The association between fear of Covid-19 and smartphone addiction among individuals: the mediating and moderating role of cyberchondria severity

Investigation of the effect of internet addiction on cyberchondria

This research was conducted to examine the effect of internet addiction on cyberchondria. The research is important to understand how today's digital technologies contribute to health-related concerns and affect individuals' perceptions of health. Quantitative research design was used in this research conducted in Konya, a metropolitan city in Turkey. The study was conducted using the convenience sampling method on 403 participants. In the research, 'Personal Information Form', 'Internet Addiction Scale' and 'Cyberchondria Scale' were used. The data were analyzed with the SPSS program. As an analysis method, upon determining that the data were normally distributed, t-test, ANOVA, Pearson correlation and simple linear regression analyzes were applied in independent groups. The majority of participants (69%) were female, 52.9% were between the ages of 18-27 and 53.8% were married. In terms of education level, 44.9% had a bachelor's degree or higher, and 59.6% earned minimum wage or less. Among the occupational groups, the largest proportion was students (31.5%), and their daily internet use was mostly 2-3 hours (44.4%). Internet is most frequently used for social media (47.4%) and news/agenda follow-up (25.1%). Within the scope of the research, internet addiction varies significantly according to the participants' age groups, education levels, professions, average daily internet usage time, and internet usage purposes; it was found that the cyberchondria levels of the participants showed significant differences according to the variables of income level, profession, daily internet usage time and internet use purpose. The research revealed a positive and significant relationship between the level of internet addiction and the level of cyberchondria. It has also been observed that internet addiction has a positive and significant effect on cyberchondria. These results show that cyberchondria tendencies become stronger with the increase in internet use among individuals.

Risk perception of COVID-19, depressive symptoms and Internet addiction among undergraduates: a longitudinal study

Background

The COVID-19 pandemic has caused serious negative psychological effects worldwide, relatively little research has been performed on the potential enduring effects of COVID-19 on people's emotional health and Internet addiction. This study was to examine the longitudinal associations between risk perception of COVID-19, depressive symptoms, and Internet addiction among Chinese undergraduates.

Methods

We conducted a two-wave longitudinal survey by convenience sampling, a total of 1,153 Chinese undergraduate students completed questionnaires measuring their COVID-19 risk perception and post-traumatic growth (PTG) in December 2022 (T1) via an online survey. Subsequently, 1,008 of the T1 participants (87.42%) completed the depressive symptoms scale and Internet addiction scale 6 months later, in June 2023 (T2).

Results

(1) Risk perception of COVID-19 was significantly and positively predicted depressive symptoms and Internet addiction 6 months later; (2) Depressive symptoms played a mediating role between risk perceptions and Internet addiction; (3) PTG moderated the first-stage link between risk perception and Internet addiction, and this relationship was more robust for low PTG than for high PTG.

Conclusion

These findings advance our understanding of the relationship and mechanisms between risk perception of COVID-19 and Internet addiction, and further support developing interventions to strengthen PTG for mitigating negative outcomes during major crises.

Gender Differences in the Longitudinal Linkages between Fear of COVID-19 and Internet Game Addiction: A Moderated Multiple Mediation Model

BACKGROUND

The COVID-19 outbreak has profoundly affected the psychological well-being of university students globally. Previous studies have found a positive longitudinal link between fear of COVID-19 (FoC-19) and internet addiction. However, there is a notable gap in the literature regarding COVID-19-specific predictors and underlying mechanisms of internet gaming addiction (IGA).

METHODS

Integrating the compensatory internet use theory and social role theory as frameworks, a three-wave longitudinal approach was used in this study to test the hypothesized model. Data spanning a duration of one year were gathered from undergraduate students in China. From 2021 to 2022, we conducted online self-report surveys in the midst of the COVID-19 pandemic to obtain participants' levels of FoC-19, loneliness, depressive symptoms, and IGA.

RESULTS

FoC-19 showed a longitudinal positive relationship with IGA. The longitudinal link between FoC-19 and IGA was mediated by loneliness and depression. Gender moderated the direct effect of FoC-19 on IGA, with this effect being significant only among male students and not among their female counterparts.

