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The current paper presents the results from some research on the relationship between Internet addiction, cyberchondria, and different aspects of well-being. The information available on the Internet, which is not necessarily truthful and accurate, can unreasonably amplify users health concerns. Problematic Internet use, health anxiety aroused by online searches for health information and escalation of health concerns as an indicator of cyberchondria, are all associated with a decrease in subjective and eudaimonic well-being as well as in self-esteem. The analyses indicate positive relationships between depressive symptoms on the one hand, and Internet addiction and health anxiety, on the other. A conclusion regarding the existence of a relationship between Internet addiction, cyberchondria and decreased levels of well-being could be drawn from the research. Furthermore, the results suggest that self-esteem and eudaimonic well-being correlate positively with the number of people with whom users communicate online.
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Journal of Education Culture and Society No. 1_2013
Eliza Ivanova
Internet addiction and cyberchondria
- Their relationship with Well-Being
The current paper presents the results from some research on the relationship between In-
ternet addiction, cyberchondria, and different aspects of well-being. The information available
on the Internet, which is not necessarily truthful and accurate, can unreasonably amplify users
health concerns. Problematic Internet use, health anxiety aroused by online searches for health
information and escalation of health concerns as an indicator of cyberchondria, are all associated
with a decrease in subjective and eudaimonic well-being as well as in self-esteem. The analyses
indicate positive relationships between depressive symptoms on the one hand, and Internet ad-
diction and health anxiety, on the other. A conclusion regarding the existence of a relationship
between Internet addiction, cyberchondria and decreased levels of well-being could be drawn
from the research. Furthermore, the results suggest that self-esteem and eudaimonic well-being
correlate positively with the number of people with whom users communicate online.
Key words: Internet addiction, health anxiety, cyberchondria, well-being
The purpose of this paper is to study the relationships between Internet addic-
tion, cyberchondria and well-being. To broaden the scope of ndings, the concept
of well-being has been elaborated by measuring subjective well-being, eudaimonic
well-being, self-esteem and depression. The assumption is that self-esteem is con-
sistent with well-being, while depression is negatively associated with well-being
(Ryff, & Keyes, 1995; Wood, & Joseph, 2010).
Internet addiction
There are not only terminological differences between researches in the eld of
problematic Internet use, but there are also contrasts between their views on the nature
of Internet addiction. Most widely the criteria for pathological gambling from DSM-IV
have been adapted for problematic Internet use. Thus Internet addiction is commonly
de ned as impulse control disorder (Young, 1996). As far as the variations of Internet
addiction are concerned, there are also some contrasting opinions. David Green eld
(1999) distinguishes between a primary problem and a secondary problem with the In-
ternet. The primary problem is characterized with the Internet itself being the focus of
problematic behaviour, while the secondary problem arises when a pre-existing com-
DOI: 10.15503/jecs20131-57-70
58 Transgression
pulsive behaviour is released via the Internet. According to Green eld (1999) aspects of
the Internet such as: easy access, anonymity, no time and space restrictions, and disin-
hibition, turn it into an object of addiction and a tool for augmenting it. Richard Davis
(2001, as cited in Caplan, 2005), similarly to Green eld, differentiates between speci c
and generalized pathological Internet use. The speci c pathological use is devoted to
a single activity online: gambling, auctions, sexual content and so on. The generalized
pathological use is versatile and encompasses many Internet applications.
Internet addiction could be connected with depressive affect, loneliness and unful-
lling relationships (Caplan, 2003, 2005; Young, & Rodgers, 1998). D. Green eld (1999)
argues that the Internet is used as a coping tool for distraction from negative thoughts
and for mood alteration. Kimberly Young (1999) stated that people with low self-es-
teem and depressive people are highly prone to Internet addiction, because they use
the Internet predominantly for communication, in order to cope with their problems
or compensate for them online. Findings suggest that users addicted to the Internet are
more depressive and mainly introverted, in contrast with users who do not consider
themselves problematic (Petrie & Gunn, 1998, as cited in Widyanto, & Grif ths, 2005).
Gert-Jan Meerkerk, Regina Eijnden, Ad Vermulst, and Henk Garretsen (2007)
established that real time Internet communication could be connected with com-
pulsive tendencies, namely loss of control and preoccupation with the Internet. The
authors inferred a relationship between Internet communication and depressive af-
fect for a six-month period. They noted that communicating with strangers is associ-
ated with higher depressive affect, than communicating with friends and relatives.
Katherine Bessiere, Sara Kiesler, Robert Kraut, and Bonka Boneva (2004) claimed
that social skills in real-world situations could bene t from online communication
with strangers. In opposition to this view of social compensation is the hypothesis
“the rich get richer”, according to which people with better interpersonal skills are
those who avail themselves of online communication.
In his cognitive-behavioural theory, R. Davis (2001, as cited in Caplan, 2005) con-
tends that depression and loneliness are distant predispositions to problematic Inter-
net use. On the other hand, there is the view that excessive Internet use could lead to
social isolation and loneliness, through neglect of important aspects of personal life. K.
Young (1999) described the outcomes of Internet addiction as depression, loneliness,
joylessness. The typical addiction symptoms are: tolerance, withdrawal, constant in-
crease in the time spent online, unsuccessful attempts to cut down the time online,
negative repercussions on other aspects of life. As the addiction intensi es, the user’s
feelings become more and more negative. In turn, the addicted person tries to com-
pensate by increasing the time spent online, on order to experience positive feelings.
Junghyun Kim, Robert LaRose, and Wei Peng (2009) con rmed both assump-
tions in their ndings. It is not so much the social applications of the Internet, but
the entertainment ones, such as downloading of les and watching videos online,
that are connected with decreased well-being. Downloading and watching videos
are activities associated with loneliness to a greater extent than online communica-
tion is. Yair Amichai-Hamburger (2009) shares the opinion that online relationships
could have a positive effect on the well-being of people, due to the unique context of
openness, self-disclosure and support of the Internet.
Journal of Education Culture and Society No. 1_2013
Health anxiety
Health anxiety can be de ned as unfounded health concerns for personal health,
when there is no pathology, or excessive worries, when there is an insigni cant
health problem (Lucock & Morley, 1996, as cited in Gravatt & Brown, n.d.). Health
anxiety varies from occasional worries to intense fear and anxiety, leading to poor
well-being (Asmundson, Taylor, Sevgur, & Cox, 2001, as cited in Gravatts, & Brown,
n.d.). The cognitive-behavioural theory postulates that health anxiety is the result
of misinterpreting information regarding a person’s own bodily sensations, in line
with the arisen concerns for a serious illness (Salkovskis, Warwick, & Deale, 2003).
The desire of people with health anxiety is to nd solace in the information they
continually look through. But usually the consequences are intensi ed worries due
to anxious people’s inaccurate interpretation of medical data or their inability to
integrate positive information (Gravatt & Brown, n.d.).
Mathew Eastin and Natalie Guinsler (2006, as cited in White, & Horvitz, 2009) reg-
istered a relationship between looking for health information online and visiting a
doctor, in which health anxiety is a moderator. The ndings from Ryen White and
Eric Horvitz’s (2009) research demonstrate an even distribution between participants
who report that their health anxiety decreases after using the Internet and participants
who claim that it increases. Trait anxiety could contribute to high levels of health anxi-
ety and the escalation of health concerns caused by information on the Internet.
