Exploring the Role of Neuroticism and Insecure Attachment in Health Anxiety, Safety-Seeking Behavior Engagement, and Medical Services Utilization

The purpose of this study was to explore an extended interpersonalmodel of health anxiety, according to which health-anxious individuals are trapped in avicious circle of health-related reassurance-seeking, alienation from others, and worryabout health, while somatic absorption with body sensations, insecure attachment,neuroticism, safety-seeking behaviors, and medical services utilization were alsoincluded in the model. Data were collected from 196 Greek university students usingstandardized instruments. Results indicated that anxious attachment was directly relatedto absorption (β = .163, p < .05) and alienation (β = .204, p < .05), whileavoidant attachment was directly related to absorption (β = −.344, p < .001),reassurance-seeking (β = −.130, p < .05), and alienation (β = .148, p < .05).Neuroticism was positively and significantly associated with all dimensions of healthanxiety. Absorption, alienation, and anxious attachment were related to medical servicesutilization, which, in turn, was related to safety-seeking behaviors (β = .200, p <.01). Neuroticism and anxious attachment were also indirectly and positively associatedwith worry. Moreover, absorption was positively related to worry andreassurance-seeking, worry was positively related to reassurance-seeking, and alienationwas 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 onbodily sensations) can play in health anxiety maintenance, and the importance of anxiousand avoidant attachment in safety-seeking behavior engagement. Implications of theresults and suggestions for future research and practice are outlined