Self-esteem Interventions in Adults – A Systematic Review and Meta-analysis

Self-Esteem and Anxiety as Mediators in the Relationship Between Emotional Intelligence and Eating Disorder Symptoms

This study investigated the relationship between emotional intelligence (EI) and eating disorder symptoms (EDS) by testing the serial mediation model, with self-esteem and anxiety as mediators. A total of 923 participants (61.9% female) aged 15-60 years completed questionnaires assessing their EI, self-esteem, anxiety, and EDS. Correlational analyses were conducted to assess the relationship between the study variables, and a serial mediation analysis was conducted to test the possible mediating role of self-esteem and anxiety in the relationship between EI and EDS. Correlation analyses revealed significant bivariate relationships between EI, self-esteem, and anxiety, but no significant correlation between EI and EDS. The relationship between EI and EDS was serially mediated by self-esteem and anxiety. High levels of EI were associated with higher self-esteem, which, in turn, was associated with lower anxiety and less EDS. The results offer potential mechanisms that could explain the relationship between EI and EDS and highlight the importance of EI in regulating eating behavior through self-esteem and anxiety.

The Role of Self-Esteem and Self-Efficacy in Responsible Gambling

Responsible gambling (RG) refers to a set of protective strategies aiming at containing the negative consequences associated with gambling. To improve the effectiveness of RG, it is essential to understand factors influencing gamblers' adherence to RG. Past literatures on addictive behaviors have demonstrated that one's self-efficacy and self-esteem are associated with the adherence to protective behaviors of the specific addictive behaviors. The present study aims to test whether gamblers' self-esteem and RG self-efficacy can be applied to explain their adherence to protective gambling behaviors. Two hundred and thirty-six past-year gamblers were randomly selected to take part in a phone survey. Path analysis showed that both gamblers' RG self-efficacy and self-esteem were positively associated with gamblers' RG behaviors, while RG behaviors were negatively linked to the problem gambling tendency. The findings provided insight into potential promotion and intervention strategies based on self-esteem and self-efficacy and those strategies may be adopted in the primary prevention of gambling disorder.

The role of explicit and implicit self-esteem in the relationship between childhood trauma and adult depression and anxiety

BACKGROUND

Self-esteem is an important psychological concept that can be measured explicitly (reflective processing) and implicitly (associative processing). The current study examined 1) the association between childhood trauma (CT) and both explicit and implicit self-esteem, and 2) whether self-esteem mediated the association between CT and depression/anxiety.

METHODS

In 1479 adult participants of the Netherlands Study of Depression and Anxiety, CT was assessed with a semi-structured interview, depression/anxiety symptoms with self-report questionnaires and explicit and implicit self-esteem with the Rosenberg Self-Esteem Scale and Implicit Association Test, respectively. ANOVAs and regression analyses determined the association between CT (no/mild/severe CT), its subtypes (abuse/neglect) and self-esteem. Finally, we examined whether self-esteem mediated the relationship between CT and depression/anxiety.

RESULTS

Participants with CT reported lower explicit (but not lower implicit) self-esteem compared to those without CT (p < .001, partial η2 = 0.06). All CT types were associated with lower explicit self-esteem (p = .05 for sexual abuse, p < .001 for other CT types), while only emotional neglect significantly associated with lower implicit self-esteem after adjusting for sociodemographic characteristics (p = .03). Explicit self-esteem mediated the relationship between CT and depression/anxiety symptoms (proportion mediated = 48-77 %).

LIMITATIONS

The cross-sectional design precludes from drawing firm conclusions about the direction of the proposed relationships.

CONCLUSIONS

Our results suggested that the relationship between CT and depression/anxiety symptoms can at least partly be explained by explicit self-esteem. This is of clinical relevance as it points to explicit self-esteem as a potential relevant treatment target for people with CT.