Finding health information on the Internet could be potentially bene cial to users.
Learning more about their own health status and whether they should visit a doc-
tor could lead people to a more responsible attitude towards their condition, such as
keeping to a suitable diet, exercising, healthy living, adhering to the prescribed treat-
ment and so on. Another advantage of using the Internet for health related issues is
the social support one could receive from others with similar conditions, especially
in cases of socially intolerable illnesses or problems which could hardly be discussed
in everyday situations. Anonymity in virtual space enables people with stigmatiz-
ing problems to overcome the burden of not being able to talk about their condition.
Furthermore, by learning more about one’s illness, one can better understand the pre-
scribed treatment, become actively involved in it, and thus assist the professionals.
Broadening the knowledge of a problem widens the perspective of the person and
increases the probability of higher responsibility. The Internet could serve as a tool for
empowering patients (Jones, 2000; Powell, Darvell, & Gray, 2003).
Health oriented websites designed on the principle of self-diagnosis addition-
ally stimulate health anxiety. Furthermore these sites attract people with tendency
for cyberchondria, who can only suffer the negative consequences of using such
resources (Ryan, & Wilson, 2008). There is also a possibility of misinterpreting or
only partially understanding medical information. The user might be overwhelmed
by complex medical terminology and subsequently might become increasingly con-
cerned. The result may be a bleak self-diagnosis (Benigeri, & Pluye, 2003, as cited
in Whites, & Horvitz, 2009). Further, it should be considered that even if the user
were able to fully comprehend the information, there would be a possibility that
the patient-doctor relationship might suffer. Patients might unreasonably raise their
60 Transgression
requirements to their doctors, causing tension in the interactions and therefore im-
peding the healing process. Doctors might perceive patients’ Internet research as an
indication of mistrust, especially if a patient argues with the specialist and tries to
interfere. If a patient decides to believe what they have read online instead of what
their doctors say, the outcome might be detrimental on the treatment.
A focus group study by Gunther Eysenbach and Christian Köhler (2002) of two
groups of participants, completing health related web search tasks, indicated that users
rarely check which organisation is behind the web site and whether the information on
it is reliable. People also do not usually enter combinations of words when searching
for medical problems, which contributes to the decline in the accuracy of the results.
Users are most likely to pick one of the rst few results from the search and easily para-
phrase their key word, changing the focus of the search (Atkinson, Saperstein, & Pleis,
2009; Eysenbach, & Köhler, 2002). G. Eysenbach and C. Köhler (2002) registered that
97% of the followed links are amongst the rst ten results from the search and 71% are
amongst the rst ve. Moreover, the majority of users look for medical information not
in specialized health portals, but rather in the search engines, which display links to
all kinds of sources, including forums and blogs (Atkinson, Saperstein, & Pleis, 2009).
Christina Zarcadoolas, Mercedes Blanco, John Boyer and Andrew Pleasant (2002, as
cited in Atkinson, Saperstein, & Pleis, 2009) found that health is one of the main top-
ics being researched on the Internet by the less educated. On the other hand, Nancy
Atkinson, Sandra Saperstein, and John Pleis (2009) report more women and people
with a bachelor’s or higher degree looking for health information online, compared to
men and people with lower education. The authors conclude that people who use the
Internet daily for at least one hour are prone to search for medical information.
The term cyberchondria has been used by the researches from Harris Interactive
since 1999 (The Harris Poll, 1999) in their research on looking for health informa-
tion on the Internet. The authors who have carried out the most extensive research
on the topic are R. White and E. Horvitz (2009). They de ne cyberchondria as the
“unfounded escalation of concerns about common symptomatology, based on the
review of search results and literature on the Web” (White, & Horvitz, 2009, p. 1).
A key concept for understanding cyberchondria is the escalation of concerns, con-
nected with changing the focus of attention from nonspeci c symptoms to serious
illnesses, following the results of a web search. The authors also single out persis-
tence of concerns, search habits and cognitive bias as vital aspects of cyberchondria.
Hypochondria is typically rare – 1-5% of the population (Barsky, & Klerman,
1983) and 3% of primary care patients (Escobar, Gara, Waitzkin, Silver, Holman,
& Compton, 1998) experience it. It is characterized with fears that insigni cant non-
speci c symptoms indicate a serious illness (Barsky, & Klerman, 1983). Hypochon-
driacs have tendencies for self-examination, self-diagnosis, and are xated on their
own body. They do not trust the assurances of their doctors that they are not ill. The
Internet is therefore a stimulating medium for unfounded health concerns.
Journal of Education Culture and Society No. 1_2013
R. White and E. Horvitz (2009) conducted a research with 515 Microsoft em-
ployees, using their logs from Internet health search as well as administering a
questionnaire. The questions relate to online health search behaviour and the im-
pact of the information on health concerns. Participants demonstrated low levels
of health anxiety, but escalation of health concerns after web search was registered
in one out of every ve people. It was con rmed that the escalation of concerns
can lead to temporary or long-term increase in the levels of health anxiety and
additional doctor visits. A considerable number of the respondents used the In-
ternet as a differential diagnosis tool, by looking through a list of illnesses and
deciding which one was applicable to their condition. More than half of the re-
spondents stated that often or sometimes they considered the order of the results
from the web search a re ection of the probability of having a certain illness. Bi-
ases of judgement, such as availability bias and base-rate neglect, are regarded as
important aspects of cyberchondria (White, & Horvitz, 2009). Availability bias is
an increase in the evaluated probability that something will happen, because of re-
cent and intense exposure to particular events. Base-rate neglect is associated with
ignoring the low probability that something will happen, on account of viewing
evidence in support of the event.
R. White and E. Horvitz (2010) establish an escalation of concerns in two thirds
of the cases when a serious illness is mentioned before an alternative explanation for
a certain symptom on a web page. Should the alternative explanation precede the
serious illness, an escalation is registered in one third of the cases.
The main objective of this study is to identify and clarify the relationships be-
tween Internet addiction, cyberchondria and well-being. In this context, the aim of
the research is to examine the relationships between excessive Internet use, using
the Internet for health information and well-being indicated by: subjective well-be-
ing, eudaimonic well-being, self-esteem and depression.
Participants. The study was conducted in Bulgaria in 2012. We collected data
from 378 participants (41% male and 59% female). According to age, three groups
were set apart: up to 20 years of age (34%), from 21 to 26 years of age (33%) and
over 26 years of age (33%). As far as marital status was concerned, two groups were
formed: living without a partner (73%) and living with a partner (27%). According
to the education acquired up to the moment, participants were divided into two
groups: with secondary education (56%) and with higher education (44%). Univer-
sity and high school students composed 47% of all participants. The distribution
of respondents’ place of residence is uneven: 72% live in So a (the capital city of
Bulgaria), 15% live in another large city in the country, and 9% live in a small town
and 4% - in a village.
