Volume 12, Issue 1 (June 2026)                   Elderly Health Journal 2026, 12(1): 23-33 | Back to browse issues page

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Maleki S, Ghafori E, Babalou K, Gorbanalipour M. The Role of Health Anxiety in Illness Perception: The Mediating Effect of Bodily Symptom Vigilance among Elderly Patients Attending Medical Clinics in Urmia. Elderly Health Journal 2026; 12 (1) :23-33
URL: http://ehj.ssu.ac.ir/article-1-377-en.html
Department of Psychology, Faculty of Psychology and Educational Sciences, Islamic Azad University, Khoy Branch, Khoy, Iran , masoudqorbanalipour@gmail.com
Abstract:   (52 Views)
Introduction: Health anxiety is recognized as an important psychological factor influencing individuals’ perception of illness, particularly among older adults. However, the mechanisms underlying this relationship, especially the mediating role of bodily symptom vigilance, remain insufficiently explored. The present study aimed to investigate the role of health anxiety in illness perception, emphasizing the mediating effect of bodily symptom vigilance among elderly individuals attending medical clinics in Urmia.
Methods: This fundamental study employed a descriptive-correlational design using structural equation modeling. The statistical population included individuals aged 60 years and older who visited medical centers in Urmia in 2024. A convenience sample of 200 participants was selected. Data were collected using the Health Anxiety Inventory, the Brief Illness Perception Questionnaire, and the Body Vigilance Scale. Data analysis was performed using SPSS and SmartPLS software.
Results: Health anxiety significantly predicted illness perception both directly (β = 0.313, t = 5.04, p < 0.001) and indirectly through bodily symptom vigilance (β = 0.200, t = 4.26, p < 0.001). Health anxiety also significantly predicted bodily symptom vigilance (β = 0.323, t = 5.27, p < 0.001), while bodily symptom vigilance significantly predicted illness perception (β = 0.620, t = 10.60, p < 0.001). Model fit indices indicated an acceptable fit of the proposed model (SRMR = 0.089, NFI = 0.891).
Conclusion: Health anxiety and heightened bodily vigilance play a crucial role in shaping illness perception among older adults. These findings highlight the importance of addressing psychological factors in developing mental health policies and interventions for the elderly population.
Full-Text [PDF 523 kb]   (10 Downloads)    
Type of Study: Research | Subject: Special
Received: 2026/04/21 | Accepted: 2026/06/8 | Published: 2026/06/20

References
1. Dharmarajan T. Physiology of aging. In: Pitchumoni CS, Dharmarajan T, editors. Geriatric gastroenterology. Springer: 2021; P. 101-53.
2. Shakkarpude J, Jesse AD, Kumar P, Kumar R. Physiology of Aging. In: Principles of Veterinary Animal Physiology. CRC Press; 2025. p. 242-52.
3. Guo J, Huang X, Dou L, Yan M, Shen T, Tang W, et al. Aging and aging-related diseases: from molecular mechanisms to interventions and treatments. Signal Transduction and Targeted Therapy. 2022; 7(1): 1-40.
4. Bhandari P, Paswan B. Lifestyle behaviours and mental health outcomes of elderly: Modification of socio-economic and physical health effects. Ageing International. 2021; 46(1): 35-69.
5. Xu X, Zhang L. How does childhood socio-economic environment affect the health of middle-aged and elderly people in China? A new perspective with four dimensions of health. Journal of Public Health. 2023; 31(8): 1249-58.
6. McKenna-Plumley PE, Turner RN, Yang K, Groarke JM. “It’sa feeling of complete disconnection”: experiences of existential loneliness from youth to older adulthood. BMC Psychology. 2023; 11(1): 1-14.
7. Alsenany SA. Psychological predictors of gerascophobia among middle-aged and older adults: the role of health anxiety and body image satisfaction. GeroScience. 2026; 48(2): 2681-93.
8. Howell C, Segal DL, Segal S. Diagnosis and assessment of somatic symptom and related disorders among older adults: Issues and strategies. Journal of Clinical and Basic Psychosomatics. 2025; 3(4): 21-9.
9. Xiong C, Jiang C, Zhang H, Chen J, Zhao M, Xiong C, Luo X, et al. Self‐management and illness perception among cervical cancer patients: A cross‐sectional study. International Journal of Nursing Practice. 2023; 29(3): 13134.
