Exploring the Role of Neuroticism and Insecure Attachment in Health Anxiety, Safety-Seeking Behavior Engagement, and Medical Services Utilization: A Study Based on an Extended Interpersonal Model of Health Anxiety

The purpose of this study was to explore an extended interpersonal model of health anxiety, according to which health-anxious individuals are trapped in a vicious circle of health-related reassurance-seeking, alienation from others, and worry about health, while somatic absorption with body sensations, insecure attachment, neuroticism, safety-seeking behaviors, and medical services utilization were also included in the model. Data were collected from 196 Greek university students using standardized instruments. Results indicated that anxious attachment was directly related to absorption ( = .163, p < .05) and alienation ( = .204, p < .05), while avoidant attachment was directly related to absorption ( = -.344, p < .001), reassurance-seeking ( = -.130, p < .05), and alienation ( = .148, p < .05). Neuroticism was positively and significantly associated with all dimensions of health anxiety. Absorption, alienation, and anxious attachment were related to medical services utilization, which, in turn, was related to safety-seeking behaviors ( = .200, p < .01). Neuroticism and anxious attachment were also indirectly and positively associated with worry. Moreover, absorption was positively related to worry and reassurance-seeking, worry was positively related to reassurance-seeking, and alienation was positively related to worry. Study results highlight the key role that interpersonal (e.g., alienation from others) and perceptual factors (e.g., the tendency to focus on bodily sensations) can play in health anxiety maintenance, and the importance of anxious and avoidant attachment in safety-seeking behavior engagement. Implications of the results and suggestions for future research and practice are outlined.