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Short Health Anxiety Inventory (HAI-18)
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About Short Health Anxiety Inventory (HAI-18)
Scale Name
Short Health Anxiety Inventory (HAI-18)
Author Details
Paul M. Salkovskis, Katherine A. Rimes, Helen M. C. Warwick, and David M. Clark
Translation Availability
English
Background/Description
The Short Health Anxiety Inventory (HAI-18) is a widely used psychological assessment tool designed to measure the severity of health anxiety, a condition characterized by persistent fears of having or developing serious illness despite appropriate medical reassurance. Health anxiety, historically referred to as hypochondriasis, is now conceptualized within contemporary diagnostic frameworks as part of illness anxiety disorder and related somatic symptom conditions. The HAI-18 captures cognitive, emotional, and behavioral dimensions of this anxiety, offering a comprehensive yet concise measure suitable for both clinical and research contexts.
The development of the HAI-18 emerged from the need for a brief, psychometrically sound instrument that could efficiently assess health-related fears without compromising conceptual depth. Earlier instruments often lacked practicality in busy clinical environments or large-scale research studies. Salkovskis and colleagues designed the inventory to reflect key theoretical principles from cognitive-behavioral models of health anxiety, particularly the role of maladaptive beliefs about bodily sensations, illness interpretation, and reassurance-seeking behaviors.
Importantly, the HAI-18 assesses health anxiety independently of actual physical health status, making it particularly valuable in distinguishing pathological worry from realistic health concerns. It has been applied across diverse populations, including clinical samples, primary care patients, and general community groups. Its sensitivity to change also makes it suitable for monitoring treatment outcomes, especially in cognitive-behavioral interventions targeting health anxiety.
Administration, Scoring and Interpretation
- Obtain the Official Copy: Acquire the scale through authorized academic publications, the original authors, or licensed psychological test distributors.
- Explain the Purpose: Inform respondents that the instrument assesses thoughts, feelings, and behaviors related to health concerns and illness-related anxiety.
- Provide Instructions: Ask participants to respond based on their typical experiences over a recent period, reflecting how they generally think and feel about their health.
- Time Required: The inventory typically takes approximately 5–10 minutes to complete.
- Administer the Scale: It can be administered by trained psychologists, clinicians, or researchers in clinical, academic, or healthcare settings, ensuring confidentiality and ethical use.
Reliability and Validity
The Short Health Anxiety Inventory demonstrates strong psychometric properties across multiple studies. Research consistently reports high internal consistency, indicating that the items reliably measure the underlying construct of health anxiety. Test–retest reliability findings suggest stability of scores over time in the absence of intervention.
Construct validity is well supported, with the HAI-18 showing meaningful associations with related constructs such as anxiety sensitivity, somatic symptom distress, and illness-related beliefs. It also demonstrates good discriminant validity by differentiating health anxiety from general anxiety and depression constructs.
Criterion validity has been established through its ability to distinguish between clinical and non-clinical populations, particularly individuals diagnosed with health anxiety or hypochondriasis. Furthermore, the scale has shown sensitivity to therapeutic change, supporting its use in outcome evaluation for psychological interventions.
Available Versions
18-Items
Reference
Salkovskis, P. M., Rimes, K. A., Warwick, H. M. C., & Clark, D. M. (2002). The Health Anxiety Inventory: Development and validation of scales for the measurement of health anxiety and hypochondriasis. Psychological Medicine, 32(5), 843–853. https://doi.org/10.1017/S0033291702005822
Abramowitz, J. S., Deacon, B. J., & Valentiner, D. P. (2007). The Short Health Anxiety Inventory: Psychometric properties and construct validity in a non-clinical sample. Cognitive Therapy and Research, 31(6), 871–883.
Important Link
Scale File:
Frequently Asked Questions
What does the Short Health Anxiety Inventory measure?
It measures the severity of health-related anxiety, including worries about illness and related behaviors.
Who can use the HAI-18?
It is primarily used by psychologists, clinicians, and researchers in clinical and academic settings.
Is the HAI-18 suitable for diagnosis?
No, it is a screening and assessment tool and should not be used as a standalone diagnostic instrument.
How long does it take to complete?
Typically between 5 and 10 minutes.
Can it be used to monitor treatment progress?
Yes, it is sensitive to change and commonly used in evaluating intervention outcomes.
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