Self-esteem and cyberchondria: The mediation effects of health anxiety and obsessive–compulsive symptoms in a community sample

Abstract

Cyberchondria refers to the excessive and repeated searching for medical information on the Internet and may be considered as health-related problematic Internet use. Previous findings indicated that cyberchondria is positively associated with health anxiety and obsessive-compulsive symptoms. Also, research suggests that excessive or problematic Internet use as well as health worries and compulsive behaviors are present among individuals with low self-esteem. This study sought to examine: (1) the association between self-esteem and cyberchondria, and (2) the mediating role of health anxiety and obsessivecompulsive symptoms in the relationship between self-esteem and cyberchondria. Participants (N = 207) from a community sample completed self-report measures assessing global self-esteem, health anxiety, obsessive-compulsive symptoms, and cyberchondria. We found that self-esteem directly predicted cyberchondria and that health anxiety and obsessive-compulsive symptoms parallelly mediated the relationship between self-esteem and cyberchondria. These findings suggest that low selfesteem, health anxiety and obsessive-compulsive symptoms can be considered vulnerability factors for cyberchondria. In addition, the reverse mediation model indicated that cyberchondria potentially predicts self-esteem both directly and through health anxiety and obsessive-compulsive symptoms. The bidirectional relationship among the analyzed variables are discussed in the context of potential psychological predictors and consequences of cyberchondria and possible mechanisms explaining cyberchondria. The current study provides further insight into the conceptualization of cyberchondria and the feasibility of specific treatment directions.

Recent Insights Into Cyberchondria

“…The correlations between cyberchondria and OCD symptoms have similarly been robust and ranged from 0.38 to 0.56 [14,17,21,22] for the total scores on the Dimensional Obsessive-Compulsive Scale. When the correlations were calculated for scores on the subscales of the Dimensional Obsessive-Compulsive Scale, they were lower (rs = 0.21-0.44) [22,29], as were the correlations with scores on the subscales of the Maudsley Obsessive-Compulsive Inventory (rs = 0.27-0.40) [30].…”

“…The concept of cyberchondria was developed on the basis of its hypothesized relationships with health anxiety and hypochondriasis. Many studies [11,12,14,[17][18][19][20][21][22][23][24][25][26] have confirmed moderate to strong correlations between cyberchondria and health anxiety (rs ranging from 0.48 to 0.68, depending on the instrument used for the assessment of health anxiety). Only one study [13] found this correlation to be relatively weak (r = 0.23).…”

Cyberchondria in the time of the COVID ‐19 pandemic

“…Cyberchondria has been strongly associated with a heightened health anxiety (Bajcar & Babiak, 2019; Bajcar, Babiak, & Olchowska‐Kotala, 2019; Barke, Bleichhardt, Rief, & Doering, 2016; Fergus, 2014; McMullan, Berle, Arnáez, & Starcevic, 2019; Norr, Albanese, Oglesby, Allan, & Schmidt, 2015; Starcevic, Baggio, Berle, Khazaal, & Viswasam, 2019) and PIU (Fergus & Spada, 2017; McElroy & Shevlin, 2014; Singh & Brown, 2014; Starcevic et al, 2019). Cyberchondria is also related to obsessive–compulsive disorder (OCD; Bajcar et al, 2019; Bajcar & Babiak, 2019; Fergus, 2014; Fergus & Russell, 2016; Fergus & Spada, 2018; Vismara et al, 2020). According to the reassurance‐seeking model of cyberchondria (Starcevic & Berle, 2013), cyberchondria is maintained by uncertainty embedded in OHR, intolerance of ambiguity and uncertainty, dilemmas about the trustworthiness of the sources of online health information, need for a “definitive” or “straightforward” explanation and difficulty coping with an abundance of information (“information overload”), especially if much of that information is conflicting or contradictory.…”

General practitioners’ challenges and strategies in dealing with Internet-related health anxieties—results of a qualitative study among primary care physicians in Germany

“…They also assess the quality of online health services as much higher and show a wider tendency to self-medicate. Depending on the severity of a hypochondriacal disorder, it can have a significant impact on things such as work ability, coping with everyday life, self-esteem, or resilience [28,[33][34][35][36][37][38].…”