Googling and using apps for health-related information are highly prevalent worldwide. So far, little is known about the emotional, body-related, and behavioral effects of using both Google and health-related apps. In our experimental study, bodily symptoms were first provoked by a standardized hyperventilation test. A total of 147 participants (96.6% students) were then randomly assigned to one of three conditions: Googling for the causes of the currently experienced bodily symptoms, using a medical app to diagnose the experienced symptoms, and a waiting control condition. Health-related Internet use for symptoms led to stronger negative affect, increased health anxiety, and increased need to consult a physician compared with the control condition. Googling and using the medical app showed comparable adverse emotional and behavioral effects. The findings are in line with current models of cyberchondria in which health-related Internet use represents an essential factor in maintaining and amplifying emotional distress.

Alterations in interoception - the perception of internal bodily signals - have been repeatedly linked to psychopathology. Recent findings suggest that both the attention devoted to, and the accuracy of, interoceptive perceptions have opposed effects on subclinical symptomatology such as alexithymia. Thus, providing well-validated tools that tap onto these interoceptive processes is crucial for advancing the understanding of the relation between interoceptive processing and subclinical psychopathology. In the current multicenter study (N = 857), we aimed to (1) validate the German version of the Interoceptive Attention Scale (IATS; Gabriele et al., 2022), and (2) test the differential association of subjective interoceptive attention and accuracy with subclinical psychopathology, including alexithymia, somatic, depressive, and anxious symptomatology. Across three samples we found a one-factor solution to be the best-fitting model for the IATS. The IATS also showed good internal consistency but poor test-retest reliability. In terms of convergent and discriminate validity, the IATS showed positive correlations with other proposed measures of interoceptive attention, but no relationship with measures of interoceptive accuracy. Further, subjective interoceptive attention and accuracy scores were differentially related to subclinical psychopathology: self-reported interoceptive attention was significantly positively related to all measures of psychopathology (except for depressive symptomatology), interoceptive accuracy scores, however, showed significant negative or nonsignificant relations with subclinical measures of psychopathology. Altogether our data suggest that the IATS is a reliable and valid instrument that can be applied to German samples. Moreover, our findings emphasize the need to distinguish between constructs of interoception in relation to subclinical psychopathology.

Processing of internal bodily signals, also known as interoception, and associated impairments are thought to be implicated in the development of psychopathology. Recent proposals highlight the need to differentiate between dimensions of interoception, in particular between accuracy and attention, to better understand its relation to mental health. In the current study, we aimed to adapt the German version of the recently developed Interoceptive Accuracy Scale (IAS; Murphy et al., 2020) and investigate its relation to clinical measures, using a multicenter approach (Ntotal = 3462). The German version of the IAS was best explained by a one-factor structure and showed acceptable test-retest reliability and good convergent validity. Furthermore, we replicated previous findings showing a negative association between self-reported interoceptive accuracy and measures of alexithymia. Going beyond this, we find that IAS scores were negatively and consistently (i.e., across samples and measures) related to several measures of clinical symptomatology and mental health, including anxiety, depressive-, and somatoform symptoms, as well as neurotic traits. These findings provide empirical evidence for the protective role of subjective interoceptive accuracy in the existence of psychopathological symptom burden and emphasize the importance of distinguishing between dimensions of interoception to understand its modulatory role in mental health.

Abstract. Background: Only recently has interoception been discussed as a common risk factor for psychopathology. Recent approaches distinguish between the ability to accurately perceive ( interoceptive accuracy) and the propensity to attend ( interoceptive attention) to internal signals. Objective: To examine the latent structure of self-reported interoceptive accuracy and attention and their relationships to psychopathology. Methods: We used a confirmatory factor analysis to clarify the latent structure of interoceptive accuracy and attention. Structural equation modeling was utilized to determine relationships between both abilities with internalizing and somatoform symptomatology according to the HiTOP model ( Kotov et al., 2017 ). Data from N = 619 persons from the German general population were analyzed. Results: Interoceptive attention showed significant positive relationships with all psychopathological traits ( r = .221 to r = .377), whereas interoceptive accuracy was negatively associated with internalizing symptomatology ( r = -.106). Conclusion: The present findings indicate that personal beliefs about interoceptive abilities have different influences on psychopathological developments.

For the first time, Jungmann et al. (2020) showed in a randomized controlled trial that using a health app to request health-related information can lead to similar negative emotional and behavioral effects as searching online for health-related information. In 2021, Multmeier and colleagues published a Letter to the Editor referring to these findings. In our response, we critically evaluate their major comments and ask for empirical evidence supporting their claims. We provide an outlook on how we envision the scientific discourse regarding the findings and why further peer-reviewed (at best, open science oriented) publications are essential.