Examining the Whiteley Index-6 as a screener for DSM-5 presentations of severe health anxiety in primary care

摘要

Psychological screening is essential within primary care settings, with growing evidence that health anxiety could be important to screen for in such settings. Brief screeners in primary care settings are considered most viable for routine use. This study provided the first known examination of a version of the Whiteley Index (WI; Pilowksy, 1967) as a screener for primary care patients who are experiencing DSM-5 presentations of severe health anxiety (i.e., somatic symptom disorder, illness anxiety disorder). A six-item short form of the WI (i.e., WI-6), with item responses made using an ordered-category response option, was examined. Consecutively enrolled U.S. patients presenting for treatment at a community health center (N = 202) completed the WI-6 and a semi-structured interview assessing clinically severe health anxiety in the form of somatic symptom disorder and illness anxiety disorder. A total of 61 participants met criteria for clinically severe health anxiety and were compared to patients who did not meet criteria for clinically severe health anxiety. Results from a receiver operating characteristic (ROC) analysis indicated that a cutoff score of 18 on the WI-6 adequately balanced sensitivity (75%) and specificity (77%). The area under the curve (AUC) indicated the WI-6 did a reasonable job discriminating between the two groups (AUC = 0.83, p < .001, 95% confidence interval = 0.77-0.89). Study results offer preliminary support for the WI-6 as a practical screener for identifying cases of severe health anxiety in U.S. primary care settings that may warrant further evaluation.