CONCLUSION

These findings advance our comprehension of the mechanisms and gender differences underlying the link between FoC-19 and IGA, and provide a novel perspective for interventions to reduce IGA.

A national survey of pandemic fear and cyberchondria after ending zero-COVID policy: The chain mediating role of alexithymia and psychological distress

BACKGROUND

More than half the domestic population in China were infected with COVID-19 in two months after ending "zero-infection policy", which severely overwhelmed frontline healthcare providers with stress and fear. However, there is no study to date investigating the associations between nurses' fear of pandemic and cyberchondria. This study aimed to 1) investigate the correlations between fear pandemic and cyberchondria among frontline nurses, and 2) discover its potential mechanism.

METHODS

A cross-sectional sample of frontline nurses (N = 8161) was recruited from 98 hospitals across China in February 2023. Participants were invited to complete an online, self-rated standardized questionnaire focused on pandemic fear, alexithymia, psychological distress, and cyberchondria. Environmental, clinical and socioeconomic information were collected for adjustment while conducting chain mediation analysis.

RESULTS

When other covariates were controlled, it was found that fear of the pandemic significantly contributed to cyberchondria (b = 0.58, 95%CI [0.56, 0.60], p < .001). The chain mediation model suggested that both alexithymia and psychological distress were mediating factors between pandemic fear and cyberchondria.

CONCLUSIONS

The higher the perceived fear, the greater the cyberchondria, which suggests that reducing fear about the pandemic and providing adequate support could reduce the incidence of cyberchondria. As alexithymia and psychological distress may be transdiagnostic mechanisms between fear and cyberchondria, targeted interventions focused on expression dysregulation and emotional identification could be useful.

Perceived stress of COVID-19 pandemic and problematic mobile phone use during quarantine conditions among Chinese adolescents: a mediated moderation model

The relation between perceived general stress and problematic mobile phone use (PMPU) has been well established. With the outbreak of the coronavirus disease (COVID-19), the present study was designed to examine the association between perceived stress of COVID-19 as a kind of event-related stress and PMPU, and the mechanisms underlying this relation. Participants were 724 adolescents ranging from 12 to 16 years old (M = 13.28, SD = 1.05) who completed four online questionnaires addressing perceived stress of COVID-19, search for meaning in life, escapism motivation, and PMPU. The results revealed that escapism motivation mediated the relationship between perceived stress of COVID-19 and PMPU. In addition, search for meaning in life played a moderating role between perceived stress of COVID-19 and escapism motivation. These findings extend the literature by addressing how and under what conditions perceived stress of COVID-19 can contribute to PMPU. We discussed the implications for developing targeted intervention programs aimed at reducing PMPU among adolescents.

COVID-19 victimization experience and university students' smartphone addiction: the mediating role of emotional intelligence

OBJECTIVES

During the post-COVID-19 era, everyone has the risk of contracting the virus and becoming the victims of COVID-19. Examining the relationship between the COVID-19 victimization experience and its effects is more urgent. The aim of present study is to propose a mediation model to investigate the association between COVID-19 victimization experience and smartphone addiction, and the mediating role of emotional intelligence.

METHODS

A online questionnaire including the COVID-19 Victimization Experience Scale, the Smartphone Addiction Scale, and the Emotional Intelligence Scale among Chinese university students, were employed in this study. Finally, 1154 valid questionnaires were collected. The reliability and confirmatory factor analysis results showed that all three scales had good reliability and validity.

RESULTS

Structural Equation Model (SEM) demonstrated that COVID-19 victimization experience significantly predicted smartphone addiction in university students, and emotional intelligence partially mediated the association between COVID-19 victimization experience and smartphone addiction. Bootstrap results furthermore tested the rigor of the mediating effect.

CONCLUSION

COVID-19 victimization experience was a important variables in predicting university students's martphone addiction, and emotional intelligence was a protective factor in decreasing the negative effect of COVID-19 victimization experience on addictive behaviors. It is suggested that instructors should integrate emotional intelligence training programs into mental health courses so as to improve students' emotional intelligence ability.

