Cyberchondria: examining relations with problematic internet use and metacognitive beliefs
Open accessAbstract
Cyberchondria refers to the repeated use of the Internet to search for health-related information, which leads to negative consequences. This two-part study provides the first known examination of how cyberchondria relates to (a) problematic Internet use and (b) metacognitive beliefs. Participants were U.S. community adults who reported using the Internet to search for health-related information (Study 1: N = 337, Study 2: N = 260). In Study 1, cyberchondria shared a strong association with problematic Internet use, and that association was unaccounted for by age, gender, current reported medical status, negative affect, or health anxiety. In Study 2, cyberchondria was found to share moderate to strong associations with metacognitive beliefs. The association between cyberchondria and metacognitive beliefs about the uncontrollability of thoughts remained intact after accounting for the Study 1 covariates, as well as anxiety sensitivity and intolerance of uncertainty. Neither anxiety sensitivity nor intolerance of uncertainty shared unique associations with cyberchondria. These results provide a preliminary indication that a metacognitive conceptualization of problematic Internet use may be applicable to cyberchondria.
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Hierarchical multiple linear regression analyses controlling for relevant covariates showed that negative metacognitions and obsessive-compulsive symptoms contributed significantly to the variance in cyberchondria.
“Hierarchical multiple linear regression analyses statistically controlling for relevant covariates (ie, age, gender, physical health status, HA negative affect, and anxiety sensitivity) showed that negative metacognitions (ie, uncontrollability of thoughts [22,31], beliefs about rituals [22], and beliefs about stop signals [22]) and obsessive-compulsive symptoms [22] contributed significantly to”
From Conceptualizations of cyberchondria and relations to the anxiety spectrum: Systematic review and meta-analysis (2021) · cites this paper as [31]
The Results (page unavailable) report that hierarchical regression found significant unique variance in cyberchondria associated with metacognitive beliefs, specifically beliefs that thoughts are uncontrollable. The paper does not report significant contributions from obsessive-compulsive symptoms or beliefs about rituals or stop signals; those parts of the claim are unsupported. (LLM, conf=0.90)
Experimental — accuracy not yet measuredFergus and Spada concluded that cyberchondria could be viewed as a specific form of problematic internet use, indicating that concepts of problematic internet use may be relevant to understanding cyberchondria.
“Fergus and Spada [31] concluded that cyberchondria could be viewed as a specific form of problematic internet use, indicating that concepts of problematic internet use may be of relevance to understanding cyberchondria.”
From Conceptualizations of cyberchondria and relations to the anxiety spectrum: Systematic review and meta-analysis (2021) · cites this paper as [31]
The Discussion reports a robust association between cyberchondria and problematic internet use and says that PIU conceptualizations may apply to cyberchondria. That supports the claim about the relevance of PIU concepts, but the paper does not conclude that cyberchondria is a specific form of PIU; it describes the constructs as linked and conceptually overlapping. (LLM, conf=0.82)
Experimental — accuracy not yet measuredThe relevance of metacognitive aspects for cyberchondria was supported by several results from 3 web-based questionnaire surveys using the Metacognitions Questionnaire-Health Anxiety.
“The relevance of metacognitive aspects for cyberchondria was supported by several results from 3 web-based questionnaire surveys by the same authors [22,31], in which the Metacognitions Questionnaire–Health Anxiety (MCQ-HA; [57]) was used.”
From Conceptualizations of cyberchondria and relations to the anxiety spectrum: Systematic review and meta-analysis (2021) · cites this paper as [31]
The Results report that Study 2 found associations between metacognitive beliefs and cyberchondria, and the Method section confirms that it used the MCQ-HA with participants recruited online. This paper reports two studies, not three surveys, and its MCQ-HA findings come from Study 2; the cited sentence also references another source, which may account for the remaining survey. (LLM, conf=0.87)
Experimental — accuracy not yet measuredMultiple linear regression with N=337 participants showed the robustness of the relationship between cyberchondria and problematic internet use (step 2; β=.41; P<.001) after controlling for age, gender, physical health, negative affect, and health anxiety.
“In addition, multiple linear regression with N=337 participants showed the robustness of this relationship (step 2; β=.41; P<.001) by controlling for age, gender, physical health, negative affect, and HA, where HA was the only covariate that accounted for variance in cyberchondria scores.”