10. Singh A, Rejeb A. Illness perception: a bibliometric study. Heliyon. 2024; 10(11(: 1-26.
11. Scollan-Koliopoulos M. Lifestyle r-educing program: risk–education in groups with depression to prevent diabetes. Regis College; 2022.
12. Bilondi SS, Noghabi AD, Aalami H. The relationship between illness perception and medication adherence in patients with diabetes mellitus type II: illness perception and medication adherence. Journal of Preventive Medicine and Hygiene. 2022; 62(4): 966-71.
13. Leventhal H, Halm E, Horowitz C, Leventhal EA, Ozakinci G. Living with chronic illness: A contextualized, self-regulation approach. The Sage Handbook of Health Psychology. 2004: 197-240.
14. Ma H, Hu K, Wu W, Wu Q, Ye Q, Jiang X, et al. Illness perception profile among cancer patients and its influencing factors: A cross-sectional study. European Journal of Oncology Nursing. 2024; 69: 102526.
15. Fournier H, Calcagni N, Morice-Picard F, Quintard B. Psychosocial implications of rare genetic skin diseases affecting appearance on daily life experiences, emotional state, self-perception and quality of life in adults: a systematic review. Orphanet Journal of Rare Diseases. 2023; 18(1): 1-49.
16. Nie R, Han Y, Xu J, Huang Q, Mao J. Illness perception, risk perception and health promotion self-care behaviors among Chinese patient with type 2 diabetes: A cross-sectional survey. Applied Nursing Research. 2018; 39: 89-96.
17. de Santana Silva JP, Cruz HRA, Silva GAG, Gualdi LP, Lima ÍNDF. Illness perception and self-care in hypertension treatment: a scoping review of current literature. BMC Health Services Research. 2024; 24(1): 1-14.
18. Zhu Y, Cai N, Wang Z, Li J, Guo T, He J, et al. Perceived social support and psychosocial adaptation in patients with chronic skin diseases: the mediating role of self-disclosure. Frontiers in Psychiatry. 2025; 16: 1-16.
19. Bassi M, Falautano M, Cilia S, Goretti B, Grobberio M, Pattini M, et al. Illness perception and well-being among persons with multiple sclerosis and their caregivers. Journal of Clinical Psychology in Medical Settings. 2016; 23(1): 33-52.
20. Ośmiałowska E, Staś J, Chabowski M, Jankowska-Polańska B. Illness perception and quality of life in patients with breast cancer. Cancers. 2022; 14(5): 1-22.
21. Lebel S, Mutsaers B, Tomei C, Leclair CS, Jones G, Petricone-Westwood D, et al. Health anxiety and illness-related fears across diverse chronic illnesses: A systematic review on conceptualization, measurement, prevalence, course, and correlates. Plos One. 2020; 15(7): 1.-48
22. Bulut BP, Bozo Ö. A helix of anxiety: a qualitative analysis of the personal experiences of individuals with health anxiety. Studies in Psychology. 2022; 42(1): 165-98.
23. Axelsson E, Hedman-Lagerlöf E. Validity and clinical utility of distinguishing between DSM-5 somatic symptom disorder and illness anxiety disorder in pathological health anxiety: Should we close the chapter? Journal of Psychosomatic Research. 2023; 165: 111133.
24. Ferguson E. A taxometric analysis of health anxiety. Psychological Medicine. 2009; 39(2): 277-85.
25. Salkovskis PM, Rimes KA, Warwick HM, Clark D. The health anxiety inventory: development and validation of scales for the measurement of health anxiety and hypochondriasis. Psychological Medicine. 2002; 32(5): 843-53.
26. Weck F, Richtberg S, MB Neng J. Epidemiology of hypochondriasis and health anxiety: comparison of different diagnostic criteria. Current Psychiatry Reviews. 2014; 10(1): 14-23.
27. Salkovskis PM, Warwick HM. Morbid preoccupations, health anxiety and reassurance: a cognitive-behavioural approach to hypochondriasis. Behaviour Research and Therapy. 1986; 24(5): 597-602.
28. Hannah K, Marie K, Olaf H, Stephan B, Andreas D, Wilson Michael L, et al. The global economic burden of health anxiety/hypochondriasis-a systematic review. BMC Public Health. 2023; 23(1): 1-11.
