Cyberchondria and intolerance of uncertainty: examining when individuals experience health anxiety in response to internet searches for medical information
Abstract
Individuals frequently use the Internet to search for medical information. However, for some individuals, searching for medical information on the Internet is associated with an exacerbation of health anxiety. Researchers have termed this phenomenon as cyberchondria. The present research sought to shed further light onto the phenomenology of cyberchondria. In particular, the moderating effect of intolerance of uncertainty (IU) on the relationship between the frequency of Internet searches for medical information and health anxiety was examined using a large sample of medically healthy community adults located in the United States (N=512). The purported moderating effect of IU was supported. More specifically, the relationship between the frequency of Internet searches for medical information and health anxiety grew increasingly stronger as IU increased. This moderating effect of IU was not attributable to general distress. These results suggest that IU is important for better understanding the exacerbation of health anxiety in response to Internet searches for medical information. Conceptual and therapeutic implications of these results are discussed.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Several studies found medium-sized positive correlations between cyberchondria and intolerance of uncertainty.
“Several studies found medium-sized positive correlations between cyberchondria and intolerance of uncertainty (Multimedia Appendix 1 [20-23]).”
From Conceptualizations of cyberchondria and relations to the anxiety spectrum: Systematic review and meta-analysis (2021) · cites this paper as [20]
Intolerance of uncertainty has been shown to moderate the impact of health-related internet use on health anxiety.
“Furthermore, intolerance of uncertainty has been shown to moderate the impact of health-related internet use on HA [20,24].”
From Conceptualizations of cyberchondria and relations to the anxiety spectrum: Systematic review and meta-analysis (2021) · cites this paper as [20]
Cites
Multiple regression: testing and interpreting interactions
(1992) · Choice Reviews Online · doi:10.5860/choice.29-3352 · Cited by 36,644 · see citing works
Development and validation of brief measures of positive and negative affect: The PANAS scales.
Watson, D., Clark, L. A., & Tellegen, A. (1988) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.54.6.1063 · Cited by 32,433 · see citing works
Amazon's Mechanical Turk: A New Source of Inexpensive, Yet High-Quality, Data?
Buhrmester, M., Kwang, T., & Gosling, S. D. (2011) · Perspectives on Psychological Science · doi:10.1177/1745691610393980 · Cited by 9,996 · see citing works
Overall job satisfaction: How good are single-item measures?
Wanous, J. P., Reichers, A. E., & Hudy, M. J. (1997) · Journal of Applied Psychology · doi:10.1037/0021-9010.82.2.247 · Cited by 3,479 · see citing works
Statistical difficulties of detecting interactions and moderator effects.
McClelland, G. H., & Judd, C. M. (1993) · Psychological Bulletin · doi:10.1037/0033-2909.114.2.376 · Cited by 3,270 · see citing works
Fearing the unknown: A short version of the Intolerance of Uncertainty Scale
Carleton, R. N., Norton, M. A. P. J., & Asmundson, G. J. G. (2007) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2006.03.014 · Cited by 2,288 · see citing works
Freeston, M. H., Rhéaume, J., Letarte, H., Dugas, M. J., & Ladouceur, R. (1994) · Personality and Individual Differences · doi:10.1016/0191-8869(94)90048-5 · Cited by 1,731 · see citing works
Evans, M. G. (1985) · Organizational Behavior and Human Decision Processes · doi:10.1016/0749-5978(85)90002-0 · Cited by 1,550 · see citing works
SALKOVSKIS, P. M., RIMES, K. A., WARWICK, H. M. C., & CLARK, D. M. (2002) · Psychological Medicine · doi:10.1017/s0033291702005822 · Cited by 1,351 · see citing works
Generalized anxiety disorder: advances in research and practice
(2005) · Choice Reviews Online · doi:10.5860/choice.42-3716 · Cited by 1,073 · see citing works
Carleton, R. N. (2012) · Expert Review of Neurotherapeutics · doi:10.1586/ern.12.82 · Cited by 599 · cited 1× · see citing works
“Some researchers consider uncertainty to be an essential component of anxiety, 9 which could raise concerns as to the overlap between IU and anxiety symptoms.”