62 Transgression
Internet addiction. The Internet Addiction Test (IAT), designed by K. Young (1998,
in Widyanto, & McMurran, 2004), consists of 20 items describing behaviours which
depending on their frequency could be linked to different aspects of Internet addic-
tion. Factor analyses revealed six factors: salience, excessive use, neglecting work, ne-
glecting social life, anticipation, and lack of control. For the purpose of the present
research, we used a ve-point Likert scale ranging from 1 (never) to 5 (always). The
score on the IAT ranges from 20 to 100. K. Young de ned three groups of users ac-
cording to the score: 20–39 - an average user without control issues; 40–69 - a user with
problems; 70-100 – a user with signi cant problems due to uncontrolled Internet use.
We included additional questions regarding Internet use from the research of
Oliver Egger and Matthias Rauterberg (1996): questions concerning the positive and
negative in uence of the Internet on users’ lives; questions, regarding the number
of people with whom users communicate via the Internet, the number of acquain-
tances made solely on the Internet and the number of Internet acquaintances met in
Health anxiety. The second questionnaire measures anxiety aroused by online
health information seeking (Gravatt, & Brown, n.d.). It consists of 14 items concern-
ing the use of Internet for health information, as well as the cognitions and affects
provoked by that use. The responses were measured with a ve-point Likert scale
ranging from 1 (strongly disagree) to 5 (strongly agree). The authors formed three
factors: belief that online health information is accurate; extent of online health infor-
mation seeking; anxiety aroused by online health information seeking.
Cyberchondria. The questions concerning cyberchondria were taken from R.
White, and E. Horvitz’s (2009) research. We included items concerning users’ per-
ceptions of health information on the Internet, their experience with searching the
web for health information, and the in uence of the Internet on their health con-
cerns. A few different response scales were used: a dichotomous scale with yes/no
answers; Likert type scales ranging from 1 (never) to 5 (always) and from 1 (I do not
worry at all) to 5 (I worry excessively).
Subjective well-being. The Satisfaction with Life Scale (Pavot, & Diener, 1993)
was used for assessing subjective well-being. The scale consists of ve items re ect-
ing satisfaction from the way a person lives their life and from who they are. We
applied a ve-point Likert scale ranging from 1 (Strongly disagree) to 5 (Strongly
Eudaimonic well-being. The questionnaire measuring eudaimonic well-being
was designed by Alan Waterman, Seth Schwartz, Byron Zamboanga, Russel Ravert,
Michelle Williams, Bede Agocha, Su Kim, and Brent Donnellan (2010). The authors
de ne eudaimonic well-being as incorporating subjective as well as objective ele-
ments. Subjective elements are feelings of personal expressiveness and objective ele-
ments are all behaviours directed at self-realisation, through the recognition and
development of personal potential, so that one leads a meaningful life. The ques-
tionnaire is comprised of 21 items. The scale we applied was a ve-point Likert one,
ranging from 1 (Strongly disagree) to 5 (Strongly agree).
Journal of Education Culture and Society No. 1_2013
Self-esteem. The Rosenberg Self-Esteem Scale (Rosenberg, 1989), consisting of
10 items, was used with a four-point Likert scale ranging from 1 (Strongly agree) to
4 (Strongly disagree).
Depression. We applied the short eight-item version of the Center for Epidemio-
logic Studies Depression Scale by Lenore Radloff (1977, in Van de Velde, Bracke,
& Levecque, 2008) – CES-D 8. Participants had to answer with regard to their state
during the past week. The response scale we used was four-point Likert type rang-
ing from 1 (rarely) to 4 (most of the time).
Results and Discussion
The data were analysed with the computer program SPSS.
Internet Addiction
The conducted research indicates that participants experience problems with
their Internet use (M=40.23; SD=11.53). Those participants who did not demonstrate
problematic Internet use were 55%. The problematic users were 43% of the partici-
pants in the study, and the last 2% experienced signi cant problems as a result of
their online activity. The data shows that generally participants did not display high
levels of the factors of Internet addiction described by K. Young (1998, in Widyanto,
& McMurran, 2004) (see table 1).
Table 1. Results from a descriptive analysis of the Internet Addiction Test
Mean (M) Standard
deviation (SD)
Minimum Maximum
Internet addiction 40.23 11.53 20 86
Salience 1.73 0.65 1 4.50
Lack of control 2.28 0.89 1 4.60
Neglecting work 1.82 0.72 1 5.00
Neglecting social life 1.92 0.72 1 4.67
Anticipation 2.22 0.86 1 5.00
Excessive use 2.19 0.70 1 4.67
Source: Author
The results indicate a tendency for Internet addiction, anticipation of the next
session, and use of the Internet for longer than intended, which is connected with
lack of control. However, the scores are not high enough to suggest a considerable
disturbance in the way of life of respondents due to Internet use.
Health Anxiety
The data from the questionnaire for health anxiety aroused by online searching
for health information were analysed with the methods of descriptive statistics. The
levels of: health anxiety (M=25.56; SD=7.73), belief that online health information
is accurate (M=8.34; SD=2.60), and extent of online information seeking (M=7.70;
SD=2.61) are moderate.
64 Transgression
The items of the questionnaire for cyberchondria were analysed with the meth-
ods of descriptive statistics. It was registered that participants rarely look for health
information online (M=1.91; SD=3.04) and even more so for undiagnosed health is-
sues (M=0.96; SD=1.70). These results are considerably lower than those reported by
R. White and E. Horvitz (2009). Regarding the nature of the health information which
participants search for, the results indicated that physical symptoms were what users
check online most of the time (45% looked symptoms up online). The ndings sug-
gested that 36% of participants looked for information shared by others with a similar
condition to theirs. This might be a possibility for people to be in uenced by other non-
professionals. The results revealed that 33% of respondents searched for information
on diagnosed conditions and 26% looked for information about serious illnesses. The
latter might be an indicator for cyberchondria. In the present study, 6% of participants
de ned themselves as hypochondriacs, while 11% had been referred to as such.
The questions regarding the level of hypochondria and health anxiety, as well as
the tendency for reviewing websites for serious illnesses, when looking for information
on non-speci c symptoms, represent the escalation of health concerns. We found that
34% of respondents were prone to change the focus of their search, while 26% claimed
they never did that. In contrast with our ndings, R. White and E. Horvitz (2009) reg-
istered 63% of users as likely to change the focus of their search. Our Bulgarian sample
seems to be stricter in health searches, although the percentage of people who tend to
change the search topic from a benign symptom to a serious illness is still considerable.
As for the questions on the topic of persistence of health concerns, we registered
that 46% of users continued to look for information after they had had their doubts
raised about a serious illness by information on the Internet. Only 19% reported having
disturbances in their online activities and 14% experienced disturbances in their usual
everyday activities, as a result of raised concerns. 81% declared that worrying health
information rarely or never in uenced their online activities and respectively 86%
stated that regarding their of ine activities. It can be concluded that respondents are
generally more skeptical about a possible connection between the order of the search
results and the probability of the illnesses described in each of them. According to 51%
of respondents there was no such connection, while 28% found it rarely. Only 21%
believed that there was a direct connection between the rank of the result and its rel-
evance for the searched symptom. In R. White and E. Horvitz’s (2009) study, 51% of the
sample shared that opinion. In the present study 25% of respondents used the Internet
as a diagnostic tool. This is a premise for the development of unfounded concerns. The
powerful in uence of Internet information is notable in the following results: 45% of
users visited a doctor after reviewing disturbing health information online and 86%
declared that a checkup reassured them that their concerns were unsubstantiated.
