The importance of type, amount, and timing of internet use for understanding psychological distress

Is There a Relationship Between Online Health Information Seeking and Health Anxiety? A Systematic Review and Meta-Analysis

The internet has revolutionized how we live, providing unprecedented convenience and up-to-date information. Consequently, an increasing number of individuals are turning to the internet for health-related information, despite research suggesting a correlation between this behavior and health anxiety. Therefore, drawing on cognitive - behavioral theory, we explore the link between online health information seeking and health anxiety via a systematic review and meta-analysis of cross-sectional studies. Following the Preferred Reporting Items for Systematic Reviews and Meta-analysis, we ran searches in multiple databases, including PubMed, Web of Science, Embase, Elsevier/Science Direct, Cochrane Database, China National Knowledge Infrastructure, VIP Chinese Database, and Wanfang Data. Our searches identified 16 studies eligible for review, involving 4,920 participants across seven countries. The random-effects meta-analysis revealed a significant positive correlation between online health information seeking and health anxiety (r = 0.28, 95% confidence interval [0.16, 0.41], p < .0001), despite considerable heterogeneity. Furthermore, meta-regression analysis demonstrated that the identity characteristics of the sample, female percentage, sample size, and country all contributed to the heterogeneity across studies. Overall, this meta-analysis provides support for the association between online health information seeking and health anxiety, and helps to elucidate the cognitive - behavioral theory underpinning this phenomenon.

Online health information seeking and the association with anxiety among older adults

Introduction

The Internet supplies users with endless access to a wealth of information and is generally the first source searched by U.S. adults (18 years and older) when seeking health information. Age and anxiety are associated with online health information seeking (OHIS). Older adults (65 years and older) are increasing their OHIS. Importantly, OHIS can potentially lead to improved health outcomes for older adults. The relationship between OHIS and anxiety is less clear. Studies report those with more symptoms of anxiety are more likely to be OHIS, while other studies find the reverse pattern or no association. Generalized anxiety disorder affects up to 11% of older adults and is oftentimes unrecognized and untreated.

Methods

To address the mixed findings in the literature, we analyzed six waves (2015-2020) of data from the National Health and Aging Trends Study to assess the causal relationship between anxiety and OHIS using a Random Intercept Cross-lagged Panel Model framework.

Results

We found that while anxiety symptoms lead to OHIS in the next wave, OHIS was not associated with anxiety symptoms in the next wave.

Discussion

This suggests that for this sample of older adults, OHIS does not reduce or exacerbate older adults' symptoms of anxiety.

Internet Use and Loneliness of Older Adults Over Time: The Mediating Effect of Social Contact

OBJECTIVES

The internet is increasingly commonly used by older adults. However, it remains controversial in the literature on whether older people are more or less lonely with internet adoption. The current paper aims to test the longitudinal association of internet use and loneliness and to theorize the relationship by examining the mediating effect of social contact.

METHOD

This study employed data from 2006, 2010, and 2014 waves of the Health and Retirement Study. Loneliness was measured with the three-item UCLA loneliness scale, social contact was operationalized as contact frequency with family and friends, and internet use was measured using a self-assessed dichotomous item. Longitudinal associations and mediation effects were tested using hierarchical linear modeling.

RESULTS

Internet use was associated with decreased loneliness over an 8-year period (b = -0.049, p < .001) and more social contact (b = 0.285, p < .001), which was related to lower perceived loneliness (b = -0.088, p < .001). On a scale ranges from 0 to 2 (0 = never lonely, 2 = often lonely), the total effect of internet use on loneliness was -0.060, and the mediated effect was -0.025.

DISCUSSION

These findings imply that internet use may be an effective tool for reducing loneliness in older people by maintaining social contact.

