The WI-7 is a seven-item self-report screen for health anxiety - persistent worry about having or developing a serious illness, preoccupation with bodily symptoms, and difficulty accepting medical reassurance. It is the most widely used short form of the Whiteley Index, the oldest established measure of hypochondriacal worry.
It screens and monitors; it does not diagnose illness anxiety disorder or somatic symptom disorder, which require clinical assessment against DSM-5 or ICD-11 criteria. It also does not measure the somatic symptom burden itself - that is the job of instruments like the PHQ-15 or SSS-8.
02 - Origin & purpose
Where it comes from.
The original 14-item Whiteley Index was published by Issy Pilowsky in 1967 in the British Journal of Psychiatry, derived by testing items against clinician definitions of hypochondriasis in psychiatric patients. Per Fink and colleagues at Aarhus derived the seven-item version in 1999 using latent structure analysis in primary-care and neurological in-patients, seeking a brief screen for hypochondriasis and somatization suitable for routine settings.
The WI-7 has since become a standard screening and outcome measure in research on health anxiety and functional disorders, particularly in Scandinavian primary-care research, and is attractive in clinical practice because of its brevity.
03 - Scoring & cutoffs
How scoring works.
The seven items are scored either in the original dichotomous yes/no format (total 0-7) or, in later versions, on five-point Likert-type scales, and results are not interchangeable between formats - published cut-points depend on the response format and setting. In Fink's primary-care validation using dichotomous scoring against ICD-10 somatoform-disorder diagnoses, a very low threshold (any positive answer) captured essentially all cases at the cost of specificity, while later work identified more balanced cut-points; services should adopt the threshold from the validation closest to their own population and administration format. Higher scores indicate greater illness worry, and the scale is used to track change during treatment for health anxiety.
04 - Validation evidence
How well it performs.
In the 1999 derivation study the WI-7 emerged as a psychometrically sound one-dimensional scale and has repeatedly been described as the most robust short Whiteley form for screening in primary care. Reported internal consistency varies by sample: around α 0.68 in Western clinical samples and 0.59 in community samples, with 0.73 reported in a Hong Kong general-population study - modest figures that reflect the brevity and mixed content (illness worry, bodily preoccupation, reassurance-seeking). A single-factor model has generally described the data better than multi-factor alternatives.
7
ITEMS (FROM THE ORIGINAL 14)
α ≈ 0.68
INTERNAL CONSISTENCY, WESTERN CLINICAL SAMPLES
α ≈ 0.59–0.73
INTERNAL CONSISTENCY, COMMUNITY SAMPLES
1.00
SENSITIVITY AT LOWEST CUT-POINT VS ICD-10 SOMATOFORM DISORDERS (FINK 1999; SPECIFICITY 0.65)
05 - How it compares
How it compares to the alternatives.
Instrument
Items
Time
When to reach for it
WI-7
7
~2 min
Brief health-anxiety screen and change measure; licensing unverified, so we do not reproduce the items.
Whiteley Index (WI-14)
14
~4 min
The original 1967 version; more content coverage, same caveats.
SHAI (Short Health Anxiety Inventory)
18
~5–10 min
Fuller cognitive measure of health anxiety with severity gradations; commonly used in CBT trials.
Somatic symptom burden with validated severity bands; free, calculator on this site.
06 - When to use it
Right tool, wrong tool.
The WI-7 is intended as a brief screen for health anxiety in primary care and general psychiatry, and as a change measure during treatment for health anxiety. A high score indicates that a fuller assessment of illness worry, reassurance-seeking and functional impact is warranted - it does not establish a diagnosis.
Reach for it when
-Screening for health anxiety in primary care or general psychiatry.
-Tracking illness worry during treatment for health anxiety.
-Research continuity where the Whiteley Index is the established measure.
Reach for something else when
-Diagnosing illness anxiety disorder or somatic symptom disorder.
-Measuring somatic symptom burden - use the PHQ-15 or SSS-8.
-Comparing scores across services that use different response formats.
-Any use requiring reproduction of the items until licensing is clarified.
07 - Confidence & precision
Reading the score with care.
No SEM or minimal important change has been established for the WI-7. Internal consistency in the 0.6-0.7 range means individual score changes of a point or two are within measurement noise; interpret trends over several administrations rather than single-point shifts, and anchor decisions in the clinical picture.
08 - Limitations
What it cannot tell you.
Published cut-points vary with response format (dichotomous vs Likert) and setting, so no single threshold can be quoted as standard; internal consistency is modest, particularly in community samples; the item content reflects 1960s conceptions of hypochondriasis and predates DSM-5's split into illness anxiety disorder and somatic symptom disorder; high scores occur in people with genuine serious illness, where "excessive" worry is a clinical judgement; and the licensing position of the item text is unclear, which is why this page does not include the questionnaire.
09 - Licensing, explained
How licensing works.
The Whiteley Index item text is not reproduced here. The original items were published in the British Journal of Psychiatry (1967) and we have not verified a free-use licence; clinicians should consult the original publications for the instrument itself.
Because the licensing position is unclear, this page is an information resource: it explains scoring, interpretation and evidence, but contains no WI-7 item text, no questionnaire and no calculator. Where a free, clearly licensed measure will do, the SSS-8 and PHQ-15 are available with calculators on this site - though they measure somatic symptom burden rather than illness worry.
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