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Wang D, Sun L, Shao Y, Zhang X, Maguire P, Hu Y. Research and Evaluation of a Cyberchondria Severity Scale in a Chinese Context. Psychol Res Behav Manag 2023; 16:4417-4429. [PMID: 37936970 PMCID: PMC10626044 DOI: 10.2147/prbm.s431470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/14/2023] [Indexed: 11/09/2023] Open
Abstract
Purpose Cyberchondria is a problematic or unhelpful behavior pattern that describes excessive or repetitive online health-related information searching related to an enhanced level of health anxiety. Such internet-derived medical anxiety can manifest itself in different ways across cultures. This study explores the unique nature of cyberchondria in the context of Chinese culture, identifying the risk factors for the condition and the possible negative outcomes. Methods An exploratory factor analysis (EFA) was used to explore whether the structure of the Chinese version of the Cyberchondria Severity Scale (C-CSS) is different from that in western context. Subsequently, a confirmatory factor analysis (CFA) was used to verify the model fit of the C-CSS. Finally, a series of regression analysis were used to test the relationship between cyberchondria and its antecedent variables and consequence variables in Chinese context. Results Retained 18 items and revised to 3 dimensions (Negative Effects, Excessiveness and Reassurance Seeking), the Chinese version of the Cyberchondria Severity Scale (C-CSS) was developed. In the context of China, the three antecedents were also effective predictors of cyberchondria, and C-CSS is also related to theoretically relevant outcomes. Conclusion This study initially demonstrated the validity, reliability and applicability of C-CSS to assess the severity of cyberchondria among Chinese undergraduates.
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Affiliation(s)
- Dawei Wang
- School of Psychology, Shandong Normal University, Ji’nan, Shandong, People’s Republic of China
| | - Lingchao Sun
- School of Psychology, Shandong Normal University, Ji’nan, Shandong, People’s Republic of China
| | - Yunru Shao
- School of Psychology, Shandong Normal University, Ji’nan, Shandong, People’s Republic of China
| | - Xiaoyan Zhang
- School of Psychology, Shandong Normal University, Ji’nan, Shandong, People’s Republic of China
| | - Phil Maguire
- Department of Computer Science, National University of Ireland, Galway, Ireland
| | - Yixin Hu
- School of Psychology, Shandong Normal University, Ji’nan, Shandong, People’s Republic of China
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Duradoni M, Gursesli MC, Fiorenza M, Guazzini A. The Relationship between Orthorexia Nervosa and Obsessive Compulsive Disorder. Eur J Investig Health Psychol Educ 2023; 13:861-869. [PMID: 37232703 DOI: 10.3390/ejihpe13050065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/14/2023] [Accepted: 05/15/2023] [Indexed: 05/27/2023] Open
Abstract
Orthorexia nervosa (ON) is characterized by an intense avoidance of foods considered unhealthy, obsession with healthy eating behaviors, and pathological fixation on healthy foods. Although there are still debates in the literature about the psychological factors and symptoms of ON, it should be noted that many of the symptoms share common features with obsessive compulsive disorder (OCD). The aim of the present study was to investigate the relationship between ON and OCD with its subtypes. In this framework, the cross-sectional study was conducted with an opportunistic sample of 587 participants (86% women and 14% men), with an average age of 29.32 (s.d. = 11.29; age range = 15-74). Our work showed that almost all OCD subtypes were largely correlated with ON. The lowest correlation was for "Checking" and the highest for "Obsession". Overall, the OCD subtypes (i.e., Indecisiveness, Just Right, Obsession, and Hoarding) were more strongly associated with ON measures, while subtypes Checking and Contamination, although positively associated, had lower correlation coefficients.
