*1.2. The Current Study*

The current study sought to extend prior research on health anxiety during disease outbreaks through the following main aims:

(1) To clarify the specific role of health anxiety in disease-related cognition, over and above other forms of psychopathology. Because health-related worries occur in other psychological disorders beyond health anxiety [23–28], it is not clear to what extent health anxiety symptoms contribute to perceptions of COVID-19 as dangerous, over and above

general distress and symptoms of generalized anxiety disorder, obsessive-compulsive disorder, and depressive disorders. In addition, during a disease outbreak, transient illnessrelated intrusive thoughts are fairly common [29,30] and do not necessarily indicate the presence of clinical health anxiety. Therefore, we also wanted to rule out the possibility that the purported link between health anxiety and perceptions of COVID-19 dangerousness were driven by these transient thoughts.

(2) To compare levels of health anxiety during the COVID-19 pandemic to prepandemic statistics. The literature suggests that health anxiety is relatively chronic, but it may also fluctuate in relation to life events [31]. Therefore, we also hoped to ascertain whether, on average, people reported more health anxiety symptoms during the pandemic than in pandemic-free periods, suggesting a prominent effect of stressful life events, or if reported health anxiety symptoms remained consistent, suggesting a more stable course.

Drawing on the scarce extant literature, the following hypotheses were tested: (1) health anxiety, negative affect, contamination compulsions, generalized anxiety, depression symptoms, and intrusive illness-related thoughts should be all related to the perceived dangerousness of COVID-19, and (2) health anxiety should be uniquely associated with perceived dangerousness of COVID-19, over and above the other psychological variables. Because of the variability of the prior literature, we had no a priori hypotheses about how the level of health anxiety reported by our participants would compare to prepandemic levels in similar samples.
