Illness coping strategies and hypochondriacal traits among medical inpatients

The Illness Coping Strategies scale (ICS) is an 18-Likert-item scale developed to examine illness appraisal and coping by medical patients more comprehensively than instruments which screen for hypochondriacal traits in this population. This study has examined the association of hypochondriacal traits with illness coping strategies addressed by the ICS among 101 randomly selected inpatients drawn from a general medicine unit of a teaching general hospital. Despite the exclusion of patients with substance abuse or organic mental disorder, or referral for psychiatric consultations, hypochondriacal traits were prevalent in this inpatient sample. Five factor-derived subscales of the ICS (disease vigilance, limit activity, overresponsiveness, self-treatment and obsessive worry) were extracted, and internal consistency and test-retest reliabilities were determined. Multiple regression analysis on a composite measure of hypochondriasis revealed that the five ICS factor scales accounted for 26 percent of the variance. Patients with a high hypochondriacal index had associated high scores on symptom vigilance, limit activity and obsessive worry subscales, suggesting that these illness coping strategies may represent an important aspect of hypochondriacal illness presentation. The self-treatment subscale appeared to act as a suppressor variable, contributing to the prediction of the hypochondriacal index by extracting self treatment aspects from the other illness coping factors. Illness coping responses found to be associated with hypochondriacal traits in this study were rather passive strategies which promoted increased vigilance and concern about symptoms while providing few opportunities to reduce uncertainty regarding health status.