The curious case of cyberchondria: A longitudinal study on the reciprocal relationship between health anxiety and online health information seeking
Open accessAbstract
The current study is the first to longitudinally investigate the reciprocal relationship between online health information seeking and health anxiety, i.e., cyberchondria. Expectations were that health anxious individuals who go online to find health information, experience an increase in health anxiety, which in turn will reinforce online seeking. A 4-wave longitudinal survey study among 5322 respondents aged 16-93 was conducted. Our results showed that individuals who are more health anxious than others, search online for health information more. Moreover, the results provided initial evidence for the expected reciprocal relationship between health anxiety and online health information seeking in respondents with non-clinical levels of health anxiety at the start of the study. However, this reciprocal relationship could not be found in a subsample of clinically health anxious individuals. Although for these individuals online health information seeking did not seem to exacerbate health anxiety levels, it might still serve as a maintaining factor of clinical health anxiety.
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An illness-related bias may be relevant regarding the moderating role of emotional outcomes in cyberchondria.
“Following TePoel et al [81], we hypothesize that an illness-related bias may be of certain relevance regarding the moderating role of emotional outcomes.”
From Conceptualizations of cyberchondria and relations to the anxiety spectrum: Systematic review and meta-analysis (2021) · cites this paper as [81]
Section 1.1 describes an illness-related attentional bias and suggests that attending to negative online health information may fuel existing health worries. It does not address emotional outcomes as moderators, so it supports the proposed relevance of bias to cyberchondria but not that specific moderating role. Page numbers are unavailable in our copy. (LLM, conf=0.82)
Experimental — accuracy not yet measuredVery little research to date has examined cyberchondria and how it relates to health.
“Although the number of internet searches for medical information likely increases every day, very little research to date has examined cyberchondria and how it relates to health.”
From What are the Implications of Excessive Internet Searches for Medical Information by Orthopaedic Patients? (2019) · cites this paper as [34]
The Introduction (page unavailable) says that the reciprocal relationship between online health information seeking and health anxiety over time had not been sufficiently examined. But it also identifies many earlier studies of cyberchondria that provided cross-sectional evidence, so the claim overstates the gap if it means research on cyberchondria and health generally. (LLM, conf=0.83)
Experimental — accuracy not yet measuredThe available studies of cyberchondria include only medically healthy participants from the community, rather than patients with symptoms.
“The studies available [7, 9, 31, 32, 34] include only medically healthy participants from the community, rather than patients with symptoms.”
From What are the Implications of Excessive Internet Searches for Medical Information by Orthopaedic Patients? (2019) · cites this paper as [34]
Section 2.1 describes a representative community sample drawn from Dutch households, supporting the community-sample portion of the claim. It does not say participants were medically healthy or screened to exclude people with symptoms. Section 2.3 also reports a subgroup of 751 participants meeting the study’s threshold for clinical health anxiety. (LLM, conf=0.86)
Experimental — accuracy not yet measuredOne reviewed study showed poor quality, with an AXIS score below 10.
“and only one study [60] showed poor quality (score b 10).”
From Is cyberchondria a new transdiagnostic digital compulsive syndrome? A systematic review of the evidence (2020) · cites this paper as [60]
In the pathological HA group, changes in an individual's HA score were not predicted by a change in health-related internet use 2 months earlier.
“In the pathological HA group, changes in an individual’s HA score were not predicted by a change in health-related internet use 2 months earlier.”
From Conceptualizations of cyberchondria and relations to the anxiety spectrum: Systematic review and meta-analysis (2021) · cites this paper as [81]
No evidence for a reciprocal relationship between HA and health-related internet use was found in individuals with pathological HA.
“Thus, no evidence for a reciprocal relationship between HA and health-related internet use was found in individuals with pathological HA.”
From Conceptualizations of cyberchondria and relations to the anxiety spectrum: Systematic review and meta-analysis (2021) · cites this paper as [81]
In the nonclinical group with lower HA, evidence for a reciprocal association was found, such that increases in an individual's HA were predicted by increases in health-related internet use and vice versa.
“In contrast, evidence for a reciprocal association was found in the nonclinical group with lower HA, such that increases in an individual’s HA were predicted by increases in health-related internet use and vice versa.”
