Is it all top-down? Influence of cognition and categorization on interoceptive sensitivity and bias in health anxiety

• Applicant: Dr. Anna Pohl
• Subject Area: Personality Psychology, Clinical and Medical Psychology, Methodology
• Term: from 2018 to 2023
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 403266317

Pathological health anxiety is associated with high personal and social costs. Etiological models postulate an influence of negative health-related thoughts, high sensitivity for body sensations (interoceptive sensitivity) and an attentional bias concerning health-related stimuli. The influence of the attentional bias and negative, catastrophizing thoughts on bodily sensations is empirically supported. The impact of interoceptive sensitivity is under debate, the interplay of factors rarely examined. We aim at exploring the interplay of cognitive, perceptual and interoceptive factors that may contribute to the maintainance of pathological health anxiety. We will use two adapted versions of the somatic signal detection task (SSDT) and two experiments, in which breathing is influenced by two categories of breathing effort increasing loads.Study 1: We expose healthy participants to a sham electromagnetic field, which will activate illness-relevant cognitive schemata. We assume that participants will report illusory tactile sensations in the SSDT, when sham electromagnetic field is switched ‘on’. Study 2 and 3: Patients with pathological health anxiety will undergo the second adaptation of the SSDT. Here, illness-relevant words will be used to activate disease-related cognitive schemata. An increase of tactile illusions is assumed. In study 3 patients undergo a categorization experiment. Participants have to memorize categorized loads of low (A) and high (B) intensity in a first block and label stimuli in a second block. We assume that high health anxiety is associated with a liberal response bias at the border of categories. In other words, patients will identify more loads of the low intensity category as belonging to high intensity category than healthy participants. Study 4: We will examine the influence of an arbitrary categorization (A, B) and with categorizations semantically related to illness (sensation, disease-related symptom) on evaluation of respiratory stimuli. We hypothesize that two neighboring stimuli belonging to the same category will be rated more similarly than neighboring stimuli between categories. Furthermore, the influence of a meaningful semantic categorization should be higher than the influence of an arbitrary categorization.With this project, we will contribute to a better understanding of pathological health anxiety. Improved etiological models will enable the enhancement of treatment and reduce individual and social burden.

• DFG Programme: Research Grants
• Co-Investigators: Professor Dr. Alexander L. Gerlach; Professor Dr. Michael Witthöft