From childhood maltreatment to intimate partner violence perpetration: A prospective longitudinal examination of the roles of executive functioning and self-esteem

BACKGROUND

Previous research has found that childhood maltreatment predicts increased risk for violence and partner violence and there is some evidence for poorer executive functioning and low self-esteem. To date, there have been no longitudinal studies that have examined the extent to which executive functioning and self-esteem play a role in the relationship between child maltreatment and intimate partner violence (IPV) perpetration.

METHODS

This study aims to fill this gap by utilizing data from a prospective longitudinal study of children with documented court cases of abuse and neglect (ages 0-11 years) from a metropolitan county area in the Midwest (during the years 1967-1971) and demographically matched controls. Both maltreated individuals and matched controls were followed up and assessed over several waves of the study in young and middle adulthood. At mean age 39 years, inhibition and cognitive control were evaluated, while cognitive flexibility and nonverbal reasoning were assessed at mean age 41. Self-esteem was also assessed at mean age 41. Physical IPV perpetration was evaluated at age 47 using two different scoring strategies in separate models: the number of acts and variety of acts, ensuring avoidance of potential score skewness.

RESULTS

Childhood maltreatment predicted lower executive functioning and self-esteem, and both independently predicted intimate partner violence perpetration. Lower executive functioning and self-esteem mediated the relationship between childhood maltreatment and physical IPV perpetration in midlife, irrespective of the scoring method.

CONCLUSION

Findings suggest that executive functioning and self-esteem play a role in the cycle of violence. Implications and suggestions for future directions are discussed.

Enhancing self-esteem in adults with body dysmorphic symptoms: experimental testing and initial evaluation of a brief internet-based training

BACKGROUND

Low self-esteem is an important factor associated with body dysmorphic concerns. In treatment, self-esteem cannot always be adequately addressed. Internet-based interventions offer a low-threshold and cost-efficient possibility for treating body dysmorphic disorder (BDD).

AIMS

For this reason, we conducted two studies to explore the effectiveness of an internet-based intervention targeting improving self-esteem in adults with BDD symptoms.

METHOD

The first study investigated the differential effects of a 1-week self-esteem training compared with a 1-week attention-focus training. Two hundred twenty adults with elevated body dysmorphic symptoms were randomly assigned to one of the two trainings. Our second study (n = 58 adults with body dysmorphic symptoms) evaluated an extended 2-week stand-alone self-esteem training.

RESULTS

In the first study, self-esteem in different domains (appearance, performance and social), self-focused attention, and BDD symptom severity improved in both groups. Other-focused attention only increased in the attention training group. Participants' overall adherence was high. In the second study we observed significant improvements in self-esteem, BDD symptom severity, and other secondary outcomes, with additional improvements in most outcomes in the second week. Adherence was again high.

CONCLUSIONS

Together, these findings show that a brief internet-based intervention may be a highly accepted and effective way of improving self-esteem in people suffering from BDD symptoms.

Distinct associations between gratitude, self-esteem, and optimism with subjective and psychological well-being among Japanese individuals

BACKGROUND

Mounting evidence suggests that the effectiveness of positive psychology interventions is influenced by a variety of factors, including cultural context. Identifying intervention targets that can effectively contribute to improving individual well-being under these boundary conditions is a crucial step when developing viable interventions. To this end, we examined how gratitude disposition, self-esteem, and optimism relate to the subjective well-being (SWB) and psychological well-being (PWB) of Japanese individuals.

METHODS

Multivariate regression analysis was employed to quantify the unique relationships between the three potential intervention targets and both SWB and PWB, while accounting for the influence of other variables. Participants (N = 71) also engaged in a 4-week experience sampling study to explore how gratitude, self-esteem and optimism shape the link between momentary affective states in everyday life and evaluations of day satisfaction.

RESULTS

Multivariate regression analysis revealed that self-esteem was predominantly more strongly associated with SWB compared to gratitude disposition, whereas gratitude disposition was more strongly associated with the PWB dimensions, particularly personal growth, positive relations with others and purpose in life. Experience sampling data indicated that while both gratitude disposition and self-esteem moderated the association between momentary positive affect and day satisfaction evaluations, they did so in opposite ways; greater gratitude disposition strengthened the association, while greater self-esteem weakened it.

