Psikolojik İyi Oluşu Belirleyen Bazı Faktörler: Sağlık Kaygısı, Duygu Düzenleme Güçlüğü ve Sağlık Kontrol Odağı

Öz

Psikolojik iyi oluş, pek çok insanın erişmeye çalıştığı doyumlu bir yaşamla ilişkilendirilmekte ve psikoloji alanyazını da iyi oluşun belirleyicileri üzerinde genişlemeye devam etmektedir. Bu çalışmanın amacı, psikolojik iyi oluş üzerinde sağlık kaygısı, duygu düzenleme güçlüğü ve sağlık kontrol odağının rolünün incelenmesidir. Çalışmanın örneklemini 18-53 yaş aralığındaki (Ortyaş = 32.48, SSyaş = 6.9) 490 yetişkin oluşturmuştur. Katılımcılara çevrimiçi olarak sosyal medya platformları (Twitter, Instagram vb.) aracılığı ile ulaşılmıştır. Katılımcıların 475’i (%93.13) kadın, 35’i erkek (%6.87)’tir. Ölçeklerin alt boyutları arasındaki korelasyonlar kadın ve erkek katılımcılar için ayrı ayrı incelenmiştir. Kadın ve erkek katılımcılar için sonuçların farklılaştığı görülmüştür. Psikolojik iyi oluşun bazı yordayıcılarını belirlemek üzere hiyerarşik regresyon analizi yürütülmüş ve sonuçlar sağlık kontrol odağının ve cinsiyetin beklenenin aksine regresyon modeline anlamlı bir katkı yapmadığına işaret etmiştir. Sağlık kaygısı ve duygu düzenleme güçlüğü ise regresyon modeline anlamlı katkılar sunmuş ve son adımda oluşturulan model psikolojik iyi oluşun %30.1’ini yordamıştır. Elde edilen bulgular ilgili alanyazın çerçevesinde tartışılmıştır.

Anahtar Kelimeler

• psikolojik iyi oluş
• sağlık kaygısı
• duygu düzenleme
• sağlık kontrol odağı

Some Determinants of Psychological Well-being: Health Anxiety, Difficulty in Emotion Regulation and Health Locus of Control

Öz

Psychological well-being is associated with a fulfilling life that many people strive to achieve, and the psychology literature continues to expand on the determinants of psychological well-being. This study aimed to examine the role of health anxiety, difficulty in emotion regulation, and health locus of control on psychological well-being. The study sample comprised 510 adults aged 18-53 (Mage = 32.48, SDage = 6.9). 475 participants (93.13%) were women, and 35 were men (6.87%). The participants were reached by social media channels on the Internet (Twitter, Instagram). Correlations between the subscales were examined separately for male and female participants. The results differed in terms of gender. Hierarchical regression analysis was conducted to determine some predictors of psychological well-being, and contrary to expectations, the results showed that health locus of control and gender did not make a significant contribution to the regression model. Health anxiety and difficulty in emotion regulation made significant contributions to the regression model, and the last model estimated 30.1% of psychological well-being. Results were discussed in the light of the related literature.

Anahtar Kelimeler

• psychological well-being
• health anxiety
• difficulty in emotion regulation
• health locus of control

Kaynakça

1. Abasi, I., Pourshahbaz, A., Mohammadkhani, P., ve Dolatshahi, B. (2017). Mediation role of emotion regulation strategies on the relationship between emotional intensity, safety and reward motivations with social anxiety symptoms, rumination and worry: A structural equation modeling. Iranian Journal of Psychiatry and Behavioral Sciences, 11(3), e9640. https://doi.org/10.5812/ijpbs.9640
2. Aldao, A., Nolen‐Hoeksema, S. ve Schweizer, S. (2010). Emotion‐regulation strategies across psychopathology: A meta‐analytic review. Clinical Psychology Review, 30(2), 217–237. https://doi.org/10.1016/j.cpr.2009.11.004
3. Amerikan Psikiyatri Birliği (2013). Ruhsal bozuklukların tanısal ve sayımsal elkitabı (5.Basım). (E. Köroğlu, Çev.). Hekimler Yayın Birliği.
4. Asmundson, G., Abramowitz, J. S., Richter, A. ve Whedon, M. (2010). Health anxiety: Current perspectives and future directions. Curr Psychiatry Rep., 12(4), 306-312. https://doi.org/10.1007/s11920-010-0123-9
5. Aydemı̇r, Ö., Kırpınar, İ., Satı, T., Uykur, B. ve Cengı̇sı̇z, C. (2013). Sağlık Anksiyetesi Ölçeği’nin Türkçe için güvenilirlik ve geçerlilik çalışması. Nöropsikiyatri Arşivi, 50(4), 325-331. https://doi.org/10.4274/npa.y6383
6. Barsky, A. J. ve Ahern, D. K. (2004). Cognitive behavior therapy for hypochondriasis: a randomized controlled trial. JAMA, 291(12), 1464–1470. https://doi.org/10.1001/jama.291.12.1464
7. Barsky, A. J., Wyshak, G., Klerman, L. G. ve Latham, K. S. (1990). The prevalence of hypochondriasis in medical outpatients. Social Psychiatry and Psychiatric Epidemiology, 25(2)89–94. https://doi.org/10.1007/BF00794988
8. Bem, S. L. (1981). Gender schema theory: A cognitive account of sex typing. Psychological Review, 88(4), 354−364. http://dx.doi.org/10.1037/0033-295X.88.4.354

