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Cyberchondria and its Relationships with Related Constructs: a Network Analysis

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Abstract

Cyberchondria denotes repeated online searches for health information that are associated with increasing levels of health anxiety. The aims of this study were to apply network analysis to investigate the extent to which cyberchondria is a distinct construct, ascertain which of the related constructs have the strongest relationships with cyberchondria and investigate whether some of the symptoms of cyberchondria are more central to the construct of cyberchondria. Questionnaires assessing the severity of cyberchondria, health anxiety, obsessive-compulsive disorder symptoms, intolerance of uncertainty, problematic Internet use, anxiety, depression and somatic symptoms were administered to 751 participants who searched for health information online during a previous 3-month period and were recruited from an online crowdsourcing platform. Network analyses were used to compute the networks, perform community detection tests and calculate centrality indices. Results suggest that cyberchondria is a relatively specific syndrome-like construct, distinct from all related constructs and consisting of interrelated symptoms. It has the strongest relationships with problematic Internet use and health anxiety. No symptom of cyberchondria emerged clearly as more central to the construct of cyberchondria. Future research should aim to deepen our understanding of cyberchondria and its links with psychopathology, especially its close relationship with problematic Internet use.

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References

  1. McDaid D, Park A-L. Online health: untangling the web. 2011. www.bupa.com.au/staticfiles/Bupa/HealthAndWellness/MediaFiles/PDF/LSE_Report_Online_Health.pdf. Accessed 19 December 2018.

  2. Fox S, Duggan M. Health online 2013. 2013. http://www.pewinternet.org/2013/01/15/health-online-2013/. Accessed 20 December 2018.

    Google Scholar 

  3. Prescott C. Internet access – households and individuals, Great Britain: 2016. 2016. https://www.ons.gov.uk/peoplepopulationandcommunity/householdcharacteristics/homeinternetandsocialmediausage/bulletins/internetaccesshouseholdsandindividuals/2016. Accessed 20 December 2018.

    Google Scholar 

  4. Starcevic V. Cyberchondria: challenges of problematic online searches for health-related information. Psychother Psychosom. 2017;86(3):129–33.

    Article  PubMed  Google Scholar 

  5. McElroy E, Shevlin M. The development and initial validation of the Cyberchondria severity scale (CSS). J Anxiety Disord. 2014;28(2):259–65.

    Article  PubMed  Google Scholar 

  6. Mathes BM, Norr AM, Allan NP, Albanese BJ, Schmidt NB. Cyberchondria: overlap with health anxiety and unique relations with impairment, quality of life, and service utilization. Psychiatry Res. 2018;261:204–11.

    Article  PubMed  Google Scholar 

  7. Fergus TA. The Cyberchondria severity scale (CSS): an examination of structure and relations with health anxiety in a community sample. J Anxiety Disord. 2014;28(6):504–10.

    Article  PubMed  Google Scholar 

  8. Fergus TA. Anxiety sensitivity and intolerance of uncertainty as potential risk factors for cyberchondria: a replication and extension examining dimensions of each construct. J Affect Disord. 2015;184:305–9.

    Article  PubMed  Google Scholar 

  9. Norr A, Albanese B, Oglesby M, Allan N, Schmidt N. Anxiety sensitivity and intolerance of uncertainty as potential risk factors for cyberchondria. J Affect Disord. 2015;174:64–9.

    Article  PubMed  Google Scholar 

  10. Norr A, Oglesby M, Raines A, Macatee R, Allan N, Schmidt NB. Relationships between cyberchondria and obsessive-compulsive symptom dimensions. Psychiatry Res. 2015;230(2):441–6.

    Article  PubMed  Google Scholar 

  11. Barke A, Bleichhardt G, Rief W, Doering BK. The Cyberchondria severity scale (CSS): German validation and development of a short form. Int J Behav Med. 2016;23(5):595–605.

    Article  PubMed  Google Scholar 

  12. Fergus TA, Russell L. Does cyberchondria overlap with health anxiety and obsessive-compulsive symptoms? An examination of latent structure and scale interrelations. J Anxiety Disord. 2016;38:88–94.

    Article  PubMed  Google Scholar 

  13. Fergus TA, Spada M. Cyberchondria: examining relations with problematic internet use and metacognitive beliefs. Clin Psychol Psychother. 2017;24(6):1322–30.