Refugee status is associated with double the odds of psychological distress in mid-to-late life: Findings from the Canadian Longitudinal Study on Aging

Psychological distress is associated with a range of negative outcomes including lower quality of life and an increased risk of premature all-cause mortality. The prevalence of, and factors associated with, psychological distress among middle-aged and older Canadians are understudied. Using the Canadian Longitudinal Study on Aging (CLSA) baseline data, this study examined factors associated with psychological distress among adults between 45 and 85 years, including refugee status and a wide range of sociodemographic, health-related and social support characteristics. Psychological distress was measured by Kessler's Psychological Distress Scale-K10 scores. Bivariate and multivariable binary logistic regression analyses were conducted. The prevalence of psychological distress was significantly higher among the 244 refugees (23.8%), compared to 23,149 Canadian-born Canadians (12.8%) and 4,765 non-refugee immigrants (12.6%), despite the fact that the average time the refugees had lived in Canada was more than four decades. The results of the binary logistic regression analysis indicated refugees had twice the age-sex adjusted odds of psychological distress (OR = 2.31, 95% CI: 1.74, 3.07). Even after further adjustment for 16 potential risk factors, a significant relationship remained between refugee status and psychological distress (OR = 1.56; 95% CI = 1.12, 2.17). Other significant factors associated with psychological distress included younger age, female gender, visible minority status, lower household income, not having an undergraduate degree, multimorbidities, chronic pain, and lack of social support. Policies and interventions addressing psychological distress among Canadians in mid- to later life should target refugees and other vulnerable groups.

Exploring the Relationship Between Internet Use and Mental Health Among Older Adults in England: Longitudinal Observational Study

Background

There is uncertainty about the impact of internet use on mental health in older adults. Moreover, there is very little known specifically about the impact of particular purposes of internet use.

Objective

This study aims to investigate the longitudinal relationship between two distinct concepts of mental health with the frequency of internet use among older adults: the moderating role of socioeconomic position (SEP) and the association between specific purposes of internet use.

Methods

Longitudinal fixed and random effects (27,507 person-years) models were fitted using waves 6-8 of the English Longitudinal Study of Ageing to examine the relationship between different aspects of internet use (frequency and purpose) and two mental health outcomes (depression and life satisfaction). The potential moderating effect of SEP on these associations was tested using interaction terms.

Results

Infrequent internet use (monthly or less vs daily) was predictive of deteriorating life satisfaction (β=−0.512; P=.02) but not depression. Education and occupational class had a moderating effect on the association between frequency of internet use and mental health. The associations were stronger in the highest educational group in both depression (P=.09) and life satisfaction (P=.02), and in the highest occupational group in life satisfaction (P=.05) only. Using the internet for communication was associated with lower depression (β=−0.24; P=.002) and better life satisfaction (β=.97; P<.001), whereas those using the internet for information access had worse life satisfaction (β=−0.86; P<.001) compared with those who did not.

Conclusions

Policies to improve mental health in older adults should encourage internet use, especially as a tool to aid communication.

Development and Validation of a Short-Form Internet Overuse Screening Questionnaire for Adults

AIMS

The aim of the current study was to develop and validate a short-form of the internet overuse screening questionnaire (IOS-Qs).

METHODS

A total of 571 adults were recruited from a representative, stratified, and multistage cluster sample. Among participants, 188 and 383 were used in the development and validation of the IOS-Qs, respectively.

RESULTS

Experts' ratings and Rasch model analyses led to the selection of 8 items from the IOS-Qs; latent-class analysis using these 8 items revealed an estimated prevalence of 8.6% (33 out of 383) of problematic internet over-users. Problematic internet over-users were positively associated with a 1-year prevalence rate of any mental disorder (OR 3.08, p = 0.008), mood disorder (OR 7.11, p = 0.003), and depressive disorder (OR 5.22, p = 0.016). The receiver operating characteristic curves identified an optimal cutoff score of 9.5 for differentiating problematic internet over-users from unproblematic internet users with 94% sensitivity and 94% specificity.