Cyberchondria: studies of the escalation of medical concerns in web search
White, R. W., & Horvitz, E. (2009) · ACM Transactions on Information Systems · doi:10.1145/1629096.1629101 · Cited by 546 · see citing works
Intolerance of uncertainty in obsessive-compulsive disorder
Tolin, D. F., Abramowitz, J. S., Brigidi, B. D., & Foa, E. B. (2003) · Journal of Anxiety Disorders · doi:10.1016/s0887-6185(02)00182-2 · Cited by 494 · cited 3× · see citing works
“Moreover, Tolin et al. 8 described the possible use of behavioral strategies to reduce IU (e.g., exposing individuals to uncertain situations without the use of safety behaviors).”
Abramowitz, J. S., Deacon, B. J., & Valentiner, D. P. (2007) · Cognitive Therapy and Research · doi:10.1007/s10608-006-9058-1 · Cited by 308 · see citing works
Muse, K., McManus, F., Leung, C., Meghreblian, B., & Williams, J. M. G. (2012) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2011.11.005 · Cited by 303 · see citing works
Koerner, N., & Dugas, M. J. (2008) · Cognitive Therapy and Research · doi:10.1007/s10608-007-9125-2 · Cited by 301 · see citing works
(2004) · Cited by 296 · see citing works
The Role of Health Anxiety in Online Health Information Search
Baumgartner, S. E., & Hartmann, T. (2011) · Cyberpsychology, Behavior, and Social Networking · doi:10.1089/cyber.2010.0425 · Cited by 264 · see citing works
(2004) · Cited by 261 · see citing works
Caprara, G. V., & Cervone, D. (2000) · Cambridge University Press eBooks · doi:10.1017/cbo9780511812767.006 · Cited by 244 · see citing works
A taxometric analysis of health anxiety
Ferguson, E. (2009) · Psychological Medicine · doi:10.1017/s0033291708003322 · Cited by 183 · see citing works
Online Health Information Seeking in the Context of the Medical Consultation in Switzerland
Caiata-Zufferey, M., Abraham, A., Sommerhalder, K., & Schulz, P. J. (2010) · Qualitative Health Research · doi:10.1177/1049732310368404 · Cited by 171 · see citing works
Deacon, B., & Abramowitz, J. S. (2008) · Journal of Cognitive Psychotherapy · doi:10.1891/0889-8391.22.2.115 · Cited by 157 · see citing works
A contemporary conceptual model of hypochondriasis
Abramowitz, J. S., Schwartz, S. A., & Whiteside, S. P. (2002) · Mayo Clinic Proceedings · doi:10.4065/77.12.1323 · Cited by 139 · see citing works
Intolerance of uncertainty and perceived threat
Bredemeier, K., & Berenbaum, H. (2008) · Behaviour Research and Therapy · doi:10.1016/j.brat.2007.09.006 · Cited by 119 · cited 1× · see citing works
“24 Although this explanation remains to be empirically tested, when presented with multiple explanations for symptoms, individuals with IU might be especially likely to catastrophize about the possibility of having a serious health concern and perceive such a possibility as especially costly.”
Treating Health Anxiety: A Cognitive-Behavioral Approach
Martini, S. (2005) · Psychiatric Services · doi:10.1176/appi.ps.56.9.1163-a · Cited by 115 · see citing works
A Taxometric Study of Hypochondriasis Symptoms
Longley, S. L., Broman-Fulks, J. J., Calamari, J. E., Noyes, R., Wade, M., & Orlando, C. M. (2010) · Behavior Therapy · doi:10.1016/j.beth.2010.02.002 · Cited by 103 · see citing works
Intolerance of Uncertainty, Hypochondriacal Concerns, Obsessive-Compulsive Symptoms, and Worry
Boelen, P. A., & Carleton, R. N. (2012) · Journal of Nervous & Mental Disease · doi:10.1097/nmd.0b013e318247cb17 · Cited by 90 · see citing works
Health anxiety: Comparison of the latent structure in medical and non-medical samples
Alberts, N. M., Sharpe, D., Kehler, M. D., & Hadjistavropoulos, H. D. (2011) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2011.01.011 · Cited by 70 · see citing works
Perceived threat: Exploring its association with worry and its hypothesized antecedents
Berenbaum, H., Thompson, R. J., & Bredemeier, K. (2007) · Behaviour Research and Therapy · doi:10.1016/j.brat.2007.03.015 · Cited by 65 · see citing works
Fergus, T. A., & Valentiner, D. P. (2011) · Cognitive Therapy and Research · doi:10.1007/s10608-011-9392-9 · Cited by 59 · see citing works
Self-citationPsychological Treatment of Health Anxiety and Hypochondriasis: A Biopsychosocial Approach
Abramowitz, J. S. (2008) · Cited by 39 · see citing works
Fergus, T. A., & Valentiner, D. P. (2011) · Cognitive Therapy and Research · doi:10.1007/s10608-011-9354-2 · Cited by 34 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Into the unknown: A review and synthesis of contemporary models involving uncertainty
Carleton, R. N. (2016) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2016.02.007 · Cited by 1,104 · see citing works
Fear of the unknown: One fear to rule them all?