Increased psychological distress among young people before and during the fifth wave of COVID-19 after two years of pandemic in Hong Kong: a 6-month longitudinal study

BACKGROUND

Despite over two years of COVID-19 worldwide, the outbreak of the Omicron variant has given rise to an unprecedented surge of infection with diverse lockdown measures implemented globally. Whether the emergence of a new wave of COVID-19 could further affect mental health in the population after nearly two years of the pandemic remains to be addressed. Furthermore, whether changes in smartphone overuse behaviours and physical activity - both of which are particularly relevant to young people - would together contribute to changes in distress symptoms during this wave of COVID-19 was also examined.

METHODS

A total of 248 young people from an ongoing household-based epidemiological study in Hong Kong who completed their baseline assessments prior to the Omicron variant outbreak, i.e., fifth wave of COVID-19 (July-November 2021), were invited for a 6-month follow-up study during this wave of infection (January-April 2022) (mean age = 19.7 years, SD = 2.7; 58.9% females). At both time points, levels of global distress symptoms, perceived stress, smartphone overuse, frequency of engagement in vigorous physical activity, and other potential risk and protective factors were assessed.

RESULTS

The proportion of young people presenting moderate-to-severe distress (6-item Kessler Psychological Distress Scale ≥ 5) significantly increased from 45.6 to 54.4% during the fifth wave of COVID-19 (p < 0.010). Significantly increased levels of smartphone overuse and reduced days of vigorous physical activity were also observed during the fifth wave. Notably, increased smartphone overuse and reduced physical activity both additively and interactively contributed to elevated distress at 6 months, even after accounting for demographic characteristics, psychiatric history, childhood adversity, as well as baseline distress symptoms, resilience, and recent personal stressors.

CONCLUSIONS

The findings suggest that the emergence of a new wave of COVID-19, specifically the Omicron outbreak, can further aggravate mental distress even after a protracted period of the pandemic. Awareness of the dynamic nature of COVID-19 is necessitated to address the pressing mental health needs of populations. Supporting young people in healthier patterns of smartphone use and physical activity can be helpful.

Are Cyberchondria and Intolerance of Uncertainty Related to Smartphone Addiction?

Smartphones are a medium for performing online activities, and one such activity could be the compulsive online health information search - cyberchondria. This study aimed to test whether cyberchondria and intolerance of uncertainty (IU) positively predict smartphone addiction (SA), adjusted for age, gender, daily use duration, the reason for using smartphones, and symptoms of anxiety and depression. The sample consisted of 471 adults (55.2% women) from the general population without chronic diseases (Mage = 38.67). Regression analysis showed that IU was a positive predictor of SA (β = .17, p < .001), as well as cyberchondria (β = .14, p < .001), which had a unique contribution to the explanation of SA, relative to IU. Other significant predictors were average daily smartphone use and entertainment use, the latter being the strongest predictor in the model. These results revealed cyberchondria as a unique predictor of SA.

Cyberchondria: a Growing Concern During the COVID-19 Pandemic and a Possible Addictive Disorder?

Purpose of Review

The main purpose of this narrative review is to provide a brief overview of the current empirical evidence regarding the conceptualization, assessment, and treatment of cyberchondria, with a focus on the potential classification of cyberchondria as a behavioral addiction. Although cyberchondria has been widely associated with anxiety, it has also been suggested that it may be linked to obsessive-compulsive features. A less explored proposal is the categorization of cyberchondria as a behavioral addiction. The present review explores the existing literature with respect to the possible classification of cyberchondria as a behavioral addiction by considering cyberchondria with respect to components of the interaction of person, affect, cognition and execution model.

Recent Findings

There is a lack of consensus regarding the definition and conceptualization of cyberchondria. The empirical evidence available to date suggests that cyberchondria is a multifactorial construct that operates transdiagnostically, particularly with respect to obsessive-compulsive-related disorders and health-related anxiety. The extent to which the condition may reflect a behavioral addiction as a form of problematic use of the internet also warrants consideration. Cyberchondria may have become more prevalent during the COVID-19 pandemic, with particular populations prone to health-related anxiety likely having greater vulnerability. Existing data in part support the potential classification of cyberchondria as a behavioral addiction, although many gaps in understanding currently exist.