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Affiliation(s)
- Mirko Duradoni
- Department of Education, Literatures, Intercultural Studies, Languages and Psychology, University of Florence, 50135 Firenze, Italy
| | - Mustafa Can Gursesli
- Department of Education, Literatures, Intercultural Studies, Languages and Psychology, University of Florence, 50135 Firenze, Italy
- Department of Information Engineering, University of Florence, 50139 Firenze, Italy
| | - Maria Fiorenza
- Department of Education, Literatures, Intercultural Studies, Languages and Psychology, University of Florence, 50135 Firenze, Italy
| | - Andrea Guazzini
- Department of Education, Literatures, Intercultural Studies, Languages and Psychology, University of Florence, 50135 Firenze, Italy
- Centre for the Study of Complex Dynamics, University of Florence, 50135 Firenze, Italy
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Yıldız M, Demirhan A, Gökçay G, Polat F. The relationship between cyberchondria levels, attitudes towards menopause and menopausal complaints of women in the climacteric period: Analysis with data mining. Women's Studies International Forum 2023. [DOI: 10.1016/j.wsif.2023.102701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
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Rossi AA, Panzeri A, Taccini F, Parola A, Mannarini S. The Rising of the Shield hero. Development of the Post-Traumatic Symptom Questionnaire (PTSQ) and Assessment of the Protective Effect of self-esteem from trauma-related Anxiety and Depression. J Child Adolesc Trauma 2022; 17:1-19. [PMID: 36532142 PMCID: PMC9734448 DOI: 10.1007/s40653-022-00503-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/18/2022] [Indexed: 06/17/2023]
Abstract
Background Adverse life events such as life-threatening accidents, domestic and/or sexual violence, organic diseases (i.e., cancer), or COVID-19 can have a strong traumatic impact - generating reactions as intrusive thoughts, hyperarousal, and avoidance. Indeed, the traumatic impact of COVID-19 seems to lead individuals to experience anxiety and depression. However, the Anxiety-Buffer Hypothesis suggests that self-esteem could be considered a shield (buffer) against traumatic experiences and their outcomes (i.e., anxiety and depression). The present study has two objectives. First, to develop a measure of the impact of the traumatic event considering the aforementioned reactions. Second, to test the process - triggered by COVID19-related traumatic experience - in which self-esteem buffers the path that leads to anxiety and depression. Method In Study 1 (N = 353), the Post-Traumatic Symptom Questionnaire (PTSQ) was developed and a deep investigation of its psychometric properties was conducted. In Study 2 (N = 445), a structural equation model with latent variables was performed to assess the buffering effect of self-esteem. Results The PTSQ has excellent fit indices and psychometric properties. According to the ABH, results confirm the buffering effect of self-esteem in the relationships between traumatic symptoms and both anxiety and depression. Conclusion On the one hand, the PTSQ is a solid and reliable instrument. On the other hand, that self-esteem is a protective factor against anxiety and depression related to a traumatic experience - such as COVID-19. Targeted psychological interventions should be implemented to minimize the psychological burden of the illness while promoting adaptation and positive aspects of oneself. Supplementary Information The online version contains supplementary material available at 10.1007/s40653-022-00503-z.
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Affiliation(s)
- Alessandro Alberto Rossi
- Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padova, Italy
- Interdepartmental Center for Family Research, University of Padova, Padova, Italy
| | - Anna Panzeri
- Department of General Psychology, University of Padova, Padova, Italy
| | - Federica Taccini
- Interdepartmental Center for Family Research, University of Padova, Padova, Italy
- Department of Developmental Psychology and Socialisation, University of Padova, Padova, Italy
| | - Anna Parola
- Department of Humanities, University of Naples Federico II, Naples, Italy
| | - Stefania Mannarini
- Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padova, Italy
- Interdepartmental Center for Family Research, University of Padova, Padova, Italy
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Ciułkowicz M, Misiak B, Szcześniak D, Grzebieluch J, Maciaszek J, Rymaszewska J. Social Support Mediates the Association between Health Anxiety and Quality of Life: Findings from a Cross-Sectional Study. Int J Environ Res Public Health 2022; 19:12962. [PMID: 36232258 PMCID: PMC9566112 DOI: 10.3390/ijerph191912962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 09/28/2022] [Accepted: 10/04/2022] [Indexed: 06/16/2023]
Abstract
This study aimed to test if perceived social support and cyberchondria mediate the association between health anxiety and quality of life (QoL) in a nonclinical sample. Cross-sectional research involved adult internet users (n = 538) between 16 May 2020 and 29 December 2020 in Poland who completed self-report questionnaires, including the cyberchondria severity scale (CSS-PL), the short health anxiety inventory (SHAI), the multidimensional scale of perceived social support (MSPSS) and the quality of life scale (QOLS). A mediation analysis was performed to examine the direct effects of health anxiety on cyberchondria, perceived social support and quality of life. Likewise, the effects of cyberchondria and perceived social support on QoL were analyzed. Hence, indirect effects of health anxiety on QoL through cyberchondria and perceived social support were explored. Health anxiety significantly impaired QoL both directly and indirectly through low-perceived social support. Perceived social support partly mediated the association between health anxiety and QoL. Cyberchondria did not have a significant direct effect on the latter. Thus, cyberchondria did not mediate the relationship between health anxiety and QoL. Boosting-perceived social support may mitigate the detrimental effect of health anxiety on QoL. Cyberchondria was not found to have a significant effect on QoL in contrast to health anxiety alone.
