The Illness Attitude Scales. A clinimetric index for assessing hypochondriacal fears and beliefs.

Background: The Illness Attitude Scales (IAS) were developed by Robert Kellner as a clinimetric index for measuring hypochondriacal fears and beliefs (worry about illness, concerns about pain, health habits, hypochondriacal beliefs, thanatophobia, disease phobia, bodily preoccupations, treatment experience and effects of symptoms). The IAS have been extensively used in the past two decades, but there has been no comprehensive review of their properties and applications. Methods: A review of the literature using both computerized (Medline, PsycINFO) and manual searches was performed. Results: The IAS were found to successfully discriminate between hypochondriacal patients and control subjects, and between patients with various manifestations of illness behaviour. They showed a high test-retest reliability in normal subjects, and changed in the expected direction after treatment of hypochondriasis. The IAS were also positively related to other hypochondriasis-related measures, and yielded important information in a variety of medical and surgical settings. Their content has paved the way for the development of some of the Diagnostic Criteria for Psychosomatic Research. Conclusions: The clinimetric properties and high sensitivity of the IAS make them the gold standard for the self-rated assessment of hypochondriacal fears and beliefs.