Elaine’s Guide: 5 Ps Formulation (Whole-Person Map)
If you clicked here, it’s because your Health Anxiety Map Test gave you a clear view of what’s maintaining your anxiety now — and you may be wondering:
“Why do I react like this?” or “Why did it start again?”
That’s where the 5 Ps model helps. It’s a clinical framework that gives you a whole-person map — not just symptoms.
The 5 Ps are:
- Presenting problem
- Predisposing factors
- Precipitating factors
- Perpetuating factors
- Protective factors
Your test is especially strong at identifying perpetuating factors (the maintenance loop). The optional tick-boxes help you sketch the others.
1) Presenting problem
This is what’s happening now, in real life:
- what you fear most (illness, dying, missing a sign, losing control)
- what you do when fear rises (checking, Googling, reassurance, avoidance)
- how much time/energy it takes
- how much it impacts sleep, mood, relationships, work, and freedom
If your results highlighted checking/reassurance, research, or body monitoring, that means your presenting problem likely includes:
“high threat + high certainty-seeking.”
2) Predisposing factors (vulnerabilities)
These are not “causes.” They’re factors that can make a person more vulnerable to health anxiety.
Common predisposing factors include:
- early experiences of illness or medical trauma
- loss/bereavement related to health
- a family culture of health worry
- previous anxiety/panic history
- high responsibility, perfectionism, or a strong need to do things “properly”
If you ticked any predisposing factors, it doesn’t mean you’re broken. It means your brain learned early that health uncertainty is important.
3) Precipitating factors (what triggered this episode)
This is often the “spark” that lit the cycle again:
- a new symptom or change
- a health scare
- a test, appointment, or waiting for results
- hearing about someone else’s illness
- stress, burnout, hormonal changes, postpartum shifts
- increased exposure to health content online
A key insight: the trigger is not the problem.
The problem is the loop that gets built around the trigger.
4) Perpetuating factors (what keeps it going)
This is the heart of your assessment results.
Perpetuating factors are the processes that keep the anxiety “fed,” like:
- checking & reassurance
- Googling/research
- selective attention to the body
- avoidance & safety strategies
- intolerance of uncertainty
- catastrophic meaning & rumination
Your test identified your primary and secondary maintaining patterns. That’s incredibly useful, because it tells you where treatment will have the biggest impact.
Most people try to solve health anxiety with more certainty.
But health anxiety improves by changing process:
- reducing safety behaviours
- retraining attention
- learning to hold uncertainty safely
- building behavioural evidence for Theory B
5) Protective factors (what helps you recover)
This is where hope lives, clinically.
Protective factors include:
- supportive people
- a trusted GP/clinician
- routine and structure
- movement and sleep regulation
- coping skills you’ve used before
- meaning/purpose/values
- motivation to change
If you have protective factors, you have leverage.
How I’d use the 5 Ps with your test
If you were with me in session, I’d do this:
- We name the presenting problem in one sentence.
- We identify the maintenance loop (your primary/secondary factors).
- We decide: “Which one behaviour change will give the biggest return?”
- We account for context (stress, recent illness exposure, life load).
- We build a plan that uses your protective factors.
That is exactly what a good course or therapy process does: it takes a map and turns it into action.
Start the Health Anxiety Course