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Affiliation(s)
- Marta Ciułkowicz
- Department of Psychiatry, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Błażej Misiak
- Department of Psychiatry, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Dorota Szcześniak
- Department of Psychiatry, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Jolanta Grzebieluch
- Department of Population Health, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Julian Maciaszek
- Department of Psychiatry, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Joanna Rymaszewska
- Department of Psychiatry, Wroclaw Medical University, 50-367 Wroclaw, Poland
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Abstract
To determine the effect of COVID-19 fear on the stress of the individuals, and to investigate the mediating role of cyberchondria on this effect. The population of the present study consisted of the individuals 18 years of age or older who were resident in the Bursa province of Turkey. The research enrolled 425 individuals who agreed to complete the questionnaire. The questionnaire, which consists of four sections including, (1) sociodemographic characteristics; (2) fear of COVID-19 scale; (3) short cyberchondria scale; and (4) perceived stress scale, was used to collect data in the study. Descriptive statistical methods and path analysis were used for data analysis. Fear of COVID-19 has a significant effect on perceived stress/distress which is mediated by cyberchondria. However, fear of COVID-19 does not have a significant effect on perceived insufficient self-efficacy. Similarly, cyberchondria does not have a mediating role in this effect. Reliable and accurate information resources should be presented about COVID-19; the individuals should adopt behaviors that would improve their health; and getting professional help should be encouraged for those with psychological problems. Otherwise, fear of COVID-19 causes perceived stress/distress to the individuals.
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Affiliation(s)
- Ayhan Durmuş
- Health Care Management Department, Sakarya Business School, Sakarya University, Sakarya, Turkey
| | - Serkan Deniz
- Management and Organization, Termal Vocational School, Yalova University, Yalova, Turkey
| | - Mahmut Akbolat
- Health Care Management Department, Sakarya Business School, Sakarya University, Sakarya, Turkey
| | - Mesut Çimen
- Health Care Management Department, Faculty of Health Science, Acıbadem Mehmet Ali Aydınlar University, İstanbul, Turkey
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Keller FM, Derksen C, Kötting L, Dahmen A, Lippke S. Distress, loneliness, and mental health during the COVID-19 pandemic: Test of the extension of the Evolutionary Theory of Loneliness. Appl Psychol Health Well Being 2022; 15:24-48. [PMID: 35266309 PMCID: PMC9111432 DOI: 10.1111/aphw.12352] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 02/12/2022] [Accepted: 02/15/2022] [Indexed: 01/18/2023]
Abstract
COVID-19 restrictions such as lockdowns or quarantines may increase the risk for social isolation and perceived loneliness. The mechanisms can be modeled by Cacioppo's Evolutionary Theory of Loneliness (ETL), which predicts that a lack of perceived social connectedness may lead, in the long-term, to mental and physical health consequences. However, the association between COVID-19 pandemic distress, mental health, and loneliness is not sufficiently understood. The present longitudinal study examined the relationship between distress and depression, and the mediating effects of anxiety and loneliness in a German rehabilitation sample (N = 403) at two timepoints (≤6 weeks pre-rehabilitation; ≥12 weeks post-rehabilitation; mean time between T1 and T2 was 52 days). Change scores between T1 and T2 were examined for the variables COVID-19 Peritraumatic Distress Index (CPDI), anxiety, loneliness, and depression. The results of the serial mediation analysis indicated that anxiety and loneliness were able to explain the relationship between distress and depression with 42% of variance in depression accounted for. Findings extend research on the relationship between COVID-19 and mental health by considering anxiety and loneliness as sustaining factors of depressive symptoms, thus, successfully applying the ETL. Results stress the necessity to consider anxiety and loneliness in the treatment or prevention of depression.
