Examining associations between early adverse life events and health anxiety using the DanFund study

Line Granild Bie Mertz; Tina Birgitte Wisbech Carstensen; Lisbeth Frostholm; Eva Ørnbøl; Charlotte Ulrikka Rask

doi:10.1016/j.jpsychores.2023.111496

Examining associations between early adverse life events and health anxiety using the DanFund study

J Psychosom Res. 2023 Nov:174:111496. doi: 10.1016/j.jpsychores.2023.111496. Epub 2023 Sep 11.

Authors

Line Granild Bie Mertz¹, Tina Birgitte Wisbech Carstensen², Lisbeth Frostholm², Eva Ørnbøl³, Charlotte Ulrikka Rask⁴

Affiliations

¹ The Research Unit, Department of Child and Adolescent Psychiatry, Psychiatry, Aarhus University Hospital, Aarhus, Denmark.
² Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
³ Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark.
⁴ The Research Unit, Department of Child and Adolescent Psychiatry, Psychiatry, Aarhus University Hospital, Aarhus, Denmark. Electronic address: charrask@rm.dk.

PMID: 37729751
DOI: 10.1016/j.jpsychores.2023.111496

Abstract

Childhood adverse life events, in particular illness-related events, have been proposed as a risk factor for development of health anxiety.

Objective: To examine: 1) The association between accumulated early adverse life events and health anxiety in adulthood and 2) The influence of specific types of life events, i.e., illness, injury, loss, and the impact of their exposure time on health anxiety in adulthood.

Method: A population-based, cross-sectional study including 7454 participants from the Danish study of Functional Disorders (DanFunD). Health anxiety was assessed with Whiteley-6-R and early adverse life events with the Cumulative Lifetime Adversity Measure. Caseness was defined as a Whiteley-6-R score ≥ 90%ile. Generalised linear models were used to estimate the association with relative risk (RRa, adjusted for sociodemographics).

Results: A cumulative effect was found for each additional adverse life event with 8.03% increased risk of health anxiety. Two categories were associated with a higher risk: violence (RRa = 1.65, 95% CI: 1.37-1.99, P < 0.001) and relationship stress (RRa = 1.34; 95% CI: 1.15-1.57, P < 0.001). Respondents with self-reported childhood illness were also more likely to report health anxiety (RRa = 1.52, 95% CI 1.11-2.09, P = 0.009). Timewise, health anxiety seemed associated with illness during school age and injury during adolescence.

Conclusions: Accumulated adverse life events, early exposure to specific categories and specific health-related life events were associated with self-reported health anxiety in adulthood. Our findings provide new knowledge on the potential role of early life events in health anxiety which could inform early intervention.

Keywords: Cumulative lifetime adversity measure (CLAM); DanFunD; Early adverse life events; Health anxiety; Whiteley index.