonstrates the threatening meaning assigned to the sensation. Reassurance seeking is a safety behaviour that may maintain health anxiety, but seeking reassurance is not the process being directly illustrated. Intolerance of uncertainty may contribute to persistent concern but does not itself describe the conclusion that the headache signifies cancer. Extinction would involve a reduction in conditioned fear and is therefore inconsistent with the continuing illness belief.

Reference: Bailey R, Wells A. Metacognitive beliefs moderate the relationship between catastrophic misinterpretation and health anxiety. Journal of Anxiety Disorders. 2015;34:8–14. https://pubmed.ncbi.nlm.nih.gov/26093824/