CONCLUSIONS

Overall, the current results suggest that while gratitude, self-esteem, and optimism influence individual well-being as a whole, they likely play distinct roles in facilitating SWB and PWB in the studied cohort.

Subjective well-being among Chinese breast cancer patients: The unique contributions of death anxiety, self-esteem, and social support

Previous studies have indicated that cancer patients may have a lower level of subjective well-being (SWB); nevertheless, the underlying factors for this phenomenon remain insufficiently investigated. Based on the characteristics of Chinese breast cancer patients and the unique culture, this study explored the independent contributions of death anxiety, self-esteem, and social support to SWB from the protective and risk perspectives. A cross-sectional survey recruited 514 females with breast cancer and collected participants' demographic and the above variables. The results found that death anxiety independently predicted SWB in a negative direction (β = -0.36, p < 0.001). In addition, self-esteem (β = 0.38, p < 0.001) and social support (β = 0.14, p < 0.001) also had the unique positive effects on SWB. These findings offer new insights into strengthening breast cancer patients' SWB, for instance, using relevant interventions to reduce death anxiety and improve self-esteem and social support.

Biopsychosocial Factors of Depression Among Hispanic Women Aged ≥50 Years

The purpose of the current study was to identify biopsychosocial factors associated with depressive symptoms among Hispanic women aged ≥50 years. Cross-sectional data related to 10 biological, psychological, and social factors were analyzed. Center for Epidemiologic Studies Depression Scale scores suggested that 32% of the sample had depressive symptoms. Self-esteem, self-perception of health status, income, and chronic pain had statistically significant associations with depressive symptoms. A logistic regression analysis showed that increasing self-esteem scores were associated with decreases in the likelihood of having depressive symptoms. Findings underscore that depression is associated with biological, psychological, and social factors. Culturally tailored interventions that aim at targeting these factors may have an impact on Hispanic women's depression and overall well-being. [Journal of Psychosocial Nursing and Mental Health Services, 61(11), 32-42.].

Disentangling affect from self-esteem using subliminal conditioning

Across three experiments, participants underwent conditioning sequences where the self-referential term I AM (Conditioned Stimulus, or CS+) or a scrambled counterpart M IA (CS-) was paired with either neutral (Unconditioned Stimulus, or US-) or positive attributes (US+). CS and US were presented under subliminal and/or visible conditions. A normalized indicator of affective shift and an explicit self-esteem measure were deployed as outcome measures. In Experiment 1 (N = 60), subliminal CS+ followed by visible US+ produced a significant affective shift only. Experiment 2 (N = 59) presented CS and US under subliminal conditions, which did not influence either outcome measure. In Experiment 3 (N = 60), visible CS appeared with visible US, which resulted in a significant effect on explicit self-esteem only. These findings highlight the central roles of CS and/or US visibility towards influencing reported affect and self-esteem. We theorize that configural components of subliminally presented stimuli can become perceptually encoded and influence self-related affect non-consciously.

Crying over spilled milk? A network analysis of aversive well-being comparison, brooding rumination and depressive symptoms

BACKGROUND

Comparative thinking about one's well-being is ubiquitous. Comparisons that threaten an individual's self-motives are aversive and interact with rumination and depression. Aversive well-being comparisons include upward social, past temporal, counterfactual, and criteria-based comparisons, as well as downward prospective temporal comparisons. Although the frequency, discrepancy, and affective impact of aversive comparison total scores have been associated with brooding rumination and depression, no study has investigated the interaction of specific comparison standards (e.g., social or counterfactual) with symptom cascades of brooding and depressive symptoms.