From Conceptualizations of cyberchondria and relations to the anxiety spectrum: Systematic review and meta-analysis (2021) · cites this paper as [81]
In the pathological HA group, changes in an individual's health-related internet use score were not predicted by changes in HA 2 months earlier.
“Conversely, changes in an individual’s health-related internet use score were not predicted by changes in HA 2 months earlier.”
From Conceptualizations of cyberchondria and relations to the anxiety spectrum: Systematic review and meta-analysis (2021) · cites this paper as [81]
Cyberchondria is associated with health anxiety.
“Cyberchondria and intolerance of uncertainty have been shown to be associated with health anxiety [3, 7-10, 19, 21, 22, 34]”
From What are the Implications of Excessive Internet Searches for Medical Information by Orthopaedic Patients? (2019) · cites this paper as [34]
Health anxiety can be fueled by cyberchondria.
“health anxiety can be fueled by both cyberchondria [34] and intolerance of uncertainty [10, 12].”
From What are the Implications of Excessive Internet Searches for Medical Information by Orthopaedic Patients? (2019) · cites this paper as [34]
Longitudinal studies have shown that people with health anxiety (and other forms of anxiety) die prematurely and tend to get significantly depressed if untreated; those who have had psychological treatment do not become depressed.
“Longitudinal studies have shown that people with health anxiety (and other forms of anxiety) die prematurely and also tend to get significantly depressed if untreated; those who have had psychological treatment do not become depressed.16,25,26”
From Why health anxiety needs to be recognised in hospital practice (2020) · cites this paper as [26]
The Present Study (§1.2) and Conclusion (§4.5; page numbers unavailable) examine the longitudinal relationship between health anxiety and online health-information seeking. Searches for premature death, depression, untreated anxiety, and psychological treatment found no passage addressing the claimed outcomes or treatment comparison. (LLM, conf=0.75)
Experimental — accuracy not yet measuredIntolerance of uncertainty is associated with health anxiety.
“Cyberchondria and intolerance of uncertainty have been shown to be associated with health anxiety [3, 7-10, 19, 21, 22, 34]”
From What are the Implications of Excessive Internet Searches for Medical Information by Orthopaedic Patients? (2019) · cites this paper as [34]
Section 1.1 says people with health anxiety seek reassurance to reduce uncertainty about their health. It does not address whether intolerance of uncertainty, as a distinct construct, is associated with health anxiety; a search for that term found no passage establishing the claimed association. Page numbers are unavailable in our copy. (LLM, conf=0.72)
Experimental — accuracy not yet measured
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İNTERNET BAĞIMLILIĞI VE SAĞLIK ANKSİYETESİNİN SİBERKONDRİ DAVRANIŞLARI ÜZERİNE ETKİSİ
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- Authors
- te Poel, F., Baumgartner, S. E., Hartmann, T., & Tanis, M.
- Affiliations
- University of Amsterdam (NL)
- Vrije Universiteit Amsterdam (NL)
- Venue
- Journal of Anxiety Disorders
- Publisher
- Elsevier BV
- Published
- 2016-10
- Volume
- 43
- Pages
- 32-40
- ISSN
- 0887-6185 (ISSN-L)
- OpenAlex
- W2492112509
- Cited by
- 172
- References
- 72
- Citations by year
- 2026: 16 · 2025: 10 · 2024: 20 · 2023: 22 · 2022: 26 · 2021: 21 · 2020: 23 · 2019: 19 · 2018: 8 · 2017: 6 · 2016: 1
- FWCI
- 21.08
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Anxiety Disorders (publishedVersion)
- PubMed (publishedVersion)
- UvA-DARE (University of Amsterdam) (submittedVersion, other-oa)
- VU Research Portal (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Ellen Hamaker and Loes Keijsers for their valuable advice on the application of the random intercept cross-lagged panel model
- 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, health anxiety, online health information seeking, bidirectional relationship, internet use
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Anxiety, Anxiety Disorders, Female, Humans, Longitudinal Studies, Male, Middle Aged, Internet, Young Adult, Information Seeking Behavior
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