Conceptualizations of Cyberchondria and Relations to the Anxiety Spectrum: Systematic Review and Meta-analysis

Abstract

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.

The effect of cyberchondria on anxiety, depression and quality of life during COVID-19: the mediational role of obsessive-compulsive symptoms and Internet addiction

“…Therefore, even though most of the studies on this emerging condition have concentrated on the overlapping features between cyberchondria and health anxiety (e.g., Erdoğan & Hocaoğlu, 2020 ), the strength of this relationship is still a matter of debate ( Mathes et al, 2018 ) and lines of research suggest that they may be considered as distinct constructs ( Menon et al, 2020 ; Schenkel et al, 2021 ). The latter findings implied that the evaluation of cyberchondria must be fulfilled also in the absence of pre-disposing health anxiety and it may be even considered as a vulnerability factor for health anxiety ( Menon et al, 2020 ; Singh and Brown, 2016 ).…”

New challenges in facing cyberchondria during the coronavirus disease pandemic

“…This model can also be applied to CYB, whereby repetitive checking online for medical information designed to achieve relief or reassurance about one's health status instead increases anxiety and promotes further fruitless checking. The correlation with CYB and health anxiety, broadly defined, is corroborated by recent systematic reviews and metanalyses [12,13]. However, a core preoccupation or fear of serious, progressive, or lifethreatening illnesses is not always associated with CYB.…”

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

“…The authors further observed that age was a significant moderating factor of the strength of the association between cyberchondria and health-related anxiety. Schenkel et al [ 17 ••], in their systematic review and meta-analysis, observed that the dimensions of cyberchondria correlated significantly with affective components of health-related anxiety, especially with health-related worries.…”

“…Although associations between cyberchondria and OC symptoms appear supported, the nature is incompletely understood. Several options have been proposed [ 17 ••]: (a) OC symptoms are an essential part of cyberchondria, (b) OC features contribute to the maintenance of cyberchondria, or (c) redundancy between constructs, in which health-related internet use may be a component of both cyberchondria and OC symptoms. These and other possibilities warrant direct examination.…”