Summary

Cyberchondria appears to be a growing concern. However, there is not yet enough empirical evidence to determine whether this clinical condition has enough similarities with behavioral addictions to be considered as one. Likewise, psychometric instruments that exist to date have not been designed from the theoretical framework of behavioral addictions, so most of the factors that they evaluate may be preferentially related to anxiety. Finally, there is still no consensus on whether cyberchondria should be addressed in the context of health anxiety interventions, OCRD, or behavioral addictions; thus, more empirical evidence is needed.

Health-Related Cognitions and Metacognitions Indirectly Contribute to the Relationships Between Impulsivity, Fear of COVID-19, and Cyberchondria

The aim of the study was to converge a structural equation model to unfold the compositive relationships between trait impulsivity, health cognitions, metacognitions about health, fear of COVID-19 and cyberchondria, after controlling for gender, age, marital status, having a chronic illness and chronic illness among first-degree relatives. Six hundred fifty-one participants (423 females, 65%; 228 males, 35%) participated in the study. The Short UPPS-P Impulsive Behavior Scale (S-UPPS-P), Health Cognitions Questionnaire (HCQ), The Meta-Cognitions about Health Questionnaire (MCQ-HA), Cyberchondria Severity Scale -Short Form (CSS-12), and Fear of COVID-19 Scale (FCV-19 S) were completed by volunteered participants. The structural model showed that the S-UPPS-P directly and indirectly contributed to the HCQ, MCQ-HA, CSS-12, and FCV-19 S. The multi-group structural analysis by gender showed that the structural model had a partial measurement and factorial invariance. We concluded that the significant associations between impulsivity, fear of COVID-19 and cyberchondria were indirectly contributed by health-related cognitions and metacognitions.

Cyberchondria and COVID-19 anxiety and internet addiction among nursing students

This study was conducted to determine the relationship between cyberchondria and COVID-19 anxiety and internet addiction in nursing students. This cross-sectional study was conducted with 843 students studying in the nursing department of Adnan Menderes University. The mean age of the students was 20.8 ± 1.72 years and 61.2% were female. The Cyberchondria Severity Scale-Short Form, Coronavirus Anxiety Scale, and the Young Internet Addiction Test-Short Form were used to collect data. The study found a positive association between internet addiction, cyberchondria severity, and anxiety about COVID-19. It was found that the anxiety of COVID-19 had a mediating role in the association between internet addiction and cyberchondria severity. It was found that the use of the internet as a source of information on health problems and trusting the health information found had a significant effect on high cyberchondria levels (p < 0.05). Taken together, the findings of previous studies and this study on the role of the association between internet addiction and cyberchondria exacerbating anxiety due to the pandemic provide further evidence for healthcare professionals that greater focus is needed on the problems of the new era related to people-internet interaction. To reduce the negative effects of the current health crisis and future health crises, interventions for nursing students to control their internet use and cyberchondria behaviors should be prioritized.

COVID-19-Related Self-Stigma, Post-Traumatic Stress Disorder, Insomnia, and Smartphone Addiction Among Frontline Government Workers with COVID-19 Pandemic Control Duties

Purpose

The duties related to COVID-19 control and prevention may have caused psychological stress for the individuals in charge (eg, frontline government workers) and have reportedly led to mental health issues, such as insomnia and post-traumatic stress disorder (PTSD). However, the prevalence of these COVID-19-related disorders and their associated factors remain unclear. Therefore, the purpose of the present study was to investigate the prevalence rates of insomnia, PTSD, COVID-19-related self-stigma, and smartphone addiction, along with the identification of risk factors and protective factors for Taiwan frontline government workers with COVID-19 pandemic control duties.

Methods

The survey was carried out with 151 participants between September and October 2021. All participants completed the Fear of COVID-19 Scale (assessing fear of COVID-19), Self-Stigma Scale (assessing self-stigma during the COVID-19 pandemic), Smartphone Application-Based Addiction Scale (assessing the risk of smartphone addiction), Insomnia Severity Index (assessing insomnia), Impacts of Event Scale-6 (assessing PTSD), and a self-designed set of questions assessing trait resilience.