METHODS

To examine this interaction, we conducted network analyses on the interplay between aversive well-being comparisons, brooding rumination, and depression. Specifically, we conducted a cross-sectional study in N = 500 dysphoric individuals and a longitudinal study in N = 921 participants at two timepoints, three months apart. Participants completed measures of depression, brooding, and the Comparison Standards Scale for Well-being, which assessed the frequency, perceived discrepancy, and affective impact of aversive well-being comparisons.

RESULTS

Feelings of worthlessness emerged as the most central attribute in the networks of the dysphoric sample. Longitudinally, brooding and depressive symptoms predicted aversive comparisons, but not the other way around, which accounted for social and other-referent counterfactual comparisons to a greater degree than for other comparison types.

LIMITATIONS

We used nonclinical samples.

CONCLUSIONS

The findings highlight the critical role of comparison standards in depression. Further research is warranted to detect potential intervention targets for mitigating negative effects of negative self-evaluation.

Exploring Psychological Constructs in People Receiving Treatment for Addictive Eating Behaviours: "I Hate Loving Food as Much as I Do"

Research into the complexities of addictive eating behaviours continues to develop, as a deeper understanding of this construct beyond self-report diagnostic tools emerges. In this study, we undertook structured interviews with 40 participants engaged in a personality-based management program for addictive eating, to gain insight into what situations lead people with addictive eating behaviours to overeat, and how they believe their lives would be different if they had control over their eating. A phenomenological analysis to explore compulsion and control in the context of food experiences for participants was used to construct two main themes of the addictive eating paradox and striving to transition from 'other' to 'normal'. The addictive eating paradox identified multiple contradictory experiences of a situation, e.g., 'loving food' but 'hating food'. Striving to transition from 'other' to 'normal' encompassed the idea that participants envisaged that by gaining control over their eating they could become 'normal'. This study emphasises the need to provide support and strategies to help people navigate paradoxical thoughts and presents new ideas to increase the effectiveness of interventions for individuals struggling with the complex self-beliefs held by those with addictive eating behaviours.

Self-Esteem and Self-Compassion: A Narrative Review and Meta-Analysis on Their Links to Psychological Problems and Well-Being

The present review addressed the relationship between two self-related concepts that are assumed to play a role in human resilience and well-being: self-esteem and self-compassion. Besides a theoretical exploration of both concepts, a meta-analysis (k = 76, N = 35,537 participants) was conducted to examine the magnitude of the relation between self-esteem and self-compassion and their links to indices of well-being and psychological problems. The average correlation between self-esteem and self-compassion was strong (r = 0.65, effect size = 0.71), suggesting that - despite some distinct features - the overlap between both self-related constructs is considerable. Self-esteem and self-compassion displayed relations of a similar magnitude to measures of well-being and psychological problems, and both concepts accounted for unique variance in these measures once controlling for their shared variance. Self-esteem and self-compassion can best be seen as complementary concepts and we invite researchers to look more at their joint protective role within a context of well-being and mental health as well as to their additive value in the treatment of people with psychological problems.

The Lexical Association Technique: A randomized controlled trial with breast cancer patients

Low self-esteem is a vulnerability factor for depressive disorders, and the prevention of psychological disorders is essential in cancer patients. The enhancement of self-esteem in breast cancer patients may therefore be an appropriate clinical target. Previous studies have shown the efficacy of the Lexical Association Technique to enhance self-esteem in healthy subjects. This study aims to test the clinical efficacy and acceptability of the Lexical Association Technique on the self-esteem of cancer patients. A double-blind randomized controlled trial was conducted on 63 breast cancer patients during their radiotherapy treatment. Global self-esteem measures were taken using the Rosenberg Self-Esteem Scale before and after the Lexical Association Technique and 1 month after its end. The results showed a significant improvement in global self-esteem in patients immediately after performing the Lexical Association Technique compared to an active control group. However, the positive effects did not last 1 month. These results confirm the efficacy and suitability of the Lexical Association Technique for cancer patients. Avenues of research are proposed to extend the effects of the technique and increase its transdiagnostic applicability.