From Conceptualizations of cyberchondria and relations to the anxiety spectrum: Systematic review and meta-analysis (2021) · cites this paper as [31]
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredIn all studies, zero-order correlation analyses revealed that all metacognition subscales were significantly correlated with cyberchondria (MCQ-HA-C: rs=0.32-0.49; MCQ-HA-B: rs=0.47-0.58; MCQ-HA-U: rs=0.51-0.66).
“In all studies, zero-order correlation analyses revealed that all metacognition subscales were significantly correlated with cyberchondria (MCQ-HA-C: rs=0.32-0.49, all P<.001; MCQ-HA-B: rs=0.47-0.58, all P<.001; and MCQ-HA-U: rs=0.51-0.66, all P<.001).”
From Conceptualizations of cyberchondria and relations to the anxiety spectrum: Systematic review and meta-analysis (2021) · cites this paper as [31]
Study 2’s Table 2 reports significant zero-order correlations between cyberchondria and all three MCQ-HA subscales: .49 for C, .58 for B, and .66 for U (all p < .001). These match the upper ends of the cited ranges, but the paper does not establish the lower ends or the claim about “all studies”; its Study 1 examined problematic internet use rather than the MCQ-HA subscales. (LLM, conf=0.89)
Experimental — accuracy not yet measured
Both situational factors (e.g., uncertainty and anxiety) and more permanent predisposing factors (e.g., prior beliefs such as mistrust of medical professionals and 'information is power') seem to be important in the initiation of health-related internet use.
“Besides situational factors (states) such as uncertainty and anxiety, more permanent or predisposing factors such as prior beliefs (eg, mistrust of medical professionals and information is power), seem to be important [1] as the metacognitive conceptualization of cyberchondria proposes [31].”
From Conceptualizations of cyberchondria and relations to the anxiety spectrum: Systematic review and meta-analysis (2021) · cites this paper as [31]
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredAversive negative affective states activate metacognitive beliefs that may represent plans for self-regulation strategies (health-related internet use), rituals, and stop signals to cope with aversive states (for elevated and pathological HA).
“Following Fergus and Spada [22,31] as well as Brown et al [26], we also propose for the field of elevated and pathological HA that aversive negative affective states activate metacognitive beliefs that may represent plans for self-regulation strategies (namely health-related internet use), rituals, and stop signals that are conducted to cope with aversive (affective) states.”
From Conceptualizations of cyberchondria and relations to the anxiety spectrum: Systematic review and meta-analysis (2021) · cites this paper as [31]
The Results section describes health-related thoughts activating metacognitive beliefs and self-regulation, with internet searches used to cope with distress. It does not say that aversive affect itself activates those beliefs or describe rituals as part of that process. The Discussion mentions stop signals as a treatment goal, not as a coping response, and the study does not establish the proposed sequence for elevated or pathological health anxiety (page numbers unavailable). (LLM, conf=0.85)
Experimental — accuracy not yet measuredThe analyses yielded inhomogeneous findings regarding the relevance of positive metacognitive beliefs.
“However, the analyses yielded inhomogeneous findings regarding the relevance of positive metacognitive beliefs [22,31].”
From Conceptualizations of cyberchondria and relations to the anxiety spectrum: Systematic review and meta-analysis (2021) · cites this paper as [31]
A strong association was found between cyberchondria (operationalized by the CSS) and problematic internet use (r=0.59; P<.001).
“These findings were supported by Fergus and Spada [31], who found a strong association between cyberchondria (operationalized by the CSS) and problematic internet use (r=0.59; P<.001).”
From Conceptualizations of cyberchondria and relations to the anxiety spectrum: Systematic review and meta-analysis (2021) · cites this paper as [31]
Women reported a higher CSS score (61.3 ± 15.1) than men (56.7 ± 16.6).
“Independent t-tests showed that women reported a higher CSS score (61.3 ± 15.1) than men (56.7 ± 16.6).”
From Is cyberchondria a new transdiagnostic digital compulsive syndrome? A systematic review of the evidence (2020) · cites this paper as [34]
The Method section reports an overall CSS mean of 65.64 (SD 19.32), while the Results and regression tables include gender as a covariate; none reports the claimed women’s and men’s scores or an independent t-test comparing them. Searches for 61.3, 56.7, and sex differences in CSS scores found no matching passage. (LLM, conf=0.76)
Experimental — accuracy not yet measuredWhether the relationship between cyberchondria and healthcare utilization is unique to cyberchondria remains unclear because the result was not controlled for health anxiety.
