Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

Phillip J. Brantley


Although cognitive theories suggest that attentional bias to illness stimuli and inflation of subjective risk of future negative health events are etiologically related to hypochondriacal concern, little empirical research has been conducted on these cognitive distortions. The present study investigated attentional bias, as inferred from RTs on an attentional search information processing paradigm, and subjective risk, as measured by probability judgments of future health events, in 200 medical outpatients differing in level of hypochondriacal concern. It was hypothesized that hypochondriacal concern would be associated with specific cognitive biases for illness-related, as opposed to socially threatening, stimuli. It was also hypothesized that dysphoric mood would interact with the cognitive distortions in the prediction of hypochondriacal concern. An exploratory path analysis also tested the proposed causal contributions of objective health status, minor life events, depressed mood, attentional bias, and subjective risk in the production of hypochondriacal concern. The results indicated, however, that attentional bias to socially threatening stimuli accounted for more variance in hypochondriacal concern than illness cues. Also unexpected was the finding that subjects tended to rate future positive health events as more likely to occur than negative health events as hypochondriacal concern increased in the sample. Although the results generally failed to support the hypothesis that illness-specific cognitive distortions are related to hypochondriacal concern, several factors which may have contributed to the negative findings were identified. Further investigations of cognitive distortions in individuals diagnosed with DSM-III-R hypochondriasis appears warranted.