The Relationship Between Ruminating the Catastrophic Consequences of Bodily Changes and Positive Reappraisal and Practical Problem-Solving Strategies in Individuals With Illness Anxiety Disorder

Introduction: Cognitive emotion regulation is suggested to contribute to Illness Anxiety Disorder (IAD). Reappraisal and suppression are essential ER strategies with controversial data about their roles in IAD. Relevant studies are mostly limited to exploring these two strategies in individuals without such disorder. Therefore, we aimed to study the role of emotion regulation in the psychopathology of IAD by evaluating other ER strategies in illness-anxious individuals. Furthermore, we investigated the relationship between IAD and emotion regulation by targeting the role of interpretation bias for health-related information.  Methods: The study participants were 60 university students. They underwent a semi-structured clinical interview to assess the presence or absence of IAD symptoms (n=30/group). They completed a battery of questionnaires measuring IAD, emotion regulation, and interpretation bias. Results: The illness-anxious group applied significantly less reappraisal and refocus on planning and more rumination, catastrophizing, and acceptance strategies, compared to the controls. Besides, interpretation bias was positively correlated with rumination and catastrophizing; while its association with reappraisal and planning was negative. Conclusion: Both functional (e.g. reappraisal & planning) and dysfunctional strategies (e.g. rumination & catastrophizing) contributed to the psychopathology of IAD. The biased interpretation of bodily information could make individuals prone to ruminate about the catastrophic consequences of bodily changes; such conditions interrupt fostering more positive reappraisal or practical problem-solving strategies.