“Nonetheless, whether this relationship with healthcare utilization is unique to CYB remains unclear since the result was not controlled for health anxiety.”
From Is cyberchondria a new transdiagnostic digital compulsive syndrome? A systematic review of the evidence (2020) · cites this paper as [34]
The Discussion says the study controlled for health anxiety when examining cyberchondria’s relationships with problematic internet use and metacognitive beliefs. Our copy does not address a relationship with healthcare utilization or say whether that relationship was controlled for health anxiety (searched: healthcare utilization, healthcare visits, and health-anxiety adjustment). (LLM, conf=0.72)
Experimental — accuracy not yet measuredThe original CSS was subsequently translated and validated in Polish, Turkish, and German, and translated in Portuguese.
“The original CSS was subsequently translated and validated in Polish [52], Turkish [57,70], and German [34], and translated in Portuguese [60].”
From Is cyberchondria a new transdiagnostic digital compulsive syndrome? A systematic review of the evidence (2020) · cites this paper as [34]
The citation to this paper is attached specifically to the Portuguese translation. The Method section describes the CSS and its use in the study, but neither it nor the additional passages retrieved for Portuguese translation and language-specific validation mention a Portuguese version. (LLM, conf=0.76)
Experimental — accuracy not yet measuredCyberchondria measured by the CSS was moderately correlated (r = 0.29) with healthcare utilization, measured by the number of visits to GPs and other health professionals during the previous year.
“Barke and colleagues found that CYB (measured by the CSS) was moderately correlated (r = 0.29) with healthcare utilization, measured by the number of visits to GPs and a range of other health professionals during the previous year [34].”
From Is cyberchondria a new transdiagnostic digital compulsive syndrome? A systematic review of the evidence (2020) · cites this paper as [34]
The Method section says the study measured cyberchondria with the CSS, but the Results report its correlation with problematic internet use (r = .59), not healthcare utilization. Searches for healthcare visits, Barke, and r = .29 found no passage in our copy reporting the attributed finding; page numbers were unavailable. (LLM, conf=0.78)
Experimental — accuracy not yet measured
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“However, other studies of the relationship between Intolerance of uncertainty and CYB (assessed with the CSS) did not produce consistent results [33,36,37], suggesting a need for further investigations to determinewhether Intolerance of uncertainty is a risk factor for CYB or only its correlate.”
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“Hierarchical multiple linear regression analyses statistically controlling for relevant covariates (ie, age, gender, physical health status, HA negative affect, and anxiety sensitivity) showed that negative metacognitions (ie, uncontrollability of thoughts [22,31], beliefs about rituals [22], and beliefs about stop si…”
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- Authors
- Fergus, T. A., & Spada, M. M.
- Affiliations
- Baylor University (US)
- London South Bank University (GB)
- Corresponding author
- Fergus, Thomas A.
- Venue
- Clinical Psychology & Psychotherapy
- Publisher
- Wiley
- Published
- 2017-06-16
- Volume
- 24
- Issue
- 6
- Pages
- 1322-1330
- ISSN
- 1063-3995 (ISSN-L)
- 1099-0879
- OpenAlex
- W2625380590
- Cited by
- 162
- References
- 52
- Citations by year
- 2026: 17 · 2025: 15 · 2024: 11 · 2023: 21 · 2022: 27 · 2021: 17 · 2020: 22 · 2019: 6 · 2018: 5 · 2017: 1 · 2016: 6 · 2015: 3 · 2014: 4 · 2013: 4 · 2012: 3
- FWCI
- 15.07
- Type
- journal article
- Language
- en
- Open access
- Locations
- Clinical Psychology & Psychotherapy (publishedVersion)
- PubMed (publishedVersion)
- Research Open (London South Bank University) (acceptedVersion, cc-by)
- Research Open (London South Bank University) (acceptedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- cyberchondria, problematic internet use, metacognitive beliefs, anxiety sensitivity, intolerance of uncertainty, health information seeking, health anxiety, negative affect
- MeSH terms
- Metacognition, Adolescent, Adult, Aged, Anxiety Disorders, Female, Humans, Hypochondriasis, Male, Middle Aged, United States, Internet, Uncertainty, Young Adult
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