Relationships between Internet addiction, health anxiety, cyberchondria and
To investigate the relationships between Internet addiction, health anxiety
aroused by online health search, and escalation and persistence of health concerns
as aspects of cyberchondria, we conducted correlation analyses (see Table 2).
Journal of Education Culture and Society No. 1_2013
Table 2. Results from correlation analyses of Internet addiction, health anxiety
and cyberchondria
Belief that
online health
information is
of online
Internet addiction 1 0.192* 0.033 0.144* 0.267** 0.171**
Health anxiety 1 0.372** 0.788** 0.367** 0.439**
Belief that online
health information
is accurate
10.486** 0.108* 0.214**
Extent of online
10.230* 0.421**
Escalation of
concerns 10.354*
Persistence of
concerns 1
** p<0.01; * p<0.05
Source: Author
The results showed the following tendencies. Positive relationships were regi-
stered between the studied phenomena. We established that Internet addiction was
positively correlated with escalations (r=0.267) and persistence (r=0.171) of health
concerns as indicators of cyberchondria, with health anxiety (r=0.192), and with the
extent to which respondents use the Internet for health information (r=0.144).
As expected health anxiety was correlated with the belief that online health infor-
mation is accurate (r=0.372) and with the extent to which Internet is used for health
information (r=0.788). Health anxiety was also correlated with escalation (r=0.367)
and persistence of concerns (r=0.439). Escalation of concerns correlated with persi-
stence of concerns (r=354), which was also expected, since they are both aspects of
cyberchondria. Logically the belief that online health information is accurate was
in positive relationship with the extent of online information seeking (r=0.486). We
registered weaker correlations between the belief that online health information is
accurate and escalation (r=0.108) and persistence of concerns (r=0.214). The extent
to which a user looks for health information online was positively correlated with
escalation (r=0.230) and persistence (r=0.421) of concerns.
For the revelation of the relationships between Internet addiction, health anxiety,
cyberchondria, subjective and eudaimonic well-being, self-esteem and depression,
correlation analyses were carried out. The results are presented in table 3.
66 Transgression
Table 3. Results from correlation analyses of the relationships between Internet
addiction, health anxiety, cyberchondria, well-being, self-esteem and depression
well-being Self-esteem Depression
Internet addiction -0.134** -0.199** -0.231** 0.276**
Health anxiety -0.074 -0.145** -0.154** 0.159**
Belief that online health
information is accurate 0.006 0.042 0.030 0.011
Extent of online
information seeking -0.015 -0.054 -0.088 0.087
Escalation of concerns -0.135** -0.169** -0.107* 0.187**
Persistence of concerns -0.060 -0.102 -0.014 0.108*
** p<0.01; * p<0.05
Source: Author
The analyses showed that Internet addiction correlated signi cantly and positi-
vely with depression (r=0.276) and signi cantly but negatively with subjective well-
-being (r=-0.134), eudaimonic well-being (r=-0.199) and self-esteem (r=-0.231). These
results, indicating that uncontrolled Internet use is associated with lowered levels of
well-being and self-esteem, are consistent with previous research (Young, & Rogers,
1998; Caplan, 2003, 2005).
Health anxiety was also positively correlated with depression (r=0.159) and negati-
vely correlated with self-esteem (r=-0.154) and eudaimonic well-being (r=-0.145). Esca-
lation of concerns correlated negatively with both subjective (r=-0.135) and eudaimonic
(r=-0.169) well-being as well as with self-esteem (r=-0.107). On the other hand, we re-
gistered positive correlations between escalation of concerns and depression (r=0.187)
and between persistence of concerns and depression (r=0.108). These ndings suggest
that health anxiety and escalation of concerns as an aspect of cyberchondria are negati-
vely associated with well-being and self-esteem and positively – with depression.
To examine the relationships between well-being, self-esteem and depression,
on the one hand, and the in uence of the Internet and some communication aspects,
on the other, we preformed correlation analyses (see Table 4).
The ndings show that subjective well-being did not correlate signi cantly
either with perceived positive in uence of the Internet or with its negative in uen-
ce. Eudaimonic well-being was weakly and positively correlated with positive in-
uence of the Internet (r=0.112) and weakly and negatively correlated with negative
in uence of the Internet (r=-0.162). We could speculate that eudaimonic well-being
is a more complex construct than subjective well-being which incorporates perso-
nal expressiveness as well as development of the personal potential (Waterman,
Schwartz, Zamboanga, Ravert, Williams, Agocha, Kim, & Donnellan, 2010), and
therefore eudaimonic well-being more sensitively re ects the in uence of the Inter-
net on the person. We could conclude that eudaimonic well-being is connected with
the positive in uence of the Internet on one’s life. The perceived negative in uence
of using the Internet correlated weakly and negatively with self-esteem (r=-0.142)
and positively with depression (r=0.177).
Journal of Education Culture and Society No. 1_2013
Table 4. Results from correlation analyses of positive and negative in uence of
the Internet, communicational aspects of the Internet, well-being, self-esteem and
nic well-
Self-esteem Depression
in uence of
the Internet
in uence of
the Internet
in uence of the
0.053 0.112* 0.074 -0.021 1 0.145**
in uence of the
-0.075 -0.162** -0.142** 0.177** 0.145** 1
People with
whom I
via the Internet
0.094 0.154** 0.110* -0.092 0.189** -0.005
made on the
-0.040 0.067 0.053 -0.007 0.080 0.139**
People from
my Internet
acquaintances I
met in person
0.013 0.039 0.091 -0.010 0.174* 0.001
** p<0.01; * p<0.05
Source: Author
In summary, the negative effect of the Internet on users’ lives was to some ex-
tent connected with decreased levels of eudaimonic well-being and self-esteem, and
increased levels of depression. We found that perceived positive in uence of the
Internet correlated weakly but positively with the perceived negative in uence of
the Internet (r=0.145). A possible explanation could be that the positive sides of the
Internet do not exclude the negative ones and users supposedly realise this. As well
as advantages, the Internet has inevitable setbacks - it is time-consuming and as a
result users neglect other areas of their lives.
We established that the number of people with whom respondents communi-
cate via the Internet correlated weakly but positively with eudaimonic well-being
(r=0.154), with self-esteem (r=0.110) and with the perceived positive in uence of the
Internet (r=0.189) (see Table 4). These ndings are consistent with other research on
Internet communication and well-being. Kim, LaRose and Peng (2009) con rmed
that it is not the social applications of the Internet, but the entertainment ones, that
are connected with decreased well-being. Y. Amichai-Hamburger (2009) underlines
the positive effect of online relationships on well-being.
In contrast, the number of acquaintances made solely on the Internet was posi-
tively and weakly correlated with the negative in uence of the Internet (r=0.139).
