The moderating role of working memory load on affective attentional processes in health anxiety

Background: Cognitive-behavioral models of health anxiety propose selective attention as an important factor in the development and maintenance of the disorder. However, experimental evidence for this assumption is equivocal. It is possible that subjects with sub-threshold health anxiety are able to control attention to threat stimuli (cognitive compensation hypothesis). Simultaneous working memory load (WML) may be a factor restricting this control and increasing the attentional bias. Objectives: The aim of the current study was to investigate the cognitive compensation hypothesis for health anxiety in a student analog sample. Method: An emotional Stroop task (EST) with symptom and illness words was administered to students with elevated HA (N = 27), elevated depression (DY; N = 29), and controls (CG; N = 28). Compared to the standard condition, WML was increased by simultaneous rehearsing of a number. Results: A stronger attentional bias toward symptom words for the health anxious participants compared to the other two groups was only apparent in the no WML condition at the beginning of the experiment. Contrary to our assumptions, this group difference disappeared in the high WML condition. Conclusions: There was no experimental evidence for the cognitive compensation hypothesis in this study. WML might reduce the threat potential of symptom words for health anxious participants. This moderating role of WML in the context of affective attentional processes is in line with recent findings in emotion research.