    Article  PubMed  Google Scholar 

  14. Bajcar B, Babiak J, Olchowska-Kotala A. Cyberchondria and its measurement. The polish adaptation and psychometric properties of Cyberchondria severity scale CSS-PL. Polish Psychiatry. (in press).

  15. Keller GL, Padala PR, Petty F. Clinical pearls to manage cyberchondriacs. Prim Care Compan J Clin Psychiatry. 2008;10:75–6.

    Article  Google Scholar 

  16. Selvi Y, Turan SG, Sayin AA, Boysan M, Kandeger A. The Cyberchondria severity scale (CSS): validity and reliability study of the Turkish version. Sleep Hypn. 2018;20(4):241–6.

    Article  Google Scholar 

  17. Starcevic V, Berle D. Cyberchondria: towards a better understanding of excessive health-related internet use. Exp Rev Neurotherap. 2013;13(2):205–13.

    Article  CAS  Google Scholar 

  18. Fergus TA. Cyberchondria and intolerance of uncertainty: examining when individuals experience health anxiety in response to internet searches for medical information. Cyberpsychol Behav Soc Network. 2013;16(10):735–9.

    Article  Google Scholar 

  19. Singh K, Brown RJ. Health-related internet habits and health anxiety in university students. Anxiety Stress Coping. 2014;27(5):542–54.

    Article  PubMed  Google Scholar 

  20. Fergus TA, Dolan SL. Problematic internet use and internet searches for medical information: the role of health anxiety. Cyberpsychol Behav Soc Network. 2014;17(12):761–5.

    Article  Google Scholar 

  21. Eastin MS, Guinsler NM. Worried and wired: effects of health anxiety on information-seeking and health care utilization behaviors. Cyberpsychol Behav. 2006;9(4):494–8.

    Article  PubMed  Google Scholar 

  22. Baumgartner SE, Hartmann T. The role of health anxiety in online health information search. Cyberpsychol Behav Soc Network. 2011;14(10):613–8.

    Article  Google Scholar 

  23. Muse K, McManus F, Leung C, Meghreblian B, Williams JM. Cyberchondriasis: fact or fiction? A preliminary examination of the relationship between health anxiety and searching for health information on the internet. J Anxiety Disord. 2012;26(1):189–96.

    Article  PubMed  Google Scholar 

  24. Nuijten MB, Deserno MK, Cramer AOJ, Borsboom D. Mental disorders as complex networks: an introduction and overview of a network approach to psychopathology. Clin Neuropsychiatry. 2016;13(4–5):68–76.

    Google Scholar 

  25. Borsboom D. A network theory of mental disorders. World Psychiatry. 2017;16(1):5–13.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Guyon H, Falissard B, Kop J-L. Modeling psychological attributes in psychology – an epistemological discussion: network analysis vs. latent variables. Front Psychol. 2017;8:798.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Fried EI, van Borkulo CD, Cramer AO, Boschloo L, Schoevers RA, Borsboom D. Mental disorders as networks of problems: a review of recent insights. Soc Psychiatry Psychiatr Epidemiol. 2017;52(1):1–10.

    Article  PubMed  Google Scholar 

  28. Cramer AOJ, Waldorp LJ, van der Maas HLJ, Borsboom D. Comorbidity: a network perspective. Behav Brain Sci. 2010;33(2–3):137–50.

    Article  PubMed  Google Scholar 

  29. Baggio S, Starcevic V, Studer J, Simon O, Gainsbury SM, Gmel G, et al. Technology-mediated addictive behaviors constitute a spectrum of related yet distinct conditions: a network perspective. Psychol Addict Behav. 2018;32(5):564–72.

    Article  PubMed  Google Scholar 

  30. Peer E, Brandimarte L, Samat S, Acquisti A. Beyond the Turk: alternative platforms for crowdsourcing behavioral research. J Exp Soc Psychol. 2017;70:153–63.

    Article  Google Scholar 

  31. Palan S, Schitter C. Prolific.Ac – a subject pool for online experiments. J Behav Exp Finance. 2018;17:22–7.

    Article  Google Scholar 

  32. Norr AM, Allan NP, Boffa JW, Raines AM, Schmidt NB. Validation of the Cyberchondria severity scale (CSS): replication and extension with bifactor modelling. J Anxiety Disord. 2015;31:58–64.

