Table 2 Worrying core cognitions and underlying cognitions

I have a serious disease

- I have alarming symptoms/abnormal test results which indicate serious disease.

- This is a common disease according to the media/in my family/among my friends and acquaintances.

- The symptoms I have are not normal.

- The media/my friends say that my symptoms are indicative of a serious disease.

- Now that I am getting older the chance of having a serious disease is increasing.

- The symptoms I have must be abnormal as I know of no people in my social environment and with a similar background to mine that have such symptoms.

- My symptoms have not disappeared after the treatment so something must be wrong.

My health problem will have adverse physical effects

- I have a health problem that will lead to serious illness causing disability/additional conditions/death.

- These adverse effects happen all the time according to the media/in my family/among people I know.

- My symptoms are getting worse.

- I do not know how the symptoms can be treated since I do not know what causes them.

My treatment will have adverse effects

- The treatment I received was incorrect, so my health problem will persist.

- In my social environment I have seen many cases of incorrect treatment of this problem with bad outcomes.

- If I take medication, I will have to continue to take it indefinitely/there will be side effects/I will have difficulty sticking to my drug regimen.

- In my social environment I have often seen adverse effects of medication.

My health problem will negatively impact my life

- Having health problems does not fit with how I see myself and my future.

- My social environment is not supportive when I have problems and concerns/does not allow me to deal with the problem in my own way.

- I have so many health problems at the same time/My health problems are getting worse/my treatment is no longer effective.

- My health problems will make me dependent on others/limit my daily functioning.