Hypochondriacal attitudes may reflect a general cognitive bias that is not limited to illness-related thoughts.

Previous findings suggested that hypochondriacal attitudes could originate from a pessimistic trait independent of illness-related thoughts. We hypothesised that hypochondriacal attitudes correlated with a general cognitive tendency towards negative interpretations and reduced familiarisation. Healthy non-patients were invited to participate. The sum score from the Hypochondriacal Beliefs and Disease Phobia scales of the Illness Attitude Scales assessed hypochondriacal attitudes. Participants without any knowledge of the Chinese language were asked to guess whether or not each of eight Chinese characters had a positive meaning and whether the characters appeared familiar. Stimuli without semantic content avoided a reference to illness in order to assess a general cognitive bias. Participants with high hypochondriasis scores rated apparently familiar stimuli as being less positive in comparison to low hypochondriacal participants, F(1,78) = 9.2, p = 0.003, η² = 0.10; correlation of hypochondriasis scores to the differences between ratings of familiar and unfamiliar characters: ρ = 0.345, p = 0.002. Positivity and familiarity ratings did not correlate with hypochondriacal attitudes independent of each other. A less positive appraisal of familiar experiences, which is unrelated to illness-related thoughts, may maintain hypochondriacal concerns. A general distrustful attitude towards familiar procedures should be considered in hypochondriasis.