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Affiliation(s)
| | | | | | - Alina Dahmen
- Jacobs University Bremen gGmbHBremenGermany,Dr. Becker KlinikgruppeKölnGermany,Klinikum WolfsburgWolfsburgGermany
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Airoldi S, Kolubinski DC, Nikčević AV, Spada MM. The relative contribution of health cognitions and metacognitions about health anxiety to cyberchondria: A prospective study. J Clin Psychol 2021; 78:809-820. [PMID: 34559886 DOI: 10.1002/jclp.23252] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 08/30/2021] [Accepted: 09/08/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Cyberchondria involves the excessive and compulsive use of the Internet to search for health information. The present study investigated the relative contribution of health cognitions and metacognitions about health anxiety to prospective cyberchondria scores, controlling for health anxiety and hours spent online per day. METHODS A convenience sample of 221 participants was recruited for the purpose of this study with a final sample totaling 125 participants (58.4% females, Mage = 34.51 years) who completed the full survey at baseline (T0 ) and a measure of cyberchondria after 30 days (T1 ). RESULTS The results of the study showed that metacognition about health anxiety relating to beliefs about the uncontrollability of thoughts was the only significant predictor of prospective cyberchondria scores when controlling for health anxiety. CONCLUSIONS These results offer further support to the role of beliefs about the uncontrollability of thoughts in cyberchondria. The implications of the findings are discussed.
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Affiliation(s)
- Sofia Airoldi
- Division of Psychology, School of Applied Sciences, London South Bank University, London, UK
| | - Daniel C Kolubinski
- Division of Psychology, School of Applied Sciences, London South Bank University, London, UK
| | - Ana V Nikčević
- Department of Psychology, Kingston University, Kingston Upon Thames, UK
| | - Marcantonio M Spada
- Division of Psychology, School of Applied Sciences, London South Bank University, London, UK
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Rossi A, Panzeri A, Pietrabissa G, Manzoni GM, Castelnuovo G, Mannarini S. The Anxiety-Buffer Hypothesis in the Time of COVID-19: When Self-Esteem Protects From the Impact of Loneliness and Fear on Anxiety and Depression. Front Psychol 2020; 11:2177. [PMID: 33240140 PMCID: PMC7683508 DOI: 10.3389/fpsyg.2020.02177] [Citation(s) in RCA: 91] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 08/03/2020] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION The coronavirus (COVID-19) disease has spread worldwide, generating intense fear of infection and death that may lead to enduring anxiety. At the same time, quarantine and physical isolation can intensify feelings of dispositional loneliness that, by focusing on thoughts of disconnection from others, can trigger intense anxiety. Anxiety, generated by both fear of COVID-19 and dispositional loneliness, can activate negative expectations and thoughts of death, potentially generating alarming depressive symptoms. However, the anxiety-buffer hypothesis suggests that self-esteem acts as a shield (buffer) against mental health threats - fear and loneliness - thus hampering anxiety and depressive symptoms. OBJECTIVE This study aims to test the process - triggered by COVID-19 fear and loneliness - in which self-esteem should buffer the path leading to anxiety symptoms, then to depression. METHODS An observational research design with structural equation models was used. A sample of 1200 participants enrolled from the general population answered an online survey comprising: the fear of COVID-19 scale, the UCLA loneliness scale, the Rosenberg self-esteem scale, and the anxiety and depression scales of the Symptom Checklist-90-Revised. RESULTS Structural equation models showed the link between anxiety symptoms (mediator) with both the fear of COVID-19 and dispositional loneliness (predictors), as well as its association with consequent depressive symptomatology (outcome). In line with the anxiety-buffer hypothesis, self-esteem mediated the relationship between the predictors and their adverse psychological consequences. CONCLUSION Self-esteem represents a protective factor from the antecedents of depression. Targeted psychological interventions should be implemented to minimize the psychological burden of the disease whilst promoting adaptation and positive psychological health outcomes.