Carleton, R. N. (2016) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2016.03.011 · Cited by 647 · see citing works
McMullan, R. D., Berle, D., Arnáez, S., & Starcevic, V. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.11.037 · Cited by 436 · see citing works
Manifesto for a European research network into Problematic Usage of the Internet
Fineberg, N., Demetrovics, Z., Stein, D., Ioannidis, K., Potenza, M., Grünblatt, E., Brand, M., Billieux, J., Carmi, L., King, D., et al. (2018) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2018.08.004 · Cited by 334 · see citing works
Vismara, M., Caricasole, V., Starcevic, V., Cinosi, E., Dell'Osso, B., Martinotti, G., & Fineberg, N. A. (2020) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2020.152167 · Cited by 224 · see citing works
Mathes, B. M., Norr, A. M., Allan, N. P., Albanese, B. J., & Schmidt, N. B. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2018.01.002 · Cited by 209 · see citing works
Psychological Predictors of Health Anxiety in Response to the Zika Virus
Blakey, S. M., & Abramowitz, J. S. (2017) · Journal of Clinical Psychology in Medical Settings · doi:10.1007/s10880-017-9514-y · Cited by 159 · see citing works
Fergus, T. A. (2014) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2014.05.006 · Cited by 159 · see citing works
Self-citationCyberchondria: examining relations with problematic internet use and metacognitive beliefs
Fergus, T. A., & Spada, M. M. (2017) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2102 · Cited by 162 · see citing works
Online health research and health anxiety: A systematic review and conceptual integration.
Brown, R. J., Skelly, N., & Chew-Graham, C. A. (2020) · Clinical Psychology: Science and Practice · doi:10.1111/cpsp.12299 · Cited by 140 · see citing works
Anxiety sensitivity and intolerance of uncertainty as potential risk factors for cyberchondria
Norr, A. M., Albanese, B. J., Oglesby, M. E., Allan, N. P., & Schmidt, N. B. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.11.023 · Cited by 138 · see citing works
Cyberchondria and its Relationships with Related Constructs: a Network Analysis
Starcevic, V., Baggio, S., Berle, D., Khazaal, Y., & Viswasam, K. (2019) · Psychiatric Quarterly · doi:10.1007/s11126-019-09640-5 · Cited by 135 · see citing works
Problematic internet use and internet searches for medical information: the role of health anxiety
Fergus, T. A., & Dolan, S. L. (2014) · Cyberpsychology Behavior and Social Networking · doi:10.1089/cyber.2014.0169 · Cited by 112 · see citing works
Bajcar, B., & Babiak, J. (2021) · Current Psychology · doi:10.1007/s12144-019-00216-x · Cited by 109 · see citing works
Tull, M. T., Barbano, A. C., Scamaldo, K. M., Richmond, J. R., Edmonds, K. A., Rose, J. P., & Gratz, K. L. (2020) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2020.102290 · Cited by 98 · see citing works
Fergus, T. A. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.06.017 · Cited by 90 · see citing works
Self-citationThe impact of internet-delivered cognitive behavioural therapy for health anxiety on cyberchondria
Newby, J. M., & McElroy, E. (2020) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2019.102150 · Cited by 79 · see citing works
Schenkel, S. K., Jungmann, S. M., Gropalis, M., & Witthöft, M. (2021) · Journal of Medical Internet Research · doi:10.2196/27835 · Cited by 87 · see citing works
“Several studies found medium-sized positive correlations between cyberchondria and intolerance of uncertainty (Multimedia Appendix 1 [20-23]).”
