The Role of Health Anxiety and Ambiguity Tolerance in Illness Perception Considering the Mediating Role of Perfectionism in Elderly Individuals

Abstract

Introduction and Aim: Aging is associated with extensive physical and psychological changes that may influence individuals’ perceptions of illness and health conditions. The present study aimed to investigate the role of health anxiety and ambiguity tolerance in illness perception with the mediating role of perfectionism among elderly individuals.

Methodology: This study employed a descriptive-correlational design using structural equation modeling. The statistical population consisted of elderly individuals attending medical clinics in Urmia, from whom 200 participants were selected through convenience sampling. Data collection instruments included the Health Anxiety Inventory by Salkovskis and Warwick, the Illness Perception Questionnaire, the Perfectionism Questionnaire by Hill et al., and the Ambiguity Tolerance Scale by McLain. Data were analyzed using SPSS and Smart PLS software, and bootstrap procedures were applied to examine direct and indirect relationships among variables.

Findings: The findings indicated that health anxiety had a direct and significant effect on illness perception (β=0.836, p<0.001). Health anxiety also had a significant direct effect on perfectionism (β=0.296, p=0.020), while perfectionism significantly predicted illness perception (β=0.264, p<0.001). Furthermore, the indirect effect of health anxiety on illness perception through perfectionism was significant (β=0.151, p=0.045). Although ambiguity tolerance did not show a significant direct effect on illness perception or perfectionism, its indirect effect on illness perception through perfectionism was significant (β=0.110, p=0.049). Model fit indices, including SRMR=0.068 and NFI=0.963, confirmed the satisfactory fit of the structural model.

Conclusion: The results demonstrated that health anxiety and perfectionism are among the most influential psychological factors affecting illness perception in elderly individuals, and perfectionism can play a significant mediating role in the relationship between health anxiety and illness perception. These findings highlight the importance of addressing psychological variables in designing therapeutic interventions and promoting mental health among the elderly. Enhancing coping skills and ambiguity tolerance may contribute to reducing illness-related concerns and improving psychological well-being in this population.