Patients with HYP can be characterized by attentional bias and more elaborate verbal processing. These irregularities tend to disappear after psychotherapy.
The German version of the H-YBOCS proved to be a highly effective interview instrument for the dimensional assessment of hypochondriacal characteristics and therefore constitutes an important contribution to scientific research and clinical practice.
Background
Cyberchondria describes the detrimental effects of health-related internet use. Current conceptualizations agree that cyberchondria is associated with anxiety-related pathologies and may best be conceptualized as a safety behavior; however, little is known about its exact underlying mechanisms.
Objective
This systematic review and meta-analysis aims to give an overview of the conceptualizations of cyberchondria and its relation to anxiety-related pathologies, quantify the strength of association to health anxiety by using meta-analyses, highlight gaps in the literature, and outline a hypothetical integrative cognitive-behavioral model of cyberchondria based on the available empirical evidence.
Methods
A systematic literature search was conducted using PubMed, Web of Science, and PsycINFO electronic databases. A total of 25 studies were included for qualitative synthesis and 7 studies, comprising 3069 individuals, were included for quantitative synthesis. The meta-analysis revealed a strong association of cyberchondria (r=0.63) and its subfacets (r=0.24-0.66) with health anxiety.
Results
The results indicate that cyberchondria is a distinct construct related to health anxiety, obsessive-compulsive symptoms, intolerance of uncertainty, and anxiety sensitivity. Further studies should distinguish between state and trait markers of anxiety-related pathologies and use experimental and naturalistic longitudinal designs to differentiate among risk factors, triggers, and consequences related to cyberchondria.
Conclusions
Health-related internet use in the context of health anxiety is best conceptualized as health-related safety behavior maintained through intermittent reinforcement. Here, we present a corresponding integrative cognitive-behavioral model.
Severe health anxiety constitutes a disabling and costly clinical condition. The Multidimensional Inventory of Hypochondriacal Traits (MIHT) represents an innovative instrument that was developed according to cognitive-behavioral, cognitive-perceptual, interpersonal, and trait models of hypochondriasis. We aimed at evaluating the psychometric properties of the MIHT in a sample of patients with the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) diagnosis of hypochondriasis. Using confirmatory factor analysis (CFA), the postulated four-factor structure of the MIHT was found in a first CFA in patients with hypochondriasis (n = 178) and in a second CFA based on a mixed sample, with other somatoform disorders (n = 27), panic disorder (n = 25), and healthy controls (n = 31) added to the original group of patients with hypochondriasis (n = 178). In terms of specificity, patients with hypochondriasis showed larger scores on all four MIHT subscales (i.e., affective, cognitive, behavioral, and perceptual) compared to all other groups. Analyses of convergent and discriminant validity revealed promising results concerning the MIHT affective and perceptual scales but also point to certain problematic issues concerning the MIHT cognitive and behavioral scales. The findings suggest that the proposed structure of the MIHT is valid also in patients with hypochondriasis and demonstrate the specificity of the four hypochondriacal traits assessed in the MIHT.
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