This result leads us to the conclusions drawn by researches like G. Meerkerk, R.v.d.
Eijnden, A. Vermulst, and H. Garretsen (2007), who pointed out that communica-
68 Transgression
tion with strangers is connected with higher depressive affect, than communication
with friends. Although we did not establish the same relationship with depressive
affect, we did register a connection with the negative effects of the Internet.
Nevertheless, meeting in person people met on the Internet was positively and
weakly correlated with the positive in uence of the Internet (r=0.174). We could
infer that as long as people manage to incorporate their online life with their real
life, they would probably perceive positively the Internet experience. As John Suler
(1999) states, it is important to integrate the Internet use into the real life, so that
the two would complement one another. Meeting the acquaintances made on the
Internet and communicating with friends and relatives using the Internet is a way
of enriching interpersonal relationships.
The present empirical study, conducted in Bulgarian social and cultural envi-
ronment, indicates the following main ndings. On the basis of the results it can be
concluded that participants did not demonstrate high levels of cyberchondria and
health anxiety aroused by seeking health information online. The Internet addiction
score was just in the group characterized with problematic control over Internet use.
Signi cant relationships were indenti ed between Internet addiction, health anxi-
ety aroused by seeking health information online, and escalation of concerns and per-
sistence of concerns as aspects of cyberchondria. Excessive use of the Internet, search-
ing for health information on the Internet, and subsequent worries for the personal
health, appear to be all associated with one another. Further looking into the relation-
ships between these phenomena and subjective well-being, eudaimonic well-being,
self-esteem and depression, the following was established. Elevated levels of Internet
addiction are associated with lower eudaimonic well-being, subjective well-being and
self-esteem and higher depressive affect. The same relationships were registered for
escalation of health concerns following a web search. As far as health anxiety con-
nected with health information online is concerned, it is associated with decreased
eudaimonic well-being and self-esteem, and with increased depressive affect.
Eudaimonic well-being is associated with perceived positive in uence of the
Internet on personal life. Furthermore, negative in uence of the Internet on life is
connected with lower levels of eudaimonic well-being and self-esteem and higher
levels of depression. The more people with whom a user communicates via the In-
ternet, the higher eudaimonic well-being, self-esteem and positive in uence of the
Internet are registered. The results suggest that communicating with a lot of people
whom the user does not personally know is associated with perceived negative in-
uence of the Internet. On the other hand, meeting in person the people originally
met on the Internet, turning them into a part of the real life, is connected with per-
ceived positive in uence of the Internet.
The present study builds on previous research regarding Internet use, health
anxiety, cyberchondria and well-being by revealing relationships between the phe-
nomena in Bulgarian environment, without the claim to generalise the results.
Journal of Education Culture and Society No. 1_2013
Amichai-Hamburger, Y., (2009). Technology and Psychological Well-Being. Cambridge: University Press.
Atkinson, N., Saperstein, S., & Pleis, J. (2009). Using the Internet for health-related activities: ndings
from a national probability sample. J Med Internet Res, 11(1), е4. Retrieved from http://www.jmir.
Barsky, A., & Klerman, G. (1983). Overview: hypochondriasis, bodily complaints, and somatic styles.
Amer. J. Psychiatry, 140(3), 273–283.
Bessiere, K., Kiesler, S., Kraut, R., & Boneva, B. (2004). Longitudinal effects of Internet uses on depressive affect:
a social resources approach. Carnegie Mellon University. Retrieved from
Caplan, S. (2003). Preference for online social interaction. A theory of problematic Internet use and psy-
chosocial well-being. Communication Research, 30(6), 625-648.
Caplan, S. (2005). A social skill account of problematic Internet use, Journal of Communication, December,
55(4), 721-736.
Egger, O., & Rauterberg, M. (1996). Internet behaviour and addiction. Retrieved from http://www.idem-
Eysenbach, G., & Köhler, C., (2002). How do consumers search for and appraise health information on
the world wide web? Qualitative study using focus groups, usability tests, and in-depth interviews.
Brit. Med. J., 324(7337), 573–577.
Escobar, J., Gara, M., Waitzkin, H., Silver, R.C., Holman, A., & Compton, W. (1998). DSM-IV Hypochon-
driasis in Primary Care. Gen Hosp Psychiatry, May, 20(3), 155-159.
Gravatt, S.,& Brown M., (n.d.). Health anxiety and Internet use. Retrieved from http://homepage.mac.
com/psychresearch/Sites/site2/publications/manuscripts/ HealthAnxiety-MJB.pdf.
Green eld, D. (1999). Virtual addiction: sometimes new technology can create new problems, The Center for
Internet Studies @ Psychological Health Associates. Retrieved from http://www.virtual-addiction.
Jones, R. (2000). Self care Important for health services and needing more research, BMJ, March 4; 320, 596.
Kim, J., LaRose, R., & Peng, W. (2009). Loneliness as the cause and the effect of problematic Internet
use: the relationship between Internet use and psychological well-being. CyberPsychology & Behavior,
12(4), 451-455.
Meerkerk, G, Eijnden, R. v. d., Vermulst, A., & Garretsen, H. (2007). The Compulsive Internet Use Scale
(CIUS): some psychometric properties. In: Meerkerk, G. (Ed.) Pwned by the Internet (pp.18-36). Rot-
terdam: Erasmus University.
Potts, H., & Wyatt, R. (2002). Survey of doctors’ experience of patients using the Internet, J Med Internet
Res, 4(1), e5. Retrieved from
Powell, J., Darvell, M., & Gray J. (2003). The doctor, the patient and the World-Wide Web: how the Inter-
net is changing healthcare. J R Soc Med, February, 96(2), 74–76.
Ryan, A., & Wilson, S. (2008). Internet healthcare: do self-diagnosis sites do more harm than good? Expert
Opin. Drug Saf, 7(3), 227-229
Ryff, C., & Keyes, C. (1995). The structure of psychological well-being revisited. Journal of Personality and
Social Psychology, 69(4),719-727.
Salkovskis, P., Warwick, H., & Deale, A. (2003). Cognitive-behavioral treatment for severe and persistent
health anxiety (hypochondriasis). Brief Treatment and Crisis Intervention, 3, 353-368.
Suler, J. (1999). To get what you need: healthy and pathological Internet use. Retrieved from http://users.rider.
Kim, J., LaRose, R., & Peng, W. (2009). Loneliness as the cause and the effect of problematic Internet
use: the relationship between Internet use and psychological well-being. CyberPsychology & Behavior,
12(4), 451-455.
Pavot, W., & Diener, E., (1993). Review of the satisfaction with life scale. Psychological Assessment, 5, 164-
Rosenberg, M. (1989). Society and the adolescent self-image. Revised edition. Middletown, CT: Wesleyan
University Press.
The Harris Poll (1999, February 17). Explosive growth of a new breed of “cyberchondriacs”. Retrieved
70 Transgression
Van de Velde, S., Bracke, P., & Levecque, K. (2008). The psychometric properties of the CES-D 8 depression
inventory and the estimation of cross-national differences in the true prevalence of depression. Retrieved from
Waterman, A. S., Schwartz, S. J., Zamboanga, B. L., Ravert, R. D., Williams, M. K., Agocha, V. Bede,
Kim, S. Y., & Donnellan, M. B. (2010). The questionnaire for eudaimonic well-being: psychometric
properties, demographic comparisons, and evidence of validity, The Journal of Positive Psychology, vol.