BackgroundMethodInfluentialRelationships between cyberchondria and obsessive-compulsive symptom dimensions
Norr, A. M., Oglesby, M. E., Raines, A. M., Macatee, R. J., Allan, N. P., & Schmidt, N. B. (2015) · Psychiatry Research · doi:10.1016/j.psychres.2015.09.034 · Cited by 78 · see citing works
Alschuler, K. N., & Beier, M. L. (2015) · International Journal of MS Care · doi:10.7224/1537-2073.2014-044 · Cited by 76 · see citing works
Health anxiety and Internet use: A thematic analysis
Singh, K., Fox, J. R. E., & Brown, R. J. (2016) · Cyberpsychology: Journal of Psychosocial Research on Cyberspace · doi:10.5817/cp2016-2-4 · Cited by 65 · see citing works
Intolerance of Uncertainty as a Mediator of the Relationship between Mindfulness and Health Anxiety
Kraemer, K. M., O’Bryan, E. M., & McLeish, A. C. (2016) · Mindfulness · doi:10.1007/s12671-016-0524-x · Cited by 51 · see citing works
Eichenberg, C., & Schott, M. (2019) · Journal of Medical Internet Research · doi:10.2196/10980 · Cited by 48 · see citing works
Baerg, L., & Bruchmann, K. (2022) · Acta Psychologica · doi:10.1016/j.actpsy.2022.103534 · Cited by 46 · see citing works
Blackburn, J., Fischerauer, S. F., Talaei-Khoei, M., Chen, N. C., Oh, L. S., & Vranceanu, A.-M. (2019) · Clinical Orthopaedics & Related Research · doi:10.1097/corr.0000000000000888 · Cited by 42 · see citing works
Relationships between online health information seeking and psychopathology
Berle, D., Starcevic, V., Khazaal, Y., Viswasam, K., Hede, V., & McMullan, R. D. (2020) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2019.04.006 · Cited by 29 · see citing works
O’Bryan, E. M., & McLeish, A. C. (2017) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-017-9613-y · Cited by 25 · see citing works
Anandkumar, S. (2015) · Physiotherapy Theory and Practice · doi:10.3109/09593985.2014.989296 · Cited by 11 · see citing works
Cognitive and Behavioral Mechanisms of Health Anxiety
Fergus, T. A., & Asmundson, G. J. G. (2019) · The Clinician's Guide to Treating Health Anxiety · doi:10.1016/b978-0-12-811806-1.00004-4 · Cited by 5 · see citing works
Self-citation
- Authors
- Fergus, T. A.
- Affiliations
- Baylor University (US)
- Corresponding author
- Fergus, Thomas A.
- ORCID
- Fergus, Thomas A.
- Venue
- Cyberpsychology Behavior and Social Networking
- Publisher
- SAGE Publications
- Published
- 2013-10
- Volume
- 16
- Issue
- 10
- Pages
- 735-739
- ISSN
- 2152-2715 (ISSN-L)
- 2152-2723
- OpenAlex
- W1978752924
- Cited by
- 174
- References
- 33
- Citations by year
- 2026: 12 · 2025: 19 · 2024: 15 · 2023: 17 · 2022: 23 · 2021: 19 · 2020: 17 · 2019: 12 · 2018: 8 · 2017: 9 · 2016: 9 · 2015: 5 · 2014: 8 · 2012: 1
- FWCI
- 13.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Cyberpsychology Behavior and Social Networking (publishedVersion)
- PubMed (publishedVersion)
- 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 › Clinical Psychology › COVID-19 and Mental Health
- Keywords
- cyberchondria, intolerance of uncertainty, health anxiety, moderating effect, health information seeking, general distress
- MeSH terms
- Adult, Anxiety, Female, Health, Humans, Male, Middle Aged, Psychological Tests, Internet, Uncertainty, Young Adult, Information Seeking Behavior
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