Relationship among positive self-esteem, physical literacy, and physical activity in college students: a study of a mediation model

Background

In light of the substantial decline in physical activity during college years, this study aims to examine the relationship between positive self-esteem, physical literacy, and physical activity in order to investigate the mechanisms for improving physical activity in college students and to provide a foundation for future interventions.

Methods

A cross-sectional study design was employed in this study. A total of 5,184 Participants, aged between 17 and 21 years (M = 18.97, SD = 1.10), completed the Positive Version of Rosenberg Self-esteem Scales, Perceived Physical Literacy Instruments, and the International Physical Activity Questionnaires. A mediation model was utilized to explore the associations among the three concepts.

Results

The three regression models were as follows: Physical literacy = 18.03 + 0.98 *Self-esteem, Physical activity = 43.23 + 0.16 *Self-esteem, and Physical activity = 28.18 + 0.11 *Physical literacy. Positive self-esteem, physical literacy, and physical activity were significantly linked with each other. Physical literacy mediated 26.93% of the effect, indicating a partial mediator in the relationship between positive self-esteem and physical activity.

Conclusion

The mediating effect of physical literacy on the relationship between positive self-esteem and physical activity was identified. Our findings support the development of positive self-esteem and physical literacy in college physical education curricula as part of an overall program to address students' physical inactivity at school and in the future. This study provides a new intervention perspective for improving physical inactivity in college students.

Examining the immunoepigenetic-gut microbiome axis in the context of self-esteem among Native Hawaiians and other Pacific Islanders

Introduction: Native Hawaiian and other Pacific Islander (NHPI) populations experience higher rates of immunometabolic diseases compared to other racial-ethnic groups in Hawaii. As annual NHPI mortality rates for suicide and type 2 diabetes mellitus (T2DM) exceed those of the state as a whole, understanding the social and biological mechanisms underlying these disparities are urgently needed to enable preventive strategies. Methods: A community-based approach was used to investigate the immunoepigenetic-gut microbiome axis in an NHPI-enriched cohort of Oahu residents (N = 68). Self-esteem (SE) data was collected using a modified Rosenberg self-esteem (SE) assessment as a proxy measure for mental wellbeing in consideration for cultural competency. T2DM status was evaluated using point-of-care A1c (%) tests. Stool samples were collected for 16s-based metagenomic sequencing analyses. Plasma from blood samples were isolated by density-gradient centrifugation. Peripheral blood mononuclear cells (PBMCs) were collected from the same samples and enriched for monocytes using negative selection techniques. Flow-cytometry was used for immunoprofiling assays. Monocyte DNA was extracted for Illumina EPIC array-based methylation analysis. Results: Compared to individuals with normal SE (NSE), those with low SE (LSE) exhibited significantly higher plasma concentrations (pg/ml) of proinflammatory cytokines IL-8 (p = 0.051) and TNF-α (p = 0.011). Metagenomic analysis revealed that the relative abundance (%) of specific gut bacteria significantly differed between SE groups - some of which directly correlated with SE scores. Gene ontology analysis revealed that 104 significantly differentially methylated loci (DML) between SE groups were preferentially located at genes involved in immunometabolic processes. Horvath clock analyses indicated epigenetic age (Epi-Age) deceleration in individuals with LSE and acceleration in individuals with NSE (p = 0.042), yet was not reproduced by other clocks. Discussion: These data reveal novel differences in the immunoepigenetic-gut microbiome axis with respect to SE, warranting further investigation into its relationship to brain activity and mental health in NHPI. Unexpected results from Epi-Age analyses warrant further investigation into the relationship between biological age and disparate health outcomes among the NHPI population. The modifiable component of epigenetic processes and the gut microbiome makes this axis an attractive target for potential therapeutics, biomarker discovery, and novel prevention strategies.

