Abstract

Misinterpreting an uncomfortable and ambiguous somatic symptom as a physical problem or illness is known to be a key feature of illness anxiety. This symptom interpretation bias is a universal phenomenon that everyone experiences. In mild cases, it can be an adaptive signal that help us manage our health. However, when it is excessive, it can lead to pathological illness anxiety. Attitude toward death may affect illness anxiety in people who misinterpret somatic symptoms as a fatal illness. There are various death attitudes such as fear of death, death avoidance, and avoidant, approaching, or neutral acceptance of death. The present study examined the moderating effect of death attitude on the relationship between somatic symptom interpretation bias and illness anxiety. A total of 227 adults aged 20 to 70 years were recruited through Korea Research MS Panel online survey system. Illness anxiety, somatic symptom interpretation bias, and death attitudes were measured. Regression analysis, slope analysis, and Johnson-Nayman technique were used to verify the moderating effect of death attitude. As a result, fear of death and neutral death acceptance moderated the relationship between somatic symptom interpretation bias and illness anxiety. The positive correlation between somatic symptom interpretation bias and illness anxiety increased as the level of fear of death increased, whereas the positive correlation between somatic symptom interpretation bias and illness anxiety decreased as the level of neutral acceptance of death increased. These findings suggest that the extent to which somatic symptom interpretation bias exacerbates illness anxiety might vary depending on levels of fear of death and neutral death acceptance. Reducing fear of death and promoting neutral death acceptance might prevent excessive illness anxiety.