Baylor University, Department of Psychology and Neuroscience, Waco, TX, USA.
Heart of Texas Community Health Center, Waco, TX, USA.
J Psychosom Res. 2019 Dec;127:109839. doi: 10.1016/j.jpsychores.2019.109839. Epub 2019 Oct 24.
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.
在初级保健环境中进行心理筛查至关重要，越来越多的证据表明，在这种环境中筛查健康焦虑可能很重要。初级保健环境中的简短筛查器被认为最适合常规使用。这项研究首次对 Whiteley 指数（WI；Pilowksy，1967）的一个版本进行了检查，作为对经历 DSM-5 重度健康焦虑表现（即躯体症状障碍、疾病焦虑障碍）的初级保健患者的筛查器。使用有序类别反应选项对 WI 的六项目短格式（即 WI-6）进行了检查。连续招募的美国患者在社区健康中心就诊（N=202），完成了 WI-6 和半结构化访谈，评估躯体症状障碍和疾病焦虑障碍形式的临床严重健康焦虑。共有 61 名参与者符合临床严重健康焦虑标准，并与不符合临床严重健康焦虑标准的患者进行了比较。接收器操作特征（ROC）分析的结果表明，WI-6 的 18 分截点可以很好地平衡敏感性（75%）和特异性（77%）。曲线下面积（AUC）表明，WI-6 在区分这两组方面表现良好（AUC=0.83，p<0.001，95%置信区间=0.77-0.89）。研究结果初步支持 WI-6 作为美国初级保健环境中识别严重健康焦虑病例的实用筛查器，可能需要进一步评估。