The Relationship between Competitive Class Climate and Cyberloafing among Chinese Adolescents: A Curvilinear Moderated Mediation Model

Since COVID-19 was officially listed as a pandemic, online schooling has become a more pervasive form of learning, and cyberloafing has become a widespread behavior, even among adolescents. However, less research has explored the influencing mechanism of adolescents' cyberloafing. Based on relevant studies and the real lives of adolescents, this study aimed to examine the association between a competitive class climate and cyberloafing among adolescents, its underlying mechanism, the mediating role of perceived stress and the moderating role of self-esteem. A total of 686 adolescents were recruited to complete a set of questionnaires assessing cyberloafing, perceived stress, self-esteem, and perceived competitive class climate. The results showed that a competitive class climate was positively associated with perceived stress, and the U-shaped relationship between perceived stress and cyberloafing was significant. Perceived stress mediated the relationship between a competitive class climate and cyberloafing. Meanwhile, self-esteem moderated the U-shaped relationship between perceived stress and cyberloafing and the linear relationship between a competitive class climate and perceived stress. The results of this study indicate that the influence of a competitive class climate on individual learning behavior may be nonlinear, and proper competition can contribute to reducing individual cyberloafing.

Predicting resilience during the COVID-19 Pandemic in the United Kingdom: Cross-sectional and longitudinal results

Although the COVID-19 pandemic has impacted the psychological wellbeing of some people, there is evidence that many have been much less affected. The Ecological Model of Resilience (EMR) may explain why some individuals are not resilient whilst others are. In this study we test the EMR in a comparison of UK survey data collected from the COVID-19 Psychological Research Consortium (C19PRC) longitudinal study of a representative sample of the United Kingdom (UK) adult population and data from an Italian arm of the study. We first compare data from the third wave of the UK arm of the study, collected in July/August 2020, with data from an equivalent sample and stage of the pandemic in Italy in July 2020. Next, using UK longitudinal data collected from C19PRC Waves 1, 3 and 5, collected between March 2020 and April 2021 we identify the proportion of people who were resilient. Finally, we examine which factors, drawn from the EMR, predict resilient and non-resilient outcomes. We find that the 72% of the UK sample was resilient, in line with the Italian study. In the cross-sectional logistic regression model, age and self-esteem were significantly associated with resilience whilst death anxiety thoughts, neuroticism, loneliness, and Post Traumatic Stress Disorder (PTSD) symptoms related to COVID-19 were significantly associated with Non-Resilient outcomes. In the longitudinal UK analysis, at Wave 5, 80% of the sample was Resilient. Service use, belonging to wider neighbourhood, self-rated health, self-esteem, openness, and externally generated death anxiety were associated with Resilient outcomes. In contrast, PTSD symptoms and loneliness were associated with Non-Resilient outcomes. The EMR effectively explained the results. There were some variables which are amenable to intervention which could increase resilience in the face of similar future challenges.

Toward a Unified Framework for Positive Psychology Interventions: Evidence-Based Processes of Change in Coaching, Prevention, and Training

Since 2000, research within positive psychology has exploded, as reflected in dozens of meta-analyses of different interventions and targeted processes, including strength spotting, positive affect, meaning in life, mindfulness, gratitude, hope, and passion. Frequently, researchers treat positive psychology processes of change as distinct from each other and unrelated to processes in clinical psychology. This paper presents a comprehensive framework for positive psychology processes that crosses theoretical orientation, links coherently to clinical psychology and its more dominantly "negative" processes, and supports practitioners in their efforts to personalize positive psychological interventions. We argue that a multi-dimensional and multi-level extended evolutionary approach can organize effective processes of change in psychosocial interventions, by focusing interventions on context-appropriate variation, selection, and retention of processes, arranged in terms of key biopsychosocial dimensions across psychological, biophysiological, and sociocultural levels of analysis. We review widely studied positive psychology constructs and programs and show how this evolutionary approach can readily accommodate them and provide a common language and framework for improving human and community flourishing. We conclude that Interventions should start with the person, not the protocol.

