Comparing Cognitive Therapy and Exposure Therapy in Individuals With Hypochondriasis

• Hypochondriasis Yale-Brown Obsessive-Compulsive Scale (H-YBOCS) [ Time Frame: 3 months ] [ Designated as safety issue: No ]
  clinician-rated measure that assesses hypochondriacal obsessions, compulsions and avoidance
  
  

• Illness Attitude Scales (IAS) [ Time Frame: 3 months ] [ Designated as safety issue: No ]
  self-report measure that assesses attitudes, fears, and beliefs associated with the psychopathology of hypochondriasis and that of abnormal illness behavior
  
  
• Beck-Depression Inventory II (BDI-II) [ Time Frame: 3 months ] [ Designated as safety issue: No ]
  self-report measure that assesses depressive symptoms
  
  
• Beck Anxiety Inventory (BAI) [ Time Frame: 3 months ] [ Designated as safety issue: No ]
  self-report measure that asessses anxiety symptoms
  
  
• Brief Symptom Inventory (BSI) [ Time Frame: 3 months ] [ Designated as safety issue: No ]
  self-report measure that assesses aspects of general psychopathology
  
  
• Scale for the Assessment of Illness Behavior (SAIB) [ Time Frame: 3 months ] [ Designated as safety issue: No ]
  self-report measure that focuses on illness behavior
  
  
• Health-related quality of life (SF-12) [ Time Frame: 3 months ] [ Designated as safety issue: No ]
  self-report measure the assesses the health-related quality of life
  
  
• Cognitions About Body and Health Questionnaire (CABAH) [ Time Frame: 3 months ] [ Designated as safety issue: No ]
  self-rated measure that focuses on attitudes related to the cognitive concept of hypochondriasis
  
  

Hypochondriasis is defined as a preoccupation with the fear of having a serious disease based on the person's misinterpretation of bodily symptoms (APA). For a long time hypochondriasis was seen as difficult to treat. Meanwhile effective psychological treatment for hypochondriasis exists. Psychotherapies using cognitive therapy (CT), cognitive behavioral therapy (CBT), exposure therapy (ET) or behavioral stress management approaches are effective in reducing symptoms of hypochondriasis. However, few studies compare different types of psychotherapy. In addition, in these studies numbers of participants were small, no differences between different treatments were found, and one third of the participants showed no satisfactory change. This study will compare the efficacy of CT and ET in a larger sample of 84 participants.

Participants in this randomized controlled trial (RCT) will first undergo baseline assessment. Then they will be randomly assigned to either CT, ET or a waiting list (WL), all conditions are for the duration of 12 weeks. CT includes psychoeducation, attention training, cognitive restructuring, behavioral experiments, imagery rescripting and relapse prevention. ET includes change of safety behavior, exposition (in sensu and in vivo), and relapse prevention. Both treatment trials contain the identical number of sessions. Treatment response will be assessed at week 12 and additionally one and three years after treatment. Participants of the WL will be assigned to CT or ET after the waiting period.