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Affiliation(s)
- Alessandro Rossi
- Section of Applied Psychology, Department of Philosophy, Sociology, Education, and Applied Psychology, University of Padua, Padua, Italy
- Interdepartmental Center for Family Research, University of Padua, Padua, Italy
| | - Anna Panzeri
- Unit of Psychology and Neuropsychology, Maugeri Scientific Institutes IRCCS, Novara, Italy
| | - Giada Pietrabissa
- Psychology Research Laboratory, Ospedale San Giuseppe, IRCCS, Istituto Auxologico Italiano, Verbania, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Gian Mauro Manzoni
- Psychology Research Laboratory, Ospedale San Giuseppe, IRCCS, Istituto Auxologico Italiano, Verbania, Italy
- Department of Psychology, eCampus University, Novedrate, Italy
| | - Gianluca Castelnuovo
- Psychology Research Laboratory, Ospedale San Giuseppe, IRCCS, Istituto Auxologico Italiano, Verbania, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Stefania Mannarini
- Section of Applied Psychology, Department of Philosophy, Sociology, Education, and Applied Psychology, University of Padua, Padua, Italy
- Interdepartmental Center for Family Research, University of Padua, Padua, Italy
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Chan CHY, Lau BHP, Chan THY, Leung HT, So GYK, Chan CLW. Examining the Moderating Role of Patient Enablement on the Relationship Between Health Anxiety and Psychosomatic Distress: A Cross-Sectional Study at a Traditional Chinese Medicine Outpatient Clinic in Hong Kong. Front Psychol 2020; 11:1081. [PMID: 32655430 PMCID: PMC7325961 DOI: 10.3389/fpsyg.2020.01081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 04/28/2020] [Indexed: 11/13/2022] Open
Abstract
Background Little research effort has been devoted to examining the role of patient enablement in alleviating health anxiety in primary care. In this study, we examined the role of patient enablement as a moderator in the relationship between health anxiety, psychological distress, and treatment seeking in traditional Chinese medicine (TCM). Methods The participants were 634 patients of a government-subsidized Chinese medicine outpatient clinic in Hong Kong. They were asked to complete a series of questionnaires on patient enablement, health anxiety, anxiety, depression, physical distress, annual clinic visits, and service satisfaction and provided various demographic details. Descriptive statistics, correlations, and general linear models were used to analyze the data. Results We found that patient enablement correlated positively with service satisfaction. Patient enablement also interacted significantly with health anxiety in affecting indices of psychological distress (depression, anxiety) and treatment seeking (annual visits). Among highly enabled patients, the positive association between health anxiety and indices of psychological distress was weakened, and they also showed more health anxiety-driven treatment seeking as measured by annual clinic visits. Conclusion These findings suggest a moderating mechanism by which patient enablement weakens the relationship between health anxiety on psychological well-being and increases treatment-seeking behavior in TCM. Practitioners are encouraged to provide sufficient information to patients to foster self-care and disease self-management using complementary and alternative medicine (CAM).
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Affiliation(s)
- Celia H Y Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Bobo H P Lau
- Department of Counselling and Psychology, Hong Kong Shue Yan University, North Point, Hong Kong
| | - Timothy H Y Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - H T Leung
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Georgina Y K So
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Cecilia L W Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
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Brown RJ, Skelly N, Chew-Graham CA. Online health research and health anxiety: A systematic review and conceptual integration. ACTA ACUST UNITED AC 2020. [DOI: 10.1111/cpsp.12299] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Vismara M, Caricasole V, Starcevic V, Cinosi E, Dell'Osso B, Martinotti G, Fineberg NA. Is cyberchondria a new transdiagnostic digital compulsive syndrome? A systematic review of the evidence. Compr Psychiatry 2020; 99:152167. [PMID: 32146315 DOI: 10.1016/j.comppsych.2020.152167] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 02/06/2020] [Accepted: 02/10/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Cyberchondria (CYB) has been described relatively recently as a behaviour characterized by excessive online searching for medical information that is associated with increasing levels of health anxiety. Although CYB has received some attention from researchers, there is no consensus about many of its aspects. AIMS We describe one of the first reported cases of a treatment-seeking patient with CYB. We review the published literature on the definition of CYB, its assessment, epidemiology, cost and burden, psychological models and mechanisms associated with CYB, relationships between CYB and mental disorders and prevention and treatment strategies. METHODS Systematic review of all peer-reviewed papers published within the PubMed, PsycINFO, and Cochrane Library databases. RESULTS 61 articles were selected. Nearly all the studies were descriptive and cross-sectional recruiting sample mainly from the general/university student population and collecting self-report data via online surveys. Data on epidemiology, clinical features, course, comorbidity and therapeutic interventions were scarce. CYB showed a self-reported association with health anxiety, hypochondriasis and obsessive-compulsive disorder (OCD) as well as other forms of problematic usage of the internet (PUI) The psychological mechanisms associated with CYB include low self-esteem, anxiety sensitivity, intolerance of uncertainty, pain catastrophizing and certain meta-cognitive beliefs. CONCLUSION A working definition of CYB includes excessive online health searches that are compulsive and may serve the purpose of seeking reassurance, whilst leading to a worsening of anxiety or distress and further negative consequences. CYB represents a clinically relevant transdiagnostic compulsive behavioural syndrome, closely related to PUI and usually presenting in association with health anxiety, hypochondriasis and/or OCD. CYB is clearly in need of further study and we identify key areas for future research.