9. Birnie, K., Sherry, S., Doucette, S., Sherry, D., Hadjistavropoulos, H. ve Stewart, S. (2013). The interpersonal model of health anxiety: testing predicted paths and model specificity. Personality and Individual Differences, 54(7), 856–861. https://doi.org/10.1016/j.paid.2012.12.028
10. Bleichhardt, G. ve Hiller, W. (2007). Hypocondriasis and health anxiety in German population. British Journal of Health Psychology, 12(4), 511-523. https://doi.org/10.1348/135910706X146034
11. Bruce, S. E., Yonkers, K. A., Otto, M. W., Eisen, J. L., Weisberg, R. B., Pagano, M., Shea, M. T. ve Keller, M. B. (2005). Influence of psychiatric comorbidity on recovery and recurrence in generalized anxiety disorder, social phobia, and panic disorder: a 12-year prospective study. Am J Psychiatry, 162(6), 1179-1187. https://doi.org/10.1176/appi.ajp.162.6.117
12. Caprara, G.V., Alessandri, G., Eisenberg, N., Kupfer, A., Steca, P., Caprara, M.G., Yamaguchi, S., Fukuzawa, A. ve Abela, J. (2012). The Positivity Scale. Psychol. Assess., 24(3), 701–712. https://doi.org/10.1037/a0026681
13. Chorpita, B. F. ve Barlow, D. H. (1998). The development of anxiety: the role of control in the early environment. Psychol Bull., 124(1), 3-21. https://doi.org/10.1037/0033-2909.124.1.3
14. Cisler, J. M., Olatunji, B. O., Feldner, M. T. ve Forsyth, J. P. (2010). Emotion regulation and the anxiety disorders: An integrative review. J Psychopathol Behav Assess, 32(1), 68–82. https://doi.org/10.1007/s10862-009-9161-1
15. Costanza, R., Kubiszewski, I., Giovannini, E., Lovins, H., McGlade, J. ve Pickett, K. E. (2014). Time to leave GDP behind. Nature, 505(7483), 283–285. https://doi.org/10.1038/505283a
16. Crisson, J. E. ve Keefe, F. J. (1988). The relationship of locus of control to pain coping strategies and psychological distress in chronic pain patients. Pain, 35(2), 147–154. https://doi.org/10.1016/0304-3959(88)90222-9
17. Diener, E., Oishi, S. ve Tay, L. (2018). Advances in subjective well-being research. Nature Human Behaviour, 2(4), 253-260. https://doi.org/10.1038/s41562-018-0307-6
18. Diener, E., Wirtz, D., Biswas-Diener, R., Tov, W., Kim-Prieto, C., Choi, D. ve Oishi, S. (2009). New measures of wellbeing. E. Diener (Ed.) Social indicators research series, 39 (ss. 247-266). Berlin: Springer Science and Business Media B.V. https://doi.org/10.1007/978-90-481-2354-4_12
19. Ellard, K. K., Fairholme, C. P., Boisseau, C. L., Farchione, T. J. ve Barlow, D. H. (2010). Unified protocol for the transdiagnostic treatment of emotional disorders: Protocol development and initial outcome data. Cognitive and Behavioral Practice, 17(1), 88–101. https://doi.org/10.1016/j.cbpra.2009.06.002
20. Faravelli, C., Salvatori, S., Galassi, F., Aiazzi, L., Drei, C. ve Cabras, P. (1997). Epidemiology of somatoform disorders: a community survey in Florence. Soc Psychiatry Psychiatr Epidemiol 32(1), 24-29. https://doi.org/10.1007/BF00800664
21. Feeney, J. A. (1995). Adult attachment, coping style and health locus of control as predictors of health behaviour. Australian Journal of Psychology, 47(3), 171–177. https://doi.org/10.1080/00049539508257520
22. Fergus, T. A. ve Valentiner, D. P. (2010). Disease phobia and disease conviction are separate dimensions underlying hypochondriasis. J Behav Ther Exp Psychiatry, 41(4), 438–444. https://doi.org/10.1016/j.jbtep.2010.05.002
23. Foa, E. B. ve Kozak, M. J. (1986). Emotional processing of fear: exposure to corrective information. Psychological Bulletin, 99(1), 20-35. https://doi.org/10.1037/0033-2909.99.1.20
