Previously submitted to: JMIR Mental Health (no longer under consideration since Feb 14, 2026)
Date Submitted: Feb 13, 2026
Open Peer Review Period: Feb 14, 2026 - Feb 14, 2026
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Health Anxiety and Collective Sense-Making in the Chinese Social Media Sphere: A Topic Modeling Assessment of Weibo Chatters
ABSTRACT
Background:
Health anxiety is a constant state of concern and worry about one’s physical well-being. The pervasive penetration of social media is reshaping the generative logic and communication pathways of health anxiety, which is significantly impacting public mental health and individual behavior.
Objective:
This study aimed to examine the topic threads of health anxiety discussions on Sina Weibo as well as the threat and efficacy elements contained in the health-related messages through the Extended Parallel Process Model (EPPM) framework.
Methods:
A total of 138,587 social media posts related to health anxiety were collected using keyword combination of “health” AND (“worry” OR “concern” OR “anxiety”) on the Weibo open API. Latent Dirichlet Allocation (LDA) model procedures were applied to identify the main topics in health anxiety discussions. Moreover, 1,480 most popular posts ranked by “Like” clicks were selected for manual textual analysis. Based on the Extended Parallel Process Model (EPPM), four dimensions—severity, susceptibility, self-efficacy, and response efficacy—were used as the coding framework for content analysis to systematically ascertain the topic structure, information characteristics and information acceptance of health anxiety Weibo discussions.
Results:
Discussions of health anxiety cover a wide range of topics. The most prominent topic is positive living and health ideals (intensity = 0.4456), and other major topics include sleep disorders and mental health, adolescent mental health education and social adaptation, healthy lifestyle and self-management. There is a noticeable imbalance between elements of threat and efficacy in health anxiety discussions. Threat information dominates health anxiety discussions, with severity being the most prevalent component (73.24%). Conversely, efficacy information is much less featured, particularly regarding response efficacy (16.15%). Higher perceived threat levels in health anxiety discussions correlate with reduced engagement (fewer likes), whereas greater efficacy information levels are associated with increased engagement (more likes).
Conclusions:
Health anxiety discussions on social media exhibit a generative logic characterized by thematic threads emphasizing positive confidence-building, proactive measures, ailment-specific guidance, and subgroup-focused solution tips. Users' conception of health anxiety reflects a contradictory pattern of "high threat-low efficacy", wherein information about health threats is far more prevalent than information about self-efficacy. These findings validate and extend the psychological mechanisms in the EPPM framework regarding individuals' responses to risk appeal information. Clinical Trial: N/A
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