Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Feb 9, 2021
Date Accepted: Jul 21, 2021
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Conceptualizations of ‘cyberchondria’ and relations to the anxiety spectrum: A systematic review and meta-analyses
ABSTRACT
Background:
“Cyberchondria” describes detrimental effects of health-related Internet use. Current conceptualizations agree that cyberchondria is associated with anxiety-related pathologies and might best be conceptualized as a safety behavior, but little is known about its exact underlying mechanisms.
Objective:
The present systematic review and meta-analyses were conducted (a) to give an overview of conceptualizations of cyberchondria and its relation to anxiety-related pathologies, (b) to quantify the strength of association to health anxiety by using meta-analytic analyses, and (c) to highlight gaps in the literature, and (d) to outline a hypothetical integrative cognitive-behavioral model of cyberchondria based on the available empirical evidence.
Methods:
A systematic literature search was conducted using the PubMed, Web of Science, and PsycInfo electronic databases. N = 25 studies were included for the qualitative and n = 7 studies, comprising N = 3,069 individuals, for the quantitative synthesis. Meta-analyses revealed a strong association of cyberchondria (r = .63) and its subfacets (rs = .24 - .66) to health anxiety.
Results:
Results indicate that cyberchondria is a construct distinct, yet related to, health anxiety, obsessive-compulsive symptoms, intolerance of uncertainty, and anxiety sensitivity. Further studies should distinguish between state and trait markers of anxiety-related pathologies and use experimental and naturalistic longitudinal designs to differentiate among risk factors, triggers, and consequences related to cyberchondria.
Conclusions:
Health-related Internet use in the context of health anxiety is best conceptualized as a health-related safety behavior maintained through intermittent reinforcement. We present a corresponding integrative cognitive-behavioral model.
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