24. Frazier, L. D. ve Waid, L. D. (1999). Influences on anxiety in later life: the role of health status, health perceptions, and health locus of control. Aging Ment Health., 3(3), 213-220. https://doi.org/10.1080/13607869956163
25. Gautreau, C. M., Sherry, S. B., Sherry, D. L., Birnie, K. A., Mackinnon, S. P. ve Stewart, S. H. (2014). Does Catastrophizing of Bodily Sensations Maintain Health-Related Anxiety? A 14-Day Daily Diary Study with Longitudinal Follow-Up. Behavioural and Cognitive Psychotherapy, 43(4), 502–512. https://doi.org/10.1017/S1352465814000150
26. Ginsberg, D. (2004). Women and anxiety disorders. CNS Spectrums, 9(9), 1–16. https://doi.org/10.1017/S1092852900001978.
27. Görgen, S. M., Hiller, W. ve Witthöft, M. (2014). Health anxiety, cognitive coping, and emotion regulation: A latent variable approach. International Journal of Behavioral Medicine, 21(2), 364–374. https://doi.org/10.1007/s12529-013-9297-y
28. Gratz, K. L. ve Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 41-54. https://doi.org/10.1023/B:JOBA.0000007455.08539.94
29. Gross, J. (2002). Emotion regulation: Affective, cognitive, and social consequences. Psychophysiology, 39(3), 281– 291. https://doi.org/10.1017/S0048577201393198
30. Gross, J. J. (1998). The emerging field of emotion regulation: An integrative review. Review of General Psychology, 2(3), 271–299. https://doi.org/10.1037/1089-2680.2.3.271
31. Gross, J. J. ve John, O. P. (2003). Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85(2), 348–362. https://doi.org/10.1037/0022-3514.85.2.348
32. Güzel, A., Turan, S. ve Üner, S. (2019). Turkish validity and reliability of Multidimensional Health Locus of Control Scale Form A. Int J Nurs Pract., 26(5), e12813. https://doi.org/10.1111/ijn.12813
33. Haenen, M. A., de Jong, P. J., Schmidt, A. J. M., Steven, S. ve Visser, L. (2000). Hypochondriacs’ estimation of negative outcomes: Domain-specificity and responsiveness to reassuring and alarming information. Behaviour Research and Therapy, 38(8), 819–833. https://doi.org/10.1016/S0005-7967(99)00128-X
34. Haga, S. M., Kraft, P. ve Corby, E. K. (2009). Emotion regulation: Antecedents and well-being outcomes of cognitive reappraisal and expressive suppression in cross-cultural samples. J Happiness Stud, 10(3), 271–291. https://doi.org/10.1007/s10902-007-9080-3
35. Haw, C. (2014). Psychological perspectives on womens vulnerability to mental illness. D. Kohen (Ed.), Women and Mental Health (ss. 65-105). Routledge.
36. Hoehn-Saric, R. ve McLeod, D. R. (1985). Locus of control in chronic anxiety disorders. Acta Psychiatrica Scandinavica, 72(6), 529–535. https://doi.org/10.1111/j.1600-0447.1985.tb02650.x
37. Kandrack, M., Grant, K. R. ve Segall, A. (1991). Gender differences in health related behaviour: some unanswered questions. Soc Sci Med, 32(5), 579–590. https://doi.org/10.1016/0277-9536(91)90293-L
38. Karademas, E. C. (2009). Effects of exposure to the suffering of unknown persons on health-related cognitions, and the role of mood. Health., 13(5), 491-504. https://doi.org/10.1177/1363459308336793
39. Karstoft, K. I., Armour, C., Elklit, A. ve Solomon, Z. (2015). The role of locus of control and coping style in predicting longitudinal PTSD-trajectories after combat exposure. Journal of Anxiety Disorders, 32, 89-94. https://doi.org/10.1016/j.janxdis.2015.03.007
40. Kolk, A. M., Hanewald, G.J.F.P., Schagen, S. ve Gijsbers van Wijk, C. M. (2003). A symptom perception approach to common physical symptoms. Social Science & Medicine, 57(12), 2343–2354. https://doi.org/10.1016/S0277-9536(02)00451-3
