Relating Differently to Intrusive Images: the Impact of Mindfulness-Based Cognitive Therapy (MBCT) on Intrusive Images in Patients with Severe Health Anxiety (Hypochondriasis)

Recurrent distressing intrusive images are a common experience in hypochondriasis. The aim of the current study was to assess the impact of mindfulness-based cognitive therapy (MBCT) for hypochondriasis on the occurrence and nature of distressing intrusive imagery in hypochondriasis. A semistructured interview was used to assess intrusive imagery, and an adapted version of the Southampton Mindfulness Questionnaire (SMQ) was used to assess participants' relationship with their intrusive images. A consecutive series of participants (N=20) who were receiving MBCT for hypochondriasis as part of an ongoing research program were assessed prior to participating in an 8-week MBCT intervention, immediately following the intervention, and at 3-month follow-up. As compared to the baseline assessment, the frequency of intrusive images, the distress associated with them, and the intrusiveness of the images were all significantly reduced at the post-MBCT assessment. Participants' adapted SMQ scores were significantly increased following the MBCT intervention, suggesting that participants' relationship with their intrusive images had changed in that they had developed a more "mindful" and compassionate response to the images when they did occur. Effect sizes from pre- to post-intervention were medium to large (Cohen's d=0.75-1.50). All treatment gains were maintained at 3-month follow-up. Results suggest that MBCT may be an effective intervention for addressing intrusive imagery in hypochondriasis.