Hypochondriasis: the role of fear-confirming reasoning

We investigated whether hypochondriacal patients are prone to selectively search for danger-confirming information when asked to judge the validity of conditional rules in the context of general and health threats. Therefore, hypochodtriacal patients (n = 27) and a healthy control group (n = 27) were presented with modified Wason Selection Tasks (WSTs) pertaining to general and health threats. The WSTs contained safety rules (If P then safe) and danger rules (If P then danger). Subjects adopted a verificationistic strategy in case of danger rules and tended to look for falsifications in case of safety rules. This danger-confirming reasoning pattern was similar for both types of contexts and not particularly pronounced in hypochondriacal persons. These findings argue against the idea that such a reasoning pattern directly causes hypochondriasis. Yet, in the presence of anxiogenic (hypochondriasis related) convictions such danger-confirming reasoning pattern logically serves to maintain or even enhance hypochondriacal complaints.