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Affiliation(s)
- Matteo Vismara
- University of Milan, Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, Milan, Italy.
| | - Valentina Caricasole
- University of Milan, Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, Milan, Italy
| | - Vladan Starcevic
- Faculty of Medicine and Health, Sydney Medical School, Nepean Clinical School, Discipline of Psychiatry, University of Sydney, Sydney, Australia; Department of Psychiatry, Nepean Hospital, Penrith, NSW, Australia
| | - Eduardo Cinosi
- Hertfordshire Partnership University NHS Foundation Trust, Rosanne House, Welwyn Garden City, Hertfordshire, UK; University of Hertfordshire, Hatfield, UK
| | - Bernardo Dell'Osso
- University of Milan, Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, Milan, Italy; Department of Psychiatry and Behavioral Sciences, Bipolar Disorders Clinic, Stanford University, CA, USA; "Aldo Ravelli" Center for Neurotechnology and Brain Therapeutic, University of Milan, Milan, Italy
| | - Giovanni Martinotti
- University G. D'Annunzio University, Department of Neuroscience, Imaging, Clinical Sciences, Chieti-Pescara, Italy
| | - Naomi A Fineberg
- Hertfordshire Partnership University NHS Foundation Trust, Rosanne House, Welwyn Garden City, Hertfordshire, UK; University of Hertfordshire, Hatfield, UK
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Starcevic V. Cyberchondria: Challenges of Problematic Online Searches for Health-Related Information. Psychother Psychosom 2018; 86:129-133. [PMID: 28490037 DOI: 10.1159/000465525] [Citation(s) in RCA: 97] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 02/25/2017] [Indexed: 11/19/2022]
Affiliation(s)
- Vladan Starcevic
- Sydney Medical School, University of Sydney, and Department of Psychiatry, Nepean Hospital, Sydney, NSW, Australia
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14
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Te Poel F, Baumgartner SE, Hartmann T, Tanis M. The curious case of cyberchondria: A longitudinal study on the reciprocal relationship between health anxiety and online health information seeking. J Anxiety Disord 2016; 43:32-40. [PMID: 27497667 DOI: 10.1016/j.janxdis.2016.07.009] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 07/20/2016] [Accepted: 07/28/2016] [Indexed: 11/21/2022]
Abstract
The current study is the first to longitudinally investigate the reciprocal relationship between online health information seeking and health anxiety, i.e., cyberchondria. Expectations were that health anxious individuals who go online to find health information, experience an increase in health anxiety, which in turn will reinforce online seeking. A 4-wave longitudinal survey study among 5322 respondents aged 16-93 was conducted. Our results showed that individuals who are more health anxious than others, search online for health information more. Moreover, the results provided initial evidence for the expected reciprocal relationship between health anxiety and online health information seeking in respondents with non-clinical levels of health anxiety at the start of the study. However, this reciprocal relationship could not be found in a subsample of clinically health anxious individuals. Although for these individuals online health information seeking did not seem to exacerbate health anxiety levels, it might still serve as a maintaining factor of clinical health anxiety.
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Silva FGD, Andrade R, Silva I, Cardoso A. Cross-cultural adaptation of the Cyberchondria Severity Scale for Brazilian Portuguese. Trends Psychiatry Psychother 2016; 38:90-5. [DOI: 10.1590/2237-6089-2015-0063] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 01/14/2016] [Indexed: 11/22/2022]
Abstract
Abstract Introduction: The internet has proven to be a valuable resource for self-care, allowing access to information and promoting interaction between professionals, caregivers, users of health care services and people interested in health information. However, recurring searches are often related to excessive health anxiety and a phenomenon known as cyberchondria can have impacts on physical and mental health. Within this background, a Cyberchondria Severity Scale has been developed to differentiate healthy and unhealthy behavior in internet searches for health information, based on the following criteria: compulsion, distress, excesses, and trust and distrust of health professionals. Objective: To conduct cross-cultural adaptation of the Cyberchondria Severity Scale for Brazilian Portuguese, because of the lack of an appropriate instrument for Brazil. Methods: This study was authorized by the original author of the scale. The process was divided into the following four steps: 1) initial translation, 2) back-translation, 3) development of a synthesized version, and 4) experimental application. Results: Translation into Brazilian Portuguese required some idiomatic expressions to be adapted. In some cases, words were not literally translated from English into Portuguese. Only items 7, 8, 12, 23 and 27 were altered, as a means of both conforming to proper grammar conventions and achieving easy comprehension. The items were rewritten without loss of the original content. Conclusion: This paper presents a translated version of the Cyberchondria Severity Scale that has been semantically adapted for the Brazilian population, providing a basis for future studies in this area, which should in turn contribute to improved understanding of the cyberchondria phenomenon in this population.