41. Kulpa, M., Kosowicz, M., Stypula-Ciuba, B. J. ve Kazalska, D. (2014). Anxiety and depression, cognitive coping strategies, and health locus of control in patients with digestive system cancer. Prz Gastroenterol, 9(6), 329–335. https://doi.org/10.5114/pg.2014.47895
42. Kulpa, M., Ziętalewicz, U., Kosowicz, M., Stypuła-Ciuba, B. ve Ziółkowska, P. (2016). Anxiety and depression and cognitive coping strategies and health locus of control in patients with ovary and uterus cancer during anticancer therapy. Contemp Oncol (Pozn), 20(2), 171-175. https://doi.org/10.5114/wo.2016.60074
43. Lebel, S., Mutsaers, B., Tomei, C., Leclair, C. S., Jones, G., Petricone-Westwood, D., Rutrowski, N., Ta, V., Trudel, G., Laflamme, S. Z., Lavigne, A. A. ve Dinkel, A. (2020). Health anxiety and illness-related fears across diverse chronic illnesses: A systematic review on conceptualization, measurement, prevalence, course, and correlates. PLoS ONE, 15(7), e0234124. https://doi.org/10.1371/journal.pone.0234124
44. Levenson, H. (1973). Reliability and validity of the I, P, and C scales - a multidimensional view of locus of control. American Psychological Association Convention, 9, 1-8. https://files.eric.ed.gov/fulltext/ED087791.pdf
45. MacSwain, K., Sherry, S., Stewart, S., Watt, M., Hadjistavropoulos, H. ve Graham, A. (2009). Gender differences in health anxiety. Personality and Individual Differences, 47(8), 938–943. https://doi.org/10.1016/j.paid.2009.07.020
46. Marcus, D. K., Hughes, K. T. ve Arnau, R. C. (2008). Health anxiety, rumination, and negative affect: a mediational analysis. J Psychosom Res., 64(5), 495–501. https://doi.org/10.1016/j.jpsychores.2008.02.004
47. Mauss, I. B., Cook, C. L., Cheng, J. Y. ve Gross, J. J. (2007). Individual differences in cognitive reappraisal: Experiential and physiological responses to an anger provocation. International Journal of Psychophysiology, 66(2), 116–124. https://doi.org/10.1016/j.ijpsycho.2007.03.017
48. McLean, C. P. ve Anderson, E. R. (2009). Brave men and timid women? A review of the gender differences in fear and anxiety. Clin Psychol Rev., 29(6), 496-505. https://doi.org/10.1016/j.cpr.2009.05.003
49. Murphy, K. M., McGuire, A. P., Ericson, T. M. ve Mezulis, A. H. (2016). Somatic symptoms mediate the relationship between health anxiety and health-related quality of life over eight weeks. Stress and Health, 33(3), 244-252. https://doi.org/10.1002/smi.2694
50. Murray, I. ve Corny, R. (1989). Locus of control in health: The effects of psychological well-being and contact with the doctor. The International Journal of Social Psychiatry, 35(4), 361-369. https://doi.org/10.1177/002076408903500409
51. Nafradi, L., Nakamoto, K. ve Schulz, P. J. (2017). Is patient empowerment the key to promote adherence? A systematic review of the relationship between self-efficacy, health locus of dev n and medication adherence. PloS one, 12(10), e0186458. https://doi.org/10.1371/journal.pone.0186458
52. Noyes, R., Kathol, R. G., Fisher, M. M., Phillips, B. M., Suelzer, M. T. Ve Holt, C. S. (1993). The validity of DSM-III-R hypochondriasis. Arch Gen Psychiatry, 50(12), 961-970. https://doi.org/10.1001/archpsyc.1993.01820240045006
53. Olatunji, B. O., Etzel, E. N., Tomarken, A. J., Ciesielski, B. G. ve Deacon, B. (2011). The effects of safety behaviors on health anxiety: an experimental investigation. Behav Res Ther, 49(11), 719–728. https://doi.org/10.1016/j.brat.2011.07.008
