Development and Validation of the Health Anxiety Inventory (HAI) Among College Students
Dr. Krishnamurthy V.S*
Assistant Professor and Head of the Department, Department of Psychology, Government Home
*Correspondence: Krishnamurthy V. S, Assistant Professor and Head of the Department, Department of Psychology, Government Home Science College for Women, Holenarsipura, India. E-mail: kmpsychology997@gmail.com
Received: 01 Dec, 2025; Accepted: 17 Dec, 2025; Published: 29 Dec, 2025.
Copyright: © 2025 Krishnamurthy V. S. This is an open-ac cess article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
The present study aimed to develop and validate a culturally appropriate Health Anxiety Inventory (HAI) for college students. The scale was constructed using established psychometric guidelines, including theoretical item development, expert review, pilot testing, and large-sample validation. The final 30-item HAI was administered to 183 college students from Holenarsipura. Reliability was evaluated using Cronbach’s alpha, and construct validity was examined using item–total correlations. The findings demonstrated excellent internal consistency (α = .912) and strong item–total correlations (.32–.68). A scoring system was standardized to aid interpretation. The results confirm that the Health Anxiety Inventory is a reliable and valid measure of health anxiety in the cultural context of Indian college students. Implications for research, psychological assessment, and mental health interventions are discussed.
Keywords
Health Anxiety, Inventory Development, Reliability, Validity, Cronbach’s Alpha, Item Analysis, Psychometrics.
Introduction
Health anxiety refers to the persistent worry about acquir ing or suffering from a serious illness, often accompanied by misinterpretation of normal bodily sensations [1]. Col lege students are particularly vulnerable to elevated health anxiety due to academic pressure, transitional stress, and extensive exposure to health information through digital media [2]. The rise of internet-based medical information has further intensified tendencies toward self-diagnosis and illness-related rumination [3].
Although existing tools such as the Short Health Anxiety Inventory [1] have been widely used, concerns remain regarding their applicability across different cultures, par ticularly in India, where health beliefs, symptom interpre tations, and cultural expressions of anxiety differ signifi cantly from Western contexts [4]. Thus, there is a need for a culturally sensitive health anxiety scale tailored for local populations.
The present study addresses this gap by developing and validating the Health Anxiety Inventory (HAI) designed by Dr. Krishnamurthy V. S. The scale development process followed standard psychometric procedures outlined in psychological measurement literature [5]. The study evaluates the reliability and validity of the HAI to determine its suitability for use among Indian college students.
Method
Research Design
A tool-development and validation approach were adopt ed, involving:
• Construction Phase (item generation, expert review) • Pilot Testing Phase (refinement)
• Standardization and Validation Phase (large-sam ple administration)
This procedure aligns with standard recommendations for psychological test construction [6].
Participants
The sample consisted of 183 college students selected through convenience sampling. According to psychometric guidelines, this sample size is adequate for validation [7].
Instrument
Health Anxiety Inventory (HAI)
• 30 items
• Developed through theoretical review, expert evalua tion, and pilot testing
• Higher scores reflect greater health anxiety •
Reliability
• Cronbach’s alpha = .912 → indicates excellent internal consistency
(Reliability benchmarks [8])
Validity
Item–total correlations ranged from .32 to .68, demonstrat ing strong construct validity [9].
Procedure
After ethical clearance and consent, the HAI was admin istered in classroom settings. Responses were scored ac cording to the standardized scoring guide, and data were analyzed in SPSS (Version 25).
Statistical Analysis
• Descriptive statistics
• Cronbach’s alpha for internal consistency • Item–total correlations for construct validity • Standardization of scores for interpretation
Results
Internal Consistency Reliability
| Measure | Value |
|---|---|
| Number of Items | 30 |
| Cronbach’s Alpha | .912 |
| This value indicates excellent internal consistency [8]. | |
Table 1: Cronbach’s Alpha for the Health Anxiety Inventory**
Construct Validity
| Item Numbers | Correlation Range |
|---|---|
| Items 1–30 | .32 – .68 |
| All items exceeded the minimum acceptable threshold of .30 [9], supporting construct validity. | |
Table 2: Item–Total Correlations for the HAI**
Standardized Score Interpretation
| Score Range | Level of Health Anxiety |
|---|---|
| 0–30 | Low |
| 31–60 | Moderate |
| 61–90 | High |
Table 3: Score Interpretation Guidelines for the HAI**
Discussion
The present study successfully developed and validated a culturally relevant Health Anxiety Inventory for Indian college students. The high internal consistency (α = .912) aligns with psychometric expectations for well-constructed psychological instruments [10] and supports the coherence of the scale. The strong item–total correlations fur ther confirm that the items adequately measure the under lying construct of health anxiety.
The findings coincide with earlier studies that empha size the need for culturally sensitive assessment tools in non-Western contexts [4]. The HAI’s strong reliability and validity suggest it can be effectively used for screening,research, and psychological intervention planning. As health anxiety continues to rise due to increased medi cal information exposure [11], the availability of a localized measurement tool becomes crucial [12]. The HAI fills this gap by providing a robust, practical, and culturally relevant instrument.
Conclusion
The Health Anxiety Inventory developed in this study is a psychometrically sound instrument with excellent reliability and strong construct validity. It is suitable for use in aca demic research, clinical screening, and counseling inter ventions. The culturally tailored items ensure its relevance and effectiveness for Indian college populations.
References
1. Salkovskis, Paul M., Katharine A. Rimes, Hilary MC Warwick, and DM12171378 Clark. “The Health Anxi ety Inventory: development and validation of scales for the measurement of health anxiety and hypochondria sis.” Psychological medicine 32, no. 5 (2002): 843-853.
2. Ferguson, M. (2009). Health anxiety and the in ternet: Understanding health information seek ing. Journal of Anxiety Disorders, 23(8), 1134–1140.
3. Baumgartner, Susanne E., and Tilo Hartmann. “The role of health anxiety in online health information search.” Cyberpsycholo gy, behavior, and social networking 14, no. 10 (2011): 613-618.
4. Chakraborty, K., & Chatterjee, A. (2018). Cul tural variations in health anxiety: A review. Indi an Journal of Social Psychiatry, 34(4), 288–295.
5. DeVellis, Robert F., and Carolyn T. Thorpe. Scale develop ment: Theory and applications. Sage publications, 2021. 6. Anastasi, A., & Urbina, S. (2010). Psy chological testing (7th ed.). Pearson.
7. Comrey, Andrew L., and Howard B. Lee. A first course in factor analysis. Psychology press, 2013.
8. George, Darren, and Paul Mallery. IBM SPSS statistics 29 step by step: A simple guide and reference. Routledge, 2024.
9. Field, Andy. Discovering statistics using IBM SPSS statistics. Sage publications limited, 2024.
10. Kline, Paul. A handbook of test construction (psychology re vivals): introduction to psychometric design. Routledge, 2015.
11. Wheaton, Michael G., Jonathan S. Abramowitz, Jo seph C. Franklin, Noah C. Berman, and Laura E. Fabricant. “Experiential avoidance and saving cog nitions in the prediction of hoarding symptoms.” Cogni tive Therapy and Research 35, no. 6 (2011): 511-516.
12. Sadeghzadeh, Marziyeh, Moslem Abbasi, Yaser Khajavi, and Hossein Amirazodi. “Psychological correlates of anxiety in response to COVID-19 outbreak among Iranian University students.” Current Psychology 41, no. 11 (2022): 7927-7936.