Health Anxiety Questionnaire (HAQ)
Also known as: HAQ
The Health Anxiety Questionnaire (HAQ) is a self-report measure assessing the preoccupation, worry, and avoidance behaviors related to health concerns. Developed by Lucock and colleagues in 2007, the HAQ measures the cognitive and behavioral dimensions of health anxiety (formerly called hypochondriasis). It is used to screen for and assess illness anxiety disorder and to monitor treatment response in cognitive-behavioral interventions targeting health-focused worry and illness avoidance.
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When to use it
The HAQ is indicated for screening health anxiety in primary care, medical specialty clinics, and mental health settings. It is useful in pre-treatment evaluation to quantify illness worry and bodily preoccupation, treatment planning for cognitive-behavioral interventions addressing catastrophic health beliefs, and monitoring treatment response in anxiety disorders with health focus. Appropriate for adolescents (age 12+) and adults; less suitable for children or those with serious medical conditions where some health anxiety is realistic and adaptive.
Strengths & limitations
- Comprehensive assessment of health anxiety across cognitive (worry, illness conviction), behavioral (reassurance-seeking, avoidance), and somatic (bodily preoccupation) dimensions.
- Strong internal consistency (Cronbach's α = 0.85–0.92) and convergent validity with other illness anxiety measures.
- Sensitive to cognitive-behavioral interventions; tracks reduction in health worry, catastrophic thinking, and reassurance-seeking behaviors.
- Brief and easy to administer; suitable for repeated measurement in clinical monitoring.
- Helpful in differential diagnosis: distinguishes health anxiety from somatic symptom disorder or panic disorder with health focus.
- Does not assess actual medical help-seeking behaviors or doctor visits in detail; relies on self-reported worry and preoccupation.
- Items are situation-nonspecific; does not assess worry about particular diseases (e.g., cancer, heart disease) that might be targeted differently.
- Psychometric data are modest compared to older measures; fewer peer-reviewed validation studies in diverse populations.
- Does not assess medical status or actual health risk; high HAQ scores in persons with genuine medical illness require careful interpretation.
Frequently asked
What is the difference between health anxiety and somatic symptom disorder?
Health anxiety (illness anxiety disorder) centers on worry about having or acquiring disease, despite few or minor symptoms. Somatic symptom disorder involves significant bodily distress (pain, fatigue, nausea) that the person finds debilitating and interprets as serious, even with medical reassurance. Health anxiety: symptom-poor + worry-rich. Somatic symptom disorder: symptom-rich + distress-rich. A person can have both.
Is health anxiety purely psychological, or can bodily symptoms be real?
Health anxiety is psychological, but bodily sensations are real. The anxiety-driven vigilance and focus amplify perception of normal sensations, creating a feedback loop. Treatment addresses the worry cycle, not denial of sensations. Many people with health anxiety also have panic attacks, tension headaches, or GI disturbance—real symptoms amplified by anxiety.
How does cognitive-behavioral therapy treat health anxiety?
CBT for health anxiety involves: (1) Psychoeducation: explaining anxiety cycles and normalizing sensations; (2) Cognitive restructuring: challenging catastrophic health beliefs (e.g., 'A headache means brain tumor'); (3) Behavioral experiments: testing health beliefs (e.g., 'Will the headache worsen if I don't rest?'); (4) Exposure: tolerating health-related uncertainty (avoiding Dr. Google, reducing reassurance-seeking); (5) Lifestyle: sleep, exercise, stress management.
When should I refer to medical specialists vs. mental health for health anxiety?
If medical investigations are normal or minimal symptoms exist, health anxiety is the primary problem → mental health referral. If serious medical conditions are present or not yet ruled out, complete medical workup first, then address anxiety. Never dismiss health anxiety as 'all in your head'; it is a real disorder requiring skilled intervention.
Sources
- Lucock, M. P., Gillespie, S. M., Perera, S., & Goodwin, K. (2008). Health Anxiety: A viable diagnosis and differential diagnosis in primary care. British Journal of General Practice, 58(556), 763–768. link ↗
How to cite this page
ScholarGate. (2026, June 3). Health Anxiety Questionnaire (HAQ). ScholarGate. https://scholargate.app/en/anxiety-disorders/health-anxiety-questionnaire
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