54. Owens, K. M. B., Asmundson, G. J. G., Hadjistavropoulos, T. ve Owens, T. J. (2004). Attentional bias toward illness threat in individuals with elevated health anxiety. Cognitive Therapy and Research, 28(1), 57–66. https://doi.org/10.1023/B:COTR.0000016930.85884.29
55. Paschali, A. A., Mitsopoulou, E., Tsaggarakis, V. ve Karademas, E. C. (2012). Changes in health perceptions after exposure to human suffering: using discrete emotions to understand underlying processes. Plos ONE, 7(4),1-8. https://doi.org/10.1371/journal.pone.0035854
56. Quinn, D. ve Norris, H. (1986). Multidimensional health locus of control: a new perspective on the psychopathology of anxiety and depression. Psychol Rep., 58(3), 903-914. https://doi.org/10.2466/pr0.1986.58.3.903
57. Rachman, S. (2012). Health anxiety disorders: A cognitive construal. Behav Res Ther, 50(7-8), 502-512. https://doi.org/10.1016/j.brat.2012.05.001
58. Rapee, R. M., Craske, M. G., Brown, R. A. ve Barlow, D. H. (1996). Measurement of perceived control over anxiety-related events. Behavior Therapy, 27(2), 279-293. https://doi.org/10.1016/S0005-7894(96)80018-9
59. Rassin, E., Muris, P., Franken, I. ve van Straten, M. (2008). The feature-positive effect and hypochondriacal concerns. Behaviour Research and Therapy, 46(2), 263–269. https://doi.org/10.1016/j.brat.2007.11.003
60. Richardson, A., Field, T., Newton, R. ve Bendell, D. (2012). Locus of control and prenatal depression. Infant Behav Dev., 35(4), 662-668. https://doi.org/10.1016/j.infbeh.2012.07.006
61. Rideout, A., Tolmie, E. ve Lindsay, G. (2017). Health locus of control in patients undergoing coronary artery surgery–changes and associated outcomes: a seven-year cohort study. European JCN., 16(1), 46-56. https://doi.org/10.1177/1474515116636501
62. Rotter, J. B. (1966). Generalized expectancies for internal versus external control of reinforcement. Psychological Monographs: General and Applied, 80(1), 1–28. https://doi.org/10.1037/h0092976
63. Rotter, J. B. (1990). Internal versus external control of reinforcement. A case history of a variable. The American Psychologist, 45(4), 489–493. https://doi.org/10.1037/0003-066X.45.4.489
64. Rugancı, R. N. (2008). The relationship among attachment style, affect regulation, psychological distress and mental construction of the relational world [Yayımlanmamış doktora tezi]. Orta Doğu Teknik Üniversitesi.
65. Rugancı, R. N. ve Gençöz, T. (2010). Psychometric properties of a turkish version of the difficulties in emotion regulation scale. Journal of Clinical Psychology, 66(4), 1-14. https://doi.org/10.1002/jclp.20665
66. Ryff, C. D. (1989). Happiness is everything, or is it? Explorations on the meaning of psychological well- being. Journal of Personality and Social Psychology, 57(6), 1069-1081. https://doi.org/10.1037/0022-3514.57.6.1069
67. Salkovskis, P. M., Rimes, K. A., Warwick, H. M. ve Clark, D. M. (2002). The Health Anxiety Inventory: development and validation of scales for the measurement of health anxiety and hypochondriasis. Psychol Med, 32(5), 843-853. https://doi.org/10.1017/s0033291702005822
68. Salkovskis, P. M., Warwick, M. C. ve Deale, A. C. (2003). Cognitive-behavioral treatment for severe and persistent health anxiety (Hypochondriasis). Brief Treatment and Crisis Intervention, 3(3), 353-367. https://doi.org/10.1093/brief-treatment/mhg026
69. Shelley, M. ve Pakenham, K. I. (2004). External health locus of control and general self-efficacy: moderators of emotional distress among university students. Aust J Psychol, 56(3), 191–199. https://doi.org/10.1080/00049530412331283336
