Your perception may predict your anxiety level: a preliminary study in primary care in Singapore

Background: Patients’ perception of their medical illness has been shown to associate with not only their responses to the illness but under certain conditions even outcomes of their illness. While anxiety is prevalent among primary care patients, illness perception studies relating to anxiety in this population are scarce. This study aimed to fill this gap and explore clues for perceptual elements of primary care patients’ effective management of their own anxiety. Methods: Ninety-five adult participants (65% female and 35% male) were recruited in two primary care clinics in this cross-sectional study. The questionnaires administered were Generalized Anxiety Disorder-7 (GAD-7) and Illness Perception Questionnaire Mental Health (IPQ-MH) were used to assess anxiety and illness perception respectively. Data analysis was conducted using Spearman’s rho correlation coefficients and linear regression. Results: Four specific dimensions of the participants’ illness perception (i.e., consequences, personal control, coherence and biology) were found to be significantly correlated with their severity of anxiety. In other words, the participants experienced higher anxiety when they perceived a serious impact of anxiety in their lives, experienced a diminished sense of self-efficacy, had trouble understanding their condition and attributed their anxiety to biological causes (which could presumably be ameliorated only with medication). Conclusion: Attribution to biological factors and personal control were highly significant predictors of severity of anxiety. Clinicians should consider psychological interventions that target patients’ medication adherence as well as their physiological responses to anxiety (e.g., breathing skills). Further, anxiety patients’ experience of personal control should be enhanced which could be facilitated through deliberate assessment and reinforcement of the strengths and resources in the patients’ psychosocial spheres