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Abstract
Objectives It is often reported by medical practitioners that medical students develop hypochondriacal concerns and symptoms relating to diseases they are studying, a phenomenon labelled ‘medical student syndrome’. However, the evidence that this syndrome exists and particularly that it contributes to an increased number of consultations (as typical hypochondriasis does) is weak. The present study investigates this phenomenon in terms of differences between medical and non-medical students in help-seeking behaviour. Design Cross-sectional survey. Setting Three universities in London. Participants Medical students (n = 103), non-medical science student controls (n = 107) and law student controls (n = 78), all third-year undergraduates, were recruited from within their universities. Main outcome measures Help-seeking behaviour was measured using the ‘Health Anxiety Questionnaire’ reassurance-seeking behaviour subscale; the overall number of doctors’ visits made for new health complaints since beginning university; a new ‘Hypochondriacal and Help-Seeking Behaviour’ scoring-system, which asked questions pertaining to not just the number but the nature of consultations, identifying participants who had experienced health concerns that were disproportionate to the diseases diagnosed. Results No significant differences were found between medical students and either control group in any of the main outcome variables. Conclusions These findings fail to support the notion that medical students, more so than other students, seek medical advice for hypochondriacal health concerns. They are pertinent to clinicians due to the potentially negative consequences of incorrectly assuming medical students to behave in this way, including cursory evaluations and disintegration of the doctor–patient relationship.
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Starcevic V, Berle D. Cyberchondria: towards a better understanding of excessive health-related Internet use. Expert Rev Neurother 2014; 13:205-13. [DOI: 10.1586/ern.12.162] [Citation(s) in RCA: 199] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Affiliation(s)
| | - David Veale
- King's College London, UK; South London and Maudsley NHS Foundation Trust, UK
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Nakao M, Shinozaki Y, Nolido N, Ahern DK, Barsky AJ. Responsiveness of hypochondriacal patients with chronic low-back pain to cognitive-behavioral therapy. Psychosomatics 2012; 53:139-47. [PMID: 22424162 DOI: 10.1016/j.psym.2011.09.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Revised: 09/15/2011] [Accepted: 09/15/2011] [Indexed: 11/16/2022]
Abstract
BACKGROUND Evidence has suggested that cognitive-behavioral therapy (CBT) is effective in reducing hypochondriacal symptoms, and another line of evidence has suggested that CBT is also effective in reducing pain and the psychological conditions associated with chronic low-back pain (CLBP). The purpose of this study was to examine the effectiveness of CBT among hypochondriacal patients with and without CLBP. METHODS A total of 182 hypochondriacal patients were randomly assigned to a CBT or control group. The Somatic Symptom Inventory was used to define CLBP, and the Symptom Checklist 90R (SCL90R) was used to assess psychological symptoms. The outcome measures for hypochondriasis, the Whiteley Index (WI) and the Health Anxiety Inventory (HAI) were administered before the intervention and at 6 and 12 months after completion of the intervention. RESULTS In the total sample, both WI and HAI scores were significantly decreased after treatment in the CBT group compared with the control group. Ninety-three (51%) patients had CLBP; the SCL90R scores for somatization, depression, phobic anxiety, paranoid ideation, and general severity were significantly higher in CLBP(+) group than in the CLBP(-) group at baseline. Although the WI and HAI scores were significantly decreased after treatment in the CLBP(-) group, such significant pre- to post-changes were not found in the CLBP(+) group. CONCLUSIONS CBT was certainly effective among hypochondriacal patients without CLBP, but it appeared to be insufficient for hypochondriacal patients with CLBP. The core psychopathology of hypochondriacal CLBP should be clarified to contribute to the adequate management of hypochondriacal symptoms in CLBP patients.
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Affiliation(s)
- Mutsuhiro Nakao
- Division of Psychosomatic Medicine, Teikyo University Hospital, Tokyo, Japan.