A New Technique to Increase Self-Esteem by Reading and Mental Visualization: The Lexical Association Technique

Introduction: Self-esteem is central to human well-being, quality of life, and mental health. Therefore, it is important to propose preventive and therapeutic techniques to deal with decline in self-esteem. Different interventions have been proposed and their efficacies have been validated. However, they present certain constraints such as a cognitive and/or emotional cost, which limit some clinical applications. Method: Based on contributions from cognitive, social, and clinical psychology, we propose to test the efficacy of a new technique for self-esteem enhancement using brief lexical associations and mental visualization (six sessions of five minutes) for a stimulation of episodic and semantic self-perceptions. Results: Comparing the Lexical Association Technique to a control technique and using a double-blind pre-post design, two studies show the efficacy of this new technique on global self-esteem in two samples of students (nStudy1 = 36; nStudy2 = 89), as well as a sustained effect up to 5 days after the technique is stopped. Discussion: The mechanisms underlying the efficacy of this technique are discussed. Further studies are needed to precise the clinical applicability of the Lexical Association Technique on patients.

The Effectiveness of Self-Esteem-Related Interventions in Reducing Suicidal Behaviors: A Systematic Review and Meta-Analysis

Suicide is a serious social issue and is often treated using psychological interventions. The current systematic review and meta-analysis aimed to investigate the effectiveness of self-esteem-related interventions on suicidal behaviors. A systematic literature search for randomized controlled trials (RCTs) including a self-esteem component was conducted on 29 May 2021 and updated on 4 April 2022. In total, 12 studies were included in the systematic review and five studies were included in the meta-analysis. Small effect sizes were found for suicidal ideation at post intervention [g = -0.24, 95% CI (-0.48, 0.00)] and a 3-month follow-up [g = -0.36, 95% CI (-0.62, -0.11)]. However, these results should be interpreted cautiously due to the limited number of included studies and varied sample population. In conclusion, the current review suggests that future intervention studies should incorporate self-esteem enhancement in the treatment of suicidal behaviors, especially for suicidal ideation.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=250882.

The Impact of COVID-19 Pandemic on Searching for Health-Related Information and Cyberchondria on the General Population in Italy

Objectives: The Internet has become one of the most common sources people use to search for health-related information, a behavior rapidly increased during the novel Coronavirus disease 2019 (COVID-19). The present study aimed to investigate behavioral patterns in the online health-related searches and Cyberchondria (CYB) during the COVID-19 pandemic time, in order to explore socio-demographic and psychopathological factors related to CYB. Methods: During the third wave of the COVID-19 pandemic in Italy, a cross-sectional online survey collected the main socio-demographic variables and habits related to Internet use of 572 participants. CYB was measured by the Cyberchondria Severity Scale-Short Version and different psychopathological factors were measured by specific questionnaires: the Coronavirus Anxiety Scale, the Hospital Anxiety and Depression Scale, the Short Health Anxiety Inventory, the Meta-Cognitions about Health Questionnaire, the Internet Addiction Test, the Maudsley Obsessional-Compulsive Questionnaire-Short Version, the Rosenberg's Self-Esteem Scale, and the WHO Quality of Life-BREF. Descriptives, non-parametric ANOVAs, and Spearman correlations were performed. Results: In the present sample, the Internet was the main source participants used to search for health-related information and nearly one-third increased this habit during the pandemic. Higher expression of CYB emerged in females, in younger participants, in students, and in those suffering from a physical/psychiatric illness. CYB showed a positive correlation with different phenomenology of anxiety (i.e., anxiety about COVID-19, health anxiety, general anxiety, metacognitive believes about anxiety) and with depression, obsessive-compulsive symptoms, and problematic usage of the Internet. Conversely, quality of life and self-esteem showed a negative correlation with CYB. Conclusion: During the COVID-19 pandemic, the use of the Internet for health-related information and CYB contribute to the psychological stress affecting individuals and society. Delineating subjects more vulnerable to CYB and associated psychopathological factors will help to elaborate operational indications for prevention and psychological support.