29. Rachman S. Health anxiety disorders: A cognitive construal. Behaviour Research and Therapy. 2012; 50(7-8): 502-12.
30. Bailer J, Kerstner T, Witthöft M, Diener C, Mier D, Rist F. Health anxiety and hypochondriasis in the light of DSM-5. Anxiety, Stress, & Coping. 2016; 29(2): 219-39.
31. Sauer KS, Witthöft M, Rief W. Somatic symptom disorder and health anxiety: assessment and management. Neurologic Clinics. 2023; 41(4): 745-58.
32. Tyrer P. Recent advances in the understanding and treatment of health anxiety. Current Psychiatry Reports. 2018; 20(7): 49.
33. Wheaton MG, Berman NC, Abramowitz JS. The contribution of experiential avoidance and anxiety sensitivity in the prediction of health anxiety. Journal of Cognitive Psychotherapy. 2010; 24(3): 229.
34. Schmidt NB, Lerew DR, Trakowski JH. Body vigilance in panic disorder: evaluating attention to bodily perturbations. Journal of Consulting and Clinical Psychology. 1997; 65(2): 214.
35. McLaughlin LE, McLeish AC, O'Bryan EM. The role of body vigilance in depression symptomatology. International Journal of Cognitive Therapy. 2016; 9(3): 217-28.
36. Zvolensky MJ, Kauffman BY, Shepherd JM, Viana AG, Bogiaizian D, Rogers AH, et al. Pain-related anxiety among Latinx college students: relations to body vigilance, worry, anxious arousal, and general depression. Journal of Racial and Ethnic Health Disparities. 2020; 7(3): 498-507.
37. Ginzburg K, Tsur N, Barak-Nahum A, Defrin R. Body awareness: differentiating between sensitivity to and monitoring of bodily signals. Journal of Behavioral Medicine. 2014; 37(3): 564-75.
38. Wright EC, Hostinar CE, Trainor BC. Anxious to see you: Neuroendocrine mechanisms of social vigilance and anxiety during adolescence. The European Journal of Neuroscience. 2020; 52(1): 2516-29.
39. Sutton R, de Jong JS, Stewart JM, Fedorowski A, de Lange FJ. Pacing in vasovagal syncope: physiology, pacemaker sensors, and recent clinical trials—precise patient selection and measurable benefit. Heart Rhythm. 2020; 17(5): 821-8.
40. Hedman E, Lekander M, Karshikoff B, Ljótsson B, Axelsson E, Axelsson J. Health anxiety in a disease-avoidance framework: Investigation of anxiety, disgust and disease perception in response to sickness cues. Journal of Abnormal Psychology. 2016; 125(7): 868-78.
41. Hayter AL, Salkovskis PM, Silber E, Morris RG. The impact of health anxiety in patients with relapsing remitting multiple sclerosis: Misperception, misattribution and quality of life. The British Journal of Clinical Psychology. 2016; 55(4): 371-86.
42. Kline RB. Principles and practice of structural equation modeling. New York: London: Guilford publications; 2023.
43. Abramowitz JS, Olatunji BO, Deacon BJ. Health anxiety, hypochondriasis, and the anxiety disorders. Behavior Therapy. 2007; 38(1): 86-94.
44. Nargesi F, Izadi F, Kariminejad K, Rezaii Sharif A. The investigation of the reliability and validity of Persian version of Health anxiety questionnaire in students of Lorestan University of Medical Sciences. Quarterly of Educational Measurement. 2017; 8(27): 147-160. [Persian]
45. Broadbent E, Petrie KJ, Main J, Weinman J. The brief illness perception questionnaire. Journal of Psychosomatic Research. 2006; 60(6): 631-7.
46. Karimian Z, Haghayegh SA, Emami Najafi Dehkordi S MH, Raisi M. The Comparison of the effectiveness of trans-diagnostic treatment and the acceptance and commitment therapy (ACT) on Emotion regulation and illness perception in patients with irritable bowel syndrome (IBS). Journal of Research in Behavioural Sciences. 2021; 19(3): 477-88. [Persian]
47. Hair JF, Risher JJ, Sarstedt M, Ringle CM. When to use and how to report the results of PLS-SEM. European Business Review. 2019; 31(1): 2-4.
48. Myers JL, Well AD, Lorch Jr, Robert F. Research design and statistical analysis. Routledge; 2013.
49. Lomax RG. A beginner's guide to structural equation modeling. psychology press; 2004.

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