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Takahashi Y, Ohura T, Ishizaki T, Okamoto S, Miki K, Naito M, Akamatsu R, Sugimori H, Yoshiike N, Miyaki K, Shimbo T, Nakayama T. Internet use for health-related information via personal computers and cell phones in Japan: a cross-sectional population-based survey. J Med Internet Res 2011; 13:e110. [PMID: 22169526 PMCID: PMC3278096 DOI: 10.2196/jmir.1796] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Revised: 07/27/2011] [Accepted: 08/26/2011] [Indexed: 12/15/2022] Open
Abstract
Background The Internet is known to be used for health purposes by the general public all over the world. However, little is known about the use of, attitudes toward, and activities regarding eHealth among the Japanese population. Objectives This study aimed to measure the prevalence of Internet use for health-related information compared with other sources, and to examine the effects on user knowledge, attitudes, and activities with regard to Internet use for health-related information in Japan. We examined the extent of use via personal computers and cell phones. Methods We conducted a cross-sectional survey of a quasi-representative sample (N = 1200) of the Japanese general population aged 15–79 years in September 2007. The main outcome measures were (1) self-reported rates of Internet use in the past year to acquire health-related information and to contact health professionals, family, friends, and peers specifically for health-related purposes, and (2) perceived effects of Internet use on health care. Results The prevalence of Internet use via personal computer for acquiring health-related information was 23.8% (286/1200) among those surveyed, whereas the prevalence via cell phone was 6% (77). Internet use via both personal computer and cell phone for communicating with health professionals, family, friends, or peers was not common. The Internet was used via personal computer for acquiring health-related information primarily by younger people, people with higher education levels, and people with higher household incomes. The majority of those who used the Internet for health care purposes responded that the Internet improved their knowledge or affected their lifestyle attitude, and that they felt confident in the health-related information they obtained from the Internet. However, less than one-quarter thought it improved their ability to manage their health or affected their health-related activities. Conclusions Japanese moderately used the Internet via personal computers for health purposes, and rarely used the Internet via cell phones. Older people, people with lower education levels, and people with lower household incomes were less likely to access the Internet via cell phone. The Internet moderately improved users’ health-related knowledge and attitudes but seldom changed their health-related abilities and activities. To encourage communication between health providers and consumers, it is important to improve eHealth literacy, especially in middle-aged people. It is also important to make adequate amendments to the reimbursement payment system and nationwide eHealth privacy and security framework, and to develop a collaborative relationship among industry, government, and academia.
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Affiliation(s)
- Yoshimitsu Takahashi
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
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Abstract
OBJECTIVE Somatoform disorders are common conditions, but the current diagnostic criteria are considered to be unreliable, based largely on medically unexplained symptoms. DSM-5 is considering other possible characteristics of somatizers including high utilization, dissatisfaction with care, and poor response to reassurance. This paper reviews the available literature for evidence to support these criteria, and evaluates if distinctive aspects of these characteristics exist in somatizers. METHODS The Pubmed database was searched combining terms such as “somatoform disorder” with “reassurance,” “satisfaction,” and “utilization.” Articles were individually inspected. RESULTS Many studies report a deficit in long-term response to reassurance in somatizers; there was some evidence that patients respond initially to reassurance, followed by return of anxiety, leading to further reassurance seeking. There was insufficient evidence to support poor satisfaction with care as a characteristic of somatizers. While there is no standard criterion for high utilization, regardless of definition, evidence was found to support over-utilization, particularly in outpatient visits. However, no unique pattern of utilization was found that could identify somatizers within a broader group of high utilizers. CONCLUSIONS This review revealed evidence of over-utilization in many areas of healthcare, as well as poor long term response to reassurance in somatizers. Dissatisfaction with care, though, was not a consistent finding. It is difficult to study alternative diagnostic criteria for somatoform patients when the current criteria rest on so many problematic assumptions. Future research should attempt to validate criteria empirically in patient groups, with selection not based on medically unexplained symptoms.
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Affiliation(s)
- Paul R Puri
- Department of Psychiatry, University of California, San Diego, CA, USA.
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Abstract
The aim of this study was to gain insight into people's drives, or motives, for seeking health information on the Internet. A systematic literature review, restricted to handbooks and reviews, was conducted by searching the databases of various disciplines. Each drive was translated into the context of health information. Five drives were retrieved from the fields of psychology, mass communication, library and information science, and medical science: drives regarding the retrieval of knowledge, social contact or support, tempering uncertainty, entertainment, and self-actualization. Based on these results, three hypotheses were generated for future research: (1) drives are interconnected and may be present simultaneously in the process of seeking information; (2) they not only serve as antecedents for the need for information, but are present throughout the entire information-seeking process; (3) they are subject to change throughout the information-seeking process. Various drives play a role in the health information-seeking process.
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Affiliation(s)
- Cécile R L Boot
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, NL-1081 BT, Amsterdam, The Netherlands.
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