Open Access Open Badges Research article

Hypochondriacal attitudes comprise heterogeneous non-illness-related cognitions

Michael Schwenzer1* and Klaus Mathiak12

Author Affiliations

1 Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, RWTH Aachen University, Pauwelsstr. 30, D-52074, Aachen, Germany

2 JARA-Brain, Jülich Aachen Research Alliance, Translational Brain Medicine, Forschungszentrum Jülich GmbH: Section of Structural and Functional Organisation of the Brain (INM-1), Institute of Neuroscience and Medicine, Research Centre Jülich, Wilhelm-Johnen-Strasse, 52425, Jülich, Germany

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BMC Psychiatry 2012, 12:173  doi:10.1186/1471-244X-12-173

Published: 17 October 2012



Hypochondriacal attitudes were associated with cognitions not related to illness: Social fears, low self-esteem, and reduced warm glow effect, i.e. less positive appraisal of familiar stimuli. Only a single study had investigated the correlation of hypochondriacal attitudes with the warm glow effect so far and the present study aimed to corroborate this association. Particularly, the present investigation tested for the first time whether social fears, low self-esteem, and reduced warm glow effect represent distinct or related biases in hypochondriacal attitudes.


Fifty-five volunteers filled in the Hypochondriacal Beliefs and Disease Phobia scales of the Illness Attitude Scales, two scales enquiring social fears of criticism and intimacy, and the Rosenberg Self-Esteem Scale. The interaction of valence and spontaneous familiarity ratings of Chinese characters indicated the warm glow effect.


A stepwise regression model revealed specific covariance of social fears and warm glow with hypochondriacal attitudes independent from the respective other variable. The correlation between low self-esteem and hypochondriacal attitudes missed significance.


Hypochondriacal attitudes are embedded in a heterogeneous cluster of non-illness-related cognitions. Each social fears and a reduced cognitive capacity to associate two features – positive appraisal and familiarity - could diminish the susceptibility to safety signals such as medical reassurance. To compensate for reduced susceptibility to safety signals, multifocal treatment and repeated consultations appear advisable.

Hypochondriacal attitudes; Social fears; Self-esteem; Warm glow effect; Safety signals; Physician-patient relationship