Negative Automatic Evaluation and Better Recognition of Bodily Symptom Words in College Students with Elevated Health Anxiety

This study explored whether better recognition of symptom words is associated with stronger negative automatic evaluations of these words. We compared participants with health anxiety (HA; N = 27) to dysphoric (N = 29) and to non-health-anxious and non-dysphoric control participants (N = 28) in the Implicit Association Test (IAT) and in a word recognition task using health-threat-related, negative emotional, and neutral control words. Participants with HA made significantly more mistakes on the IAT than both other groups, in pairing the evaluation "harmless" with specific "symptoms" (p = .02, eta(2) = .10). Additionally, recognition performance was positively related to the IAT evaluation bias. The findings suggest that persons with HA automatically interpret symptoms as being more dangerous than the others saw them. This evaluation bias might explain the facilitation of access to symptom information in working memory that underlies cognitive biases observed in HA.