    Article  PubMed  Google Scholar 

  33. Salkovskis PM, Rimes KA, Warwick H, Clark D. The health anxiety inventory: development and validation of scales for the measurement of health anxiety and hypochondriasis. Psychol Med. 2002;32(5):843–53.

    Article  CAS  PubMed  Google Scholar 

  34. Abramowitz JS, Deacon BJ, Valentiner DP. The short health anxiety inventory: psychometric properties and construct validity in a non-clinical sample. Cogn Ther Res. 2007;31(6):871–83.

    Article  Google Scholar 

  35. Foa EB, Huppert JD, Leiberg S, Langner R, Kichic R, Hajcak G, et al. The obsessive-compulsive inventory: development and validation of a short version. Psychol Assess. 2002;14(4):485–96.

    Article  PubMed  Google Scholar 

  36. Abramowitz JS, Deacon BJ. Psychometric properties and construct validity of the obsessive-compulsive inventory-revised: replication and extension with a clinical sample. J Anxiety Disord. 2006;20(8):1016–35.

    Article  PubMed  Google Scholar 

  37. Hajcak G, Huppert JD, Simons RF, Foa EB. Psychometric properties of the OCI-R in a college sample. Behav Res Ther. 2004;42(1):115–23.

    Article  PubMed  Google Scholar 

  38. Carleton RN, Norton MAPJ, Asmundson GJG. Fearing the unknown: a short version of the intolerance of uncertainty scale. J Anxiety Disord. 2007;21(1):105–17.

    Article  PubMed  Google Scholar 

  39. Meerkerk G-J, Van Den Eijnden RJJM, Vermulst AA, Garretsen HFL. The compulsive internet use scale (CIUS): some psychometric properties. Cyberpsychol Behav. 2009;12(1):1–6.

    Article  PubMed  Google Scholar 

  40. Pilkonis PA, Choi SW, Reise SP, Stover AM, Riley WT, Cella D. Item banks for measuring emotional distress from the patient-reported outcomes measurement information system (PROMIS®): depression, anxiety, and anger. Assess. 2011;18(3):263–83.

    Article  Google Scholar 

  41. Kroenke K, Spitzer RL, Williams JBW. The PHQ-9. J Gen Intern Med. 2001;16(9):606–13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Berle D, Moulds ML. An experimental investigation of emotional reasoning processes in depression. Br J Clin Psychol. 2013;52(3):316–29.

    Article  PubMed  Google Scholar 

  43. Kroenke K, Spitzer RL, Williams JBW. The PHQ-15: validity of a new measure for evaluating the severity of somatic symptoms. Psychosom Med. 2002;64(2):258–66.

    Article  PubMed  Google Scholar 

  44. Epskamp S, Borsboom D, Fried EI. Estimating psychological networks and their accuracy: a tutorial paper. Behav Res Methods. 2018;50(1):195–212.

    Article  PubMed  Google Scholar 

  45. Liu H, Han F, Yuan M, Lafferty J, Wasserman L. High-dimensional semiparametric Gaussian copula graphical models. Ann Stat. 2012;40(4):2293–326.

    Article  Google Scholar 

  46. Pons P, Latapy M. Computing communities in large networks using random walks. J Graph Algorithms Appl. 2006;10(2):191–218.

    Article  Google Scholar 

  47. McNally RJ. Can network analysis transform psychopathology? Behav Res Ther. 2016;86:95–104.

    Article  PubMed  Google Scholar 

Download references

Funding

Preparation of this paper was supported by a National Health and Medical Research Council (NHRMC) Early Career Fellowship (GNT1122203) awarded to David Berle. The NHMRC had no role in the design of the study, data collection, data analysis, interpretation of data or in the writing or revision of the manuscript. Other authors did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors for this research.

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Correspondence to Vladan Starcevic.

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Starcevic, V., Baggio, S., Berle, D. et al. Cyberchondria and its Relationships with Related Constructs: a Network Analysis. Psychiatr Q 90, 491–505 (2019). https://doi.org/10.1007/s11126-019-09640-5

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