Explaining the Structural Model of Health Anxiety on the Basis of Metacognitive Beliefs with the Mediating Role of Anxiety Sensitivity in People with Obsessive-Compulsive Symptoms

Abstract

Objective
The present study aimed to clarify a structural equation model of health anxiety based on metacognitive beliefs with anxiety sensitivity as a mediator in individuals with obsessive–compulsive symptoms.

Method
This descriptive-correlational research employed structural equation modeling. The statistical population comprised all individuals with obsessive–compulsive symptoms who attended counseling centers, psychological clinics, and psychiatric clinics in Isfahan during 1403–1404. A convenience sample of 480 participants was selected. Instruments included the Short Health Anxiety Inventory (SHAI) by Salkovskis and Warwick, the Metacognitions Questionnaire-30 (MCQ-30) by Wells and Cartwright-Hatton, and the Anxiety Sensitivity Index (ASI) by Floyd et al. Data were analyzed using SPSS and AMOS, and structural equation modeling with bootstrapping was applied for hypothesis testing.

Results
Findings indicated that direct paths among the study variables were statistically significant at p < 0.05. Anxiety sensitivity significantly mediated the relationships between metacognitive beliefs and health anxiety. Bootstrap results showed the indirect effect of metacognitive beliefs on health anxiety was 0.141 and significant at the 0.05 level.

Discussion and Conclusion
Dysfunctional metacognitive beliefs contribute to health anxiety by increasing anxiety sensitivity. Therefore, targeting metacognitive belief modification and interventions aimed at reducing anxiety sensitivity, such as interoceptive exposure and symptom reappraisal, can play an effective role in treating and reducing health anxiety in individuals with obsessive–compulsive symptoms.