Chinese Short Health Anxiety Inventory – Chinese Version

Description

Health anxiety is a spectrum of conditions ranging from normal health concerns to severe health anxiety, representing a gradual process rather than a qualitative change. Hypochondria is considered an extreme form of health anxiety, with health anxiety being less severe than hypochondria; however, the two do not differ fundamentally. Recent researchers tend to prefer the term “health anxiety,” which carries less negative connotation. In the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the term “hypochondria” has been replaced by Somatic Symptom Disorder (SSD) and Illness Anxiety Disorder (IAD). Hypochondria accompanied by physical symptoms is diagnosed as SSD, while hypochondria without physical symptoms is diagnosed as IAD. Epidemiological data shows that the prevalence of health anxiety in the general population is approximately 5%, while in patients with chronic diseases, the prevalence reaches 36%-46%. In the clinical setting, the reported prevalence is about 15-20%. Different scholars have slight variations in the assessment and diagnostic criteria for health anxiety. Chinese scholars classify the clinical symptoms of health anxiety into three main points: first is disease concern—health anxiety patients show greater concern for their health compared to healthy individuals, but it does not reach the persistent, intense, and uncontrollable levels seen in hypochondria; second is somatic symptoms—health anxiety patients may experience various physical discomforts, with vomiting being the most common; if this discomfort persists and remains unresolved, it may develop into hypochondria; third is distorted beliefs and behaviors—health anxiety patients are more sensitive to bodily sensations and often exaggerate minor symptoms, believing they have a severe illness, leading to repeated medical visits. If such beliefs and behaviors severely impact the patient’s life, and they remain convinced of having a specific physical illness despite scientific examinations, they may be diagnosed with hypochondria.

Authors and Contact Email

Yuan Yonggui, Zhang Yuqun, Yang Genglin, Hedman-Lagerlöf et al.

Purpose

To assess and measure levels of health anxiety in individuals.

Test Year

2002; Revised in 2015

Administration Method and Scoring

The Short Health Anxiety Inventory (SHAI), created by Salkovskis et al. (2002) and revised in Chinese by Zhang et al. (2015), measures individual health anxiety levels with each item scored on a 4-point scale, where 0 represents “never” and 3 represents “always.” The inventory consists of 18 items divided into two dimensions:
(1) 患病可能性 (Possibility of illness) – 14 items;
(2) 消极结果 (Negative outcomes) – 4 items.

Reliability and Validity

The Cronbach’s alpha coefficients for the Chinese version of SHAI (CSHAI) total and its subscales were 0.742, 0.743, and 0.788. In the study by Du, the internal consistency reliability was reported as Cronbach’s α = 0.887.

Factors and Subscales

1. 患病可能性 (Possibility of illness)
2. 消极结果 (Negative outcomes)

Keywords

Health Anxiety, Hypochondria, Somatic Symptoms, Illness Anxiety Disorder, Somatic Symptom Disorder

Items in Chinese

1. 我担心自己的健康。
2. 我能感觉到身体上的疼痛。
3. 我能感受到身体的感觉和变化。
4. 我很难控制有关疾病的想法。
5. 我害怕自己患上严重的疾病。
6. 我会想象自己生病的样子。
7. 我很难从脑中去除有关健康的想法。
8. 即便医生说一切健康，我还是不能放心。
9. 一听到某种疾病，我就会觉得自己得了这个病。
10. 如果身体有感觉或变化，我就会去想它意味着什么。
11. 我感觉自己有患上严重疾病的风险。
12. 我认为自己患有严重疾病。
13. 如果注意到有无法解释的身体感觉，我就很难去思考其他事情。
14. 家人和朋友认为我比较担心自己的健康。
15. 如果我患上严重的疾病，我就不能享受生活了。
16. 如果我患上严重的疾病，很难有机会治愈。
17. 严重的疾病会毁掉我生活的各个方面。
18. 如果我患上严重的疾病，我就会失去尊严。

Items in English

1. I worry about my health.
2. I can feel pain in my body.
3. I can sense physical sensations and changes in my body.
4. I find it hard to control thoughts about illness.
5. I am afraid I have a serious illness.
6. I imagine what it would be like to be ill.
7. I find it difficult to rid my mind of health-related thoughts.
8. Even when a doctor says I am healthy, I can’t relax.
9. Whenever I hear about a certain disease, I feel like I have that disease.
10. If I feel something in my body or notice a change, I think about what that could mean.
11. I feel at risk of having a serious illness.
12. I believe I have a serious illness.
13. If I notice unexplained bodily sensations, I find it hard to think about anything else.
14. Family and friends think I worry too much about my health.
15. If I have a serious illness, I cannot enjoy life.
16. If I have a serious illness, I will have little chance of recovery.
17. A serious illness would ruin every aspect of my life.
18. If I have a serious illness, I will lose my dignity.

References

袁勇贵, 张钰群, 2013
杨庚林 等, 2020
Hedman-Lagerlöf 等人, 2019
Salkovskis 等人, 2002
Zhang 等人, 2015
APA, 2013