5, 41-61.
White, R.W., & Horvitz, E. (2009). Cyberchondria: studies of the escalation of medical concerns in Web
search. ACM Transactions on Information Systems, 27(4), 1-37.
White, R.W., & Horvitz, E. (2010). Predicting escalations of medical queries based on web page structure and
content. Retrieved from
Widyanto, L., & Grif ths, M. (2005). Internet addiction: a critical review. Int J Ment Health Addict, (2006)
4, 31–51.
Widyanto, L., & McMurran, M. (2004). The psychometric properties of the Internet addiction test. Cyber
Psychology and Behavior, 7, 443-450.
Wood, A., & Joseph, S. (2010). The absence of positive psychological (eudemonic) well-being as a risk fac-
tor for depression: A ten year cohort study. Journal of Affective Disorders, 122(3), 213–217.
Young, K. (1996). Internet addiction: the emergence of a new clinical disorder, Cyber Psychology and Be-
havior, 1(3), 237-244.
Young, K., & Rodgers, R. (1998). The relationship between depression and Internet addiction. CyberPsy-
chology & Behavior, 1(1), 25-28.
Young, K. (1999). Internet addiction: symptoms, evaluation, and treatment. Professional Resource Exchange. Re-
trieved from
... Twenty-three studies (64%) [2,10,21,22,29,31,[33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49] met most of the AXIS tool criteria (scores ≥15 out of 20), suggesting high quality. Twelve articles (33%) showed moderate quality (scores between 10 and 14 out of 20) [13,30,[50][51][52][53][54][55][56][57][58][59] and only one study [60] showed poor quality (score <10). ...
... Both gambling disorder and gaming disorder are currently classified in the ICD-11 as disorders "due to addictive behaviours". CYB appears to be a particularly compulsive form of PUI focused on health concerns [50,51]. However, individuals with CYB may excessively use the Internet for other purposes as well [18]. ...
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Background Cyberchondria (CYB) has been described relatively recently as a behaviour characterized by excessive online searching for medical information that is associated with increasing levels of health anxiety. Although CYB has received some attention from researchers, there is no consensus about many of its aspects. Aims We describe one of the first reported cases of a treatment-seeking patient with CYB. We review the published literature on the definition of CYB, its assessment, epidemiology, cost and burden, psychological models and mechanisms associated with CYB, relationships between CYB and mental disorders and prevention and treatment strategies. Methods Systematic review of all peer-reviewed papers published within the PubMed, PsycINFO, and Cochrane Library databases. Results 61 articles were selected. Nearly all the studies were descriptive and cross-sectional recruiting sample mainly from the general/university student population and collecting self-report data via online surveys. Data on epidemiology, clinical features, course, comorbidity and therapeutic interventions were scarce. CYB showed a self-reported association with health anxiety, hypochondriasis and obsessive-compulsive disorder (OCD) as well as other forms of problematic usage of the internet (PUI) The psychological mechanisms associated with CYB include low self-esteem, anxiety sensitivity, intolerance of uncertainty, pain catastrophizing and certain meta-cognitive beliefs. Conclusion A working definition of CYB includes excessive online health searches that are compulsive and may serve the purpose of seeking reassurance, whilst leading to a worsening of anxiety or distress and further negative consequences. CYB represents a clinically relevant transdiagnostic compulsive behavioural syndrome, closely related to PUI and usually presenting in association with health anxiety, hypochondriasis and/or OCD. CYB is clearly in need of further study and we identify key areas for future research.
... In cyberchondria, the urge to search despite the negative effects (i.e., time-spending, higher distress, neglect of commitments, interpersonal conflict, problems with health professionals, and increasing use of health care services) and the consequent loss of control over Internet use, and in particular health information seeking, may be features associated with a form of behavioral addiction (Billieux et al., 2016;Kardefelt-Winther et al., 2017). Previous studies (Doherty-Torstrick et al., 2016;Ivanova, 2013) have already considered cyberchondria as a specifically compulsive form of problematic Internet use characterized by health concerns, suggesting potential links between cyberchondria and Internet addiction, which seem to be confirmed in a recent study by Mrayyan et al. (2022). Other scholars showed that individuals characterized by a problematic use of the Internet, which causes preoccupations, significant distress or functional impairment (Shapira et al., 2003), tend to show a more severe cyberchondria, regardless of age, gender, current reported medical status, negative affect or health anxiety (Fergus and Spada, 2017). ...
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Since the global pandemic of the coronavirus disease 2019 (COVID-19), online health information-seeking behaviors have notably increased. Cyberchondria can be a vulnerability factor for the worsening of anxiety-depressive symptoms and quality of life. The current study aims to understand the predictive effect of cyberchondria on health anxiety, anxiety, depression and quality of life considering the mediating effect of obsessive-compulsive symptoms and Internet addiction and the moderating effect of COVID anxiety. 572 Italian participants (66% female; Mean age = 34; SD = 15) took part in a cross-sectional online survey involving CSS-12, MOCQ-R, IAT, SHAI, HADS, WHOQoL-BREF and CAS. Mediation and moderation analyses were conducted. Obsessive-compulsive symptoms and Internet addiction were found to partially mediate the cyberchondria-health anxiety and the cyberchondria-anxiety links and to totally mediate the cyberchondria-depression and the cyberchondria-quality of life links. COVID anxiety was found to moderate the relationship between cyberchondria and anxiety. The findings suggest that compulsivity may have a key role in the explanation of the underlying mechanisms of cyberchondria. Healthcare practitioners should provide additional support for individuals with cyberchondria. As such, cyberchondria is a contributing factor to the exacerbation of anxiety-depressive disorders and may impact on the quality of life.
... An association between PIU and somatic symptoms has been established by various researches where it was observed that not only is PIU significantly positively correlated with health anxiety and the extent to which PIU is used for health information, but also with escalation and persistence of health concerns. 41 Given that our study was carried out during the COVID-19 pandemic, when the level of health anxiety and cyberchondria was already elevated, 42 it is reasonable to posit that persistent somatic concern can significantly predict PIU. It can be used to seek health information, and such information-seeking behaviours can be persistent to addictive levels. ...