Results

The results showed that the prevalence rate was 31.1% for insomnia and 33.8% for PTSD. Furthermore, service duration (adjusted odds ratio [AOR] = 0.93; 95% confidence interval [CI] = 0.86, 0.999) and trait resilience (AOR = 0.19; 95% CI = 0.08, 0.46) were protective factors and fear of COVID-19 (AOR = 1.91; 95% CI = 1.02, 3.57) was a risk factor for insomnia. Fear of COVID-19 (AOR = 2.63; 95% CI = 1.35, 5.14), self-stigma (AOR = 3.62; 95% CI = 1.19, 11.02), and smartphone addiction (AOR = 1.09, 95% CI = 1.001, 1.19) were risk factors, and trait resilience was a protective factor (AOR = 0.58; 95% CI = 0.29, 1.17) for PTSD.

Conclusion

The findings demonstrated a high prevalence of insomnia and PTSD. Risk-reducing strategies and protective factor promotion strategies are recommended to help reduce the symptoms of insomnia and PTSD among Taiwan frontline government workers.

Smartphone addiction risk, technology-related behaviors and attitudes, and psychological well-being during the COVID-19 pandemic

COVID-19 pandemic-related perceived risk of infection, illness fears, acute stress, emotional anxiety, exhaustion, and fatigue, psychological trauma and depressive symptoms, and sustained psychological distress can cause smartphone addiction risk and lead to technology-related cognitive, emotional, and behavioral disorders, thus impacting psychological well-being. Behavioral addiction of smartphone users can result in anxiety symptom severity, psychiatric symptoms, and depressive stress. We carried out a quantitative literature review of the Web of Science, Scopus, and ProQuest throughout June 2022, with search terms including "smartphone addiction + COVID-19" + "stress," "anxiety," "depression," "psychological distress," "screen time," and "fear." As we analyzed only articles published between 2020 and 2022, 288 papers met the eligibility criteria. By excluding sources with similar titles, having unclear findings or unsupported by replication, or displaying inconsistent content, we selected 64, mainly empirical, sources. We used layout algorithms (VOSviewer) and bibliometric mapping (Dimensions) as data visualization tools. Assessing the Methodological Quality of Systematic Reviews (AMSTAR), a systematic review and literature review software (Distiller SR), Mixed Methods Appraisal Tool (MMAT), and Systematic Review Data Repository (SRDR) were employed as methodological quality assessment tools. As limitations, we analyzed only articles published between 2020 and 2022 in scholarly outlets indexed in the Web of Science, Scopus, and ProQuest databases. The scope of our study also does not advance the inspection of sources covering vulnerable individuals suffering from certain diseases or specific generations. Subsequent analyses should develop on smartphone use and addiction among children and adolescents. Future research should thus investigate problematic smartphone use and addiction across generations Z and Alpha. Attention should be directed to their personality traits and psychopathological symptoms.

Cyberchondria, Fear of COVID-19, and Risk Perception Mediate the Association between Problematic Social Media Use and Intention to Get a COVID-19 Vaccine

Vaccination is the most effective way to control the COVID-19 pandemic, but vaccination hesitancy threatens this effort worldwide. Consequently, there is a need to understand what influences individuals’ intention to get a COVID-19 vaccine. Restriction of information gathering on societal developments to social media may influence attitudes towards COVID-19 vaccination through exposure to disinformation and imbalanced arguments. The present study examined the association between problematic social media use and intention to get the COVID-19 vaccine, taking into account the mediating roles of cyberchondria, fear of COVID-19, and COVID-19 risk perception. In a cross-sectional survey study, a total of 10,843 residents of Qazvin City, Iran completed measures on problematic social media use, fear of COVID-19, cyberchondria, COVID-19 risk perception, and intention to get a COVID-19 vaccine. The data were analyzed using structural equation modeling (SEM). The results showed that there was no direct association between problematic social media use and intention to get a COVID-19 vaccine. Nonetheless, cyberchondria, fear of COVID-19, and COVID-19 risk perception (each or serially) mediated associations between problematic social media use and intention to get a COVID-19 vaccine. These results add to the understanding of the role of problematic social media use in COVID-19 vaccine hesitancy, i.e., it is not the quantity of social media use per se that matters. This knowledge of the mediating roles of cyberchondria, fear of COVID-19, and COVID-19 risk perception can be used by public health experts and policymakers when planning educational interventions and other initiatives in COVID-19 vaccination programs.