70. Skidmore, J. R., Dyson, S. J., Kupper, A. E. ve Calabrese, D. (2014). Predicting illness behavior: Health anxiety mediated by locus of control. Am J Health Behav., 38(5), 699-707. https://doi.org/10.5993/AJHB.38.5.7
71. Tabachnick, B. ve Fidell, L. (2007). Using multivariate statistics (5. Basım). Allyn & Bacon/Pearson Education.
72. Tamres, L., Janicki, D. ve Helgeson, V. (2002). Sex differences in coping behavior. Personality and Social Psychology Review, 6(1), 2–30. https://doi.org/10.1207/S15327957PSPR0601_1
73. Telef, B. B. (2013). Psikolojik iyi oluş ölçeği: Türkçeye uyarlama, geçerlik ve güvenirlik çalışması. Hacettepe Üniversitesi Eğitim Fakültesi Dergisi, 28(28-3), 374-384. https://doi.org/10.13140/RG.2.1.2414.4480
74. Thakral, S., Bhatia, T., Gettig, E. A., Nimgaonkar, V. ve Deshpande, S. N. (2014). A comparative study of health locus of control in patients with schizophrenia and their first degree relatives. Asian Journal of Psychiatry, 7(1), 34-37. https://doi.org/10.1016/j.ajp.2013.10.004
75. Troy, A. S., Shallcross, A. J. ve Mauss, I. B. (2013). A person-by-situation approach to emotion regulation: cognitive reappraisal can either help or hurt, depending on the context. Psychol Sci., 24(12), 2505-2514. https://doi.org/10.1177/0956797613496434
76. Tull, M. T., Rodman, S. A. ve Roemer, L. (2008). An examination of fear of bodily sensations and bodily hypervigilence as predictors of emotion regulation difficulties among individuals with a recent history of uncued panic attacks. Journal of Anxiety Disorders, 22(4), 750–760. https://doi.org/10.1016/j.janxdis.2007.08.001
77. Tull, M. T., ve Roemer, L. (2007). Emotion regulation difficulties associated with the experience of uncued panic attacks: Evidence of experiential avoidance, emotional nonacceptance, and decreased emotional clarity. Behavior Therapy, 38(4), 378–391. https://doi.org/10.1016/j.beth.2006.10.006
78. Twenge, J. M., Zhang, L. ve Im, C. (2004). It’s beyond my control: A cross-temporal meta-analysis of increasing externality in locus of control, 1960-2002. Pers Soc Psychol Rev., 8(3), 308–319. https://doi.org/10.1207/s15327957pspr0803_5
79. Tyrer, P., Cooper, S., Crawford, M., Dupont, S., Green, J., Murphy, D., Salkovskis, P., Smith, G., Wang, D., Bhogal, S., Keeling, M., Loebenberg, G., Seivewright, R., Walker, G., Cooper, F., Evered, R., Kings, S., Kramo K., McNulty, A., … ve Tyrer, H. (2011). Prevalence of health anxiety problems in medical clinics. Journal of Psychosomatic Research, 71(6), 392-394. https://doi.org/10.1016/j.jpsychores.2011.07.004
80. Wallston, K. A. (1992). Hocus-pocus, the focus isn’t strictly on locus: Rotter’s social learning theory modified for health. Cognitive Therapy and Research, 16(2), 183-199. https://doi.org/10.1007/BF01173488
81. Wallston, K. A., Wallston, B. S. ve DeVellis, R. (1978). Development of the Multidimensional Health Locus of Control (MHLC) Scales. Health Education Monographs, 6(1), 160-170. https://doi.org/10.1177/109019817800600107
82. Warwick, H. M. ve Salkovskis, P. M. (1990). Hypochondriasis. Behaviour Research and Therapy, 28(2), 105–117. https://doi.org/10.1016/0005-7967(90)90023-C
83. Williams, P. G. ve Wiebe, D. J. (2000) Individual differences in self-assessed health: Gender, neuroticism and physical symptom reports. Personality and Individual Differences, 28(5), 823–835. https://doi.org/10.1016/S0191-8869(99)00140-3
84. Yılmaz, Ö. ve Dirik, G. (2020). Yetişkinlerde sağlık kaygısı ve ilişkili değişkenlerin Bilişsel-Davranışçı model kapsamında incelenmesi. Türk Psikoloji Dergisi, 35(85), 21-36. https://doi.org/10.31828/tpd1300443320181011m000014