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Background Globally, problematic internet use (PIU) is acknowledged as a significant behavioural problem in adolescents and youth. It is being researched for further clarity as an independent behavioural disorder. It is crucial to explore predictors of PIU to understand the high-risk psychosocial indicators of problematic internet use, particularly amid the COVID-19 pandemic in India. Aim The present study aimed at studying age, gender, mental health, coping strategies and lifestyle indicators as predictors for PIU in adolescents, young adults and middle-aged adults. Methods The study used a cross-sectional design, and the data was collected using Perceived Stress Scale, Internet Gaming Disorders-9, DSM-5 Self-Rated Level-1, and Brief-COPE scale. Multiple regression analysis was employed to find the predictors of PIU in a sample of 1027 i.e., adolescents (13–19 years), young adults (20–39 years), and middle-aged adults (40–60 years). Separate regression analyses were carried out for the three subgroups as well. Results Results showed that the age, perceived stress, maladaptive coping strategies (substance use, self-blaming, self-distraction, behavioural disengagement), repetitive thoughts and actions, and impact of COVID-19 were significant independent predictors of PIU. Furthermore, differences in independent predictors were found in different sub-groups of age. Discussion This study indicated that adolescents and youth are more susceptible to PIU. In addition, maladaptive coping strategies predicted PIU significantly, which indicates that PIU is not an effective coping strategy but can be understood as maladaptive behaviour involving escapism. Furthermore, only repetitive thoughts and actions predicted PIU, which clarifies PIU as an independent pathology. Conclusion This study found specific predictors for the three sub-groups – adolescents, young adults, and middle-aged adults - that would further aid management plans for problematic internet use. Moreover, the role of the COVID-19 pandemic on PIU is also critical.
... Abdelsattar et al. (2021) in their research on a sample group of Arab individuals, concluded that there is a positive relationship between the severity of cybercoderia and fear of COVID-19. In some studies, it has been concluded that addictions to smartphones, the internet and/or social media is associated with cyberchondria severity (Fergus & Spada, 2017;Ivanova, 2013;Ivanova & Karabeova, 2014;Khazaal et al. 2020). Other studies have reported that individuals who experience intense anxiety and fear during pandemics engage in behaviors that make them safe (Gaygisiz et al., 2012;Main et al., 2011). ...
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The coronavirus disease-2019 (COVID-19) has quickly spread all over the world and has contributed to psychological consequences including fear of the virus. Depending upon the severity of their problems, individuals often search the internet via their mobile devices to understand whether the symptoms they perceive are symptoms of the disease. This condition has been termed ‘cyberchondria’. In this context, the aim of this study is examine the mediating and moderating role of cyberchondria severity in the association between smartphone addiction and the fear of COVID-19. The sample comprised 520 participants (335 females [64.4%], 185 males [35.6%] aged 17 to 65 years [Mean = 28.61 years, SD = 10.60]). A survey included the Cyberchondria Severity Scale Short-Form, The Smartphone Addiction Scale-Short Version, and The Fear of COVID-19 Scale. Structural equation modeling and SPSS Process Macro moderator variable analysis were used to test the research model. The study found a positive association between smartphone addiction, fear of COVID-19, and cyberchondria severity. Cyberchondria severity had both moderating and mediating role in the association between smartphone addiction and the fear of COVID-19. In conclusion, it has been determined that during the COVID-19 pandemic, cyberchondria severity has negative effects on individuals’ fear of COVID-19.
... 6,7 In one study, significant relationships involved internet addiction, health anxiety and cyberchondria. 8 Conceptually, cyberchondria refers to experiencing increased anxiety after seeking medical information and addressing health concerns through internet, leading to unhealthy behavioural and emotional outcomes. Several definitions of cyberchondria have been proposed with excessive or repeated online searches for health-related information and health-related anxiety as common features. ...
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Objective: To study the phenomenon of cyberchondria and related worries about health among individuals without any diagnosed medical condition. . Methods: The survey-based, cross-sectional study was conducted from January to July 2018 in the twin cities of Rawalpindi and Islamabad, Pakistan, and comprised graduates of either gender aged at least 35 years with access to internet and means of use, and with no current diagnosed medical condition. The self-reporting Cyberchondria Severity Scale was used data-collection along with a demographic sheet. SPSS 21 was used for data analysis. Results: Of the 150 subjects, 90(60%) were men and 60(40%) were women. A total of 40(26.6%) subjects had low level of cyberchondria, while 35(23.3%) experienced a higher level of it. Mean scores of men on total CSS were slightly higher than those of women (p>0.05). Men also scored higher on compulsion, distress, excessiveness and reassurance subsclaes (p>0.05 each), whereas women scored slightly higherthan men on 'mistrust of medical profession' subscale (p>0.05). No significant gender differences werefound on cyberchondria and its subscales (p>0.05 each). Conclusions: Doctors / health professionals may benefit from the findings by focussing on their patients who use internet as a major source of medical information.
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Penggunaan internet saat ini sangatlah penting untuk menunjang aktivitas keseharian, namun penggunaan internet yang berlebihan juga tidaklah baik. Internet Addiction merupakan ketidakmampuan individu dalam mengontrol penggunaan internet, hal ini dapat menyebabkan masalah .psikologis, sosial, pekerjaan dan bahkan kesehatan individu tersebut. salah satu masalah psikologis pada pengguna internet yang mengalami adiksi adalah kecemasan. Penelitian ini bertujuan untuk melakukan analisis dari berbagai penelitian yang mengkaji pengaruh Internet Addiction dengan keterkaitanya dalam memunculkan Kecemasan. Metode penelitian menggunakan pendekatan meta analisis dengan menggabungkan hasil analisis data penelitian terdahulu, kami mleakukan estimasi terkait korelasi, inkonsistensi dan bias publikasi. Sebanyak 15 studi terdahulu yang telah kami review digunakan sebagai sumber utama penelitian meta analisis kali ini, data diolah berdasarkan kriteria sampel dari remaja hingga dewasa awal, ukuran sampel, instrumen penelitian dan metode. Berdasarkan hasil analisis, diperoleh nilai Pooled correlation = 0.512 (95% CI = 0.401955 to 0.608686), yang secara empiris menunjukan bahwa Internet Addiction memiliki keeratan hubungan dengan kecemasan pada kategori medium. Hasil analisis inconsistency sebesar 96,3% menunjukan bahwa variasi hasil beberapa penelitian cenderung beragam. Uji bias publikasi egger bias sebesar -0.790949 (p = 0.8868 > 0,05), dapat disimpulkan bahwa tidak terjadi bias publikasi. Penggunaan internet sebaiknya dibatasi hanya untuk keperluan yang menurut kita penting saja, sebab penggunaan internet yang tidak wajar dapat berdampak buruk pada kondisi psikologis kita, terutama kecemasan.
Conference Paper
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Purpose The purpose of this paper is to examine the relationship between the stress experienced by parents during the pandemic and their cyberchondria. The research was carried out in a descriptive and cross-sectional manner. Design/methodology/approach The sample of the research: living in Turkey and has created 432 parents with at least one child between the ages of 6 and 15. Participant information form, parental stress scale and cyberchondria scale were used in the study. Data were collected through online surveys between July 1, 2020, and August 31, 2020. Findings In the study, when the scores obtained from the Parental Stress Scale and the Cyberchondria Scale were compared with the demographic characteristics, a significant difference was found between gender, age, marital status, education level, economic status, number of children and presence of chronic diseases ( p < 0.05). It was determined that there is a significant difference between the responses of the parents regarding the pandemic process and the Parental Stress Scale and the Cyberchondria Scale ( p < 0.05). A positive significant correlation was found between the Parental Stress Scale and the total and subdimensions of the Cyberchondria Scale ( p < 0.05). Research limitations/implications The research was carried out with only parents with children between the ages of 6 and 15, but it reveals the stress and cyberchondria of the parents during the pandemic. Originality/value The results obtained reflect the factors affecting the stress and cyberchondria levels experienced by parents during the pandemic process. Also, as the stress of the parent's increases, it has seen that the level of cyberchondria increases in parallel.
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The use of the Internet for medical information elicited a recent term called “cyberchondria”. This study aimed to scrutinize the mediating effects of health anxiety (HA), anxiety symptoms (AS), and Internet addiction (IA) in the pathway from distress tolerance (DT) to cyberchondria by using a bootstrapping method. In order to examine the role of age in the proposed model, multiple-group path analysis was used to evaluate differences between young and middle adulthood groups. The final sample consisted of both young adult (n = 209) and middle adult (n = 221) Internet users located in Ankara, Turkey. The results of path analyses for both age groups showed that DT is negatively associated with AS and HA; AS and HA are positively associated with IA; IA and HA are positively associated with cyberchondria. Mediation analysis for both age groups demonstrated that AS and HA significantly mediated the relationship between DT and IA; IA significantly mediated the relationships of AS and HA with cyberchondria; HA significantly mediated the relationship between DT and cyberchondria. The results of the multiple-group path analysis showed that the relationship between IA and cyberchondria is significantly stronger in middle adulthood than young adulthood. The results of the current study are consistent with the relevant literature and provide crucial contribution especially by focusing on the role of age.
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The Satisfaction With Life Scale (SWLS) was developed to assess satisfaction with the respondent’s life as a whole. The scale does not assess satisfaction with life domains such as health or finances but allows subjects to integrate and weight these domains in whatever way they choose. Normative data are presented for the scale, which shows good convergent validity with other scales and with other types of assessments of subjective well-being. Life satisfaction as assessed by the SWLS shows a degree of temporal stability (e.g., 54 for 4 years), yet the SWLS has shown sufficient sensitivity to be potentially valuable to detect change in life satisfaction during the course of clinical intervention. Further, the scale shows discriminant validity from emotional well-being measures. The SWLS is recommended as a complement to scales that focus on psychopathology or emotional well-being because it assesses an individuals’ conscious evaluative judgment of his or her life by using the person’s own criteria.
In the modern world we are surrounded by technology. Gadgets such as cell phones, portable computers, and electronic diaries accompany us throughout the day. But is this a good thing? Are we being served by these technological wonders, or have we become enslaved by them? Does constant availability via technology make us more efficient or more stressed? Is our ability to connect with others all over the world, day or night, making us more sociable or turning us into recluses in a virtual world? This book considers the impact of technology on the different spheres of our life - work, home, family and leisure - and assesses ways in which to build better communication between technology developers and society to ensure that technology enhances our lives and psychological well-being, rather than damaging them.
Anecdotal reports indicated that some on-line users were becoming addicted to the Internet in much the same way that others became addicted to drugs or alcohol, which resulted in academic, social, and occupational impairment. However, research among sociologists, psychologists, or psychiatrists has not formally identified addictive use of the Internet as a problematic behavior. This study investigated the existence of Internet addiction and the extent of problems caused by such potential misuse. Of all the diagnoses referenced in the Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV; American Psychiatric Association, 1995), Pathological Gambling was viewed as most akin to the pathological nature of Internet use. By using Pathological Gambling as a model, addictive Internet use can be defined as an impulse-control disorder that does not involve an intoxicant. Therefore, this study developed a brief eight-item questionnaire referred to as a Diagnostic Questionnaire (DQ), which modified criteria for pathological gambling to provide a screening instrument for classification of participants. On the basis of this criteria, case studies of 396 dependent Internet users (Dependents) and 100 nondependent Internet users (Nondependents) were classified. Qualitative analyses suggest significant behavioral and functional usage differences between the two groups such as the types of applications utilized, the degree of difficulty controlling weekly usage, and the severity of problems noted. Clinical and social implications of pathological Internet use and future directions for research are discussed.
SUMMARY The Internet itself is a neutral device originally designed to facilitate research among academic and military agencies. How some people have come to use this medium, however, has created a stir among the mental health community by great discussion of Internet addiction. Addictive use of the Internet is a new phenomenon which many practitioners are unaware of and subsequently unprepared to treat. Some therapists are unfamiliar with the Internet, making its seduction difficult to understand. O ther tim es, its im pact on the individual's life is m inim ized. T he purpose of this chapter is to enable clinicians to better detect and treat Internet addiction. The chapter will first focus on the complications of diagnosis of Internet addiction. Second, the negative consequences of such Internet abuse are explored. Third, how to properly assess and identify triggers causing the onset of pathological Internet use are discussed. Fourth, a number of recovery strategies are presented. Lastly, since Internet addiction is an emergent disorder, implications for future practice are presented. Complications In Diagnosing Internet Addiction Negative Consequences Of Addictive Use Of The Internet
Prior research has utilized the Zung Depression Inventory (ZDI) and found that moderate to severe rates of depression coexist with pathological Internet use.1 Although the ZDI was utilized for its expediency with on-line administration, its limitations include poor normative data and less frequent clinical use. Therefore, this study utilized the Beck Depression Inventory (BDI), which has more accurate norms and frequent usage among dual diagnostic patient populations. An on-line survey administered on a World Wide Web site utilized the BDI as part of a larger study. A total of 312 surveys was collected with 259 valid profiles from addicted users, which again supported significant levels of depression to be associated with pathological Internet use. This article discusses how a treatment protocol should emphasis the primary psychiatric condition if related to a subsequent impulse control problem such as pathological Internet use. Effective management of psychiatric symptoms may indirectly correct pathological Internet use. Prior research has identified the existence of addictive Internet use, which has been associated with significant social, psychological, and occupational impairment.2 Addicts in this study used the Internet an average of 38 hr per week for nonacademic or non-employment purposes, which caused detrimental effects such as poor grade performance among students, discord among couples, and reduced work performance among employees. This is compared to non-addicts who used the Internet an average of 8 hr per week with no significant consequences reported. Predominantly, the interactive capabilities of the Internet such as chat rooms or on-line games were seen to be the most addictive. This type of behavioral impulse control failure, which does not involve an intoxicant, was seen as most akin to pathological gambling. Therefore, a formal term utilized in this article is pathological Internet use (PIU) to refer to cases of addictive Internet use. Research in the addictions field has shown that psychiatric illnesses such as depression are often associated with alcoholism3 and drug addiction.4 Further, research has shown that other addictive behaviors overlap with depression-for example, eating disorders5'6 and pathological gambling.7-9 Although the concept of Internet addiction has gained credibility among mental health professionals both in academic and clinical realms, little research has been conducted to examine if similar underlying psychiatric illnesses may contribute to such Internet abuse.1 Therefore, the objective of this study was to assess depression and compare such results to other established dual diagnostic populations. Young1 utilized the Zung Depression Inventory10 (ZDI), which suggested that increased levels of depression are associated with moderate to severe levels of PIU. However, the ZDI yields limited clinical utility; therefore, this study used the Beck Depression Invento#1 (BDI) because it is a more psychometrically and clinically valid