CONCLUSION

The results suggest that the IOS-Qs was valid, and items including social isolation were crucial to the brief distinction of at-risk internet users. Because of its brevity, the questionnaire can be effectively administered as a large-scale survey.

Digital Pathways to Positive Health Perceptions: Does Age Moderate the Relationship Between Medical Satisfaction and Positive Health Perceptions Among Middle-Aged and Older Internet Users?

Objectives

We explored the influence of e-trust, e-health literacy, e-health information seeking, and e-health information consumerism on medical satisfaction and positive health perceptions.

Methods

Our sample consisted of 499 randomly selected panel members aged 40–93. We employed hierarchical ordinary least squares (OLS) regression analyses and structural equation modeling (SEM). We examined the moderating role of age on the relationship between medical satisfaction and positive health perceptions.

Results

A significant interaction was found between age and medical satisfaction in predicting positive health perceptions in the OLS regression models. Medical satisfaction has a stronger association with self-care, health-related quality of life, and health status in the older adult sample as compared with the middle-aged sample. SEM analyses revealed that e-health information seeking has an indirect effect on both medical satisfaction and positive health perceptions through its significant direct effect on e-health information consumerism. Both e-trust and e-health consumerism were significant predictors. The e-health literacy and e-trust measures were significant predictors of the positive health perception index in the OLS regression models.

Discussion

The results contribute to our understanding of the potential benefits information technologies have for the health and well-being of computer-connected aging adults.

Prevalence and risk factors of problematic internet use and the associated psychological distress among graduate students of Bangladesh

A growing body of epidemiological literature suggests that problematic Internet use (PIU) is associated with a range of psychological health problems in adolescents and young adults. This study aimed to explore socio-demographic and behavioural correlates of PIU and examine its association with psychological distress. A total of 573 graduate students from Dhaka University of Bangladesh responded to a self-administered questionnaire that included internet addiction test (IAT), 12-items General Health Questionnaire and a set of socio-demographic and behavioural factors. The study found that nearly 24% of the participants displayed PIU on the IAT scale. The prevalence of PIU significantly varied depending on gender, socioeconomic status, smoking habit and physical activity (p < 0.05). The multiple regression analyses suggested that PIU is strongly associated with psychological distress regardless of all other explanatory variables (adjusted OR 2.37, 95% CI 1.57, 3.58). Further research is warranted to confirm this association by employing prospective study designs.

Internet use and depression among retired older adults in the United States: a longitudinal analysis

OBJECTIVES

The purpose of this study is to examine the association between Internet use among retired older adults in the United States and changes in a commonly used predictor of depression (the CES-D).

METHOD

Analyzing data from four waves (2002-2008) of the Health and Retirement Survey, we assess whether an available and commonly used index of a depression state was affected by prior values of the index and Internet use. The sample includes 3,075 respondents observed over 4 waves of data, yielding a total of 12,300 observations. We analyzed the effect on depression of Internet use and past depression in a full sample and a matched sample. We also conducted informal tests for confounders. Finally, we tested a basic mediation model to determine whether Internet use affected depression through its relationship with loneliness and social isolation.

RESULTS

Across methods, we found a positive contribution of Internet use to mental well-being of retired older adults in the United States, where Internet use reduced the probability of a depression state by one third. We found no evidence of confounding. Some evidence of mediation was found.

DISCUSSION

Our dynamic probit model indicates that for retired older adults in the United States, Internet use was found to reduce the probability of a depressed state by about 33%. Number of people in the household partially mediates this relationship, with the reduction in depression largest for people living alone. This provides some evidence that the mechanism linking Internet use to depression is the remediation of social isolation and loneliness. Encouraging older adults to use the Internet may help decrease isolation and depression.

Sharing, liking, commenting, and distressed? The pathway between Facebook interaction and psychological distress

Studies on the mental health implications of social media have generated mixed results. Drawing on a survey of college students (N=513), this research uses structural equation modeling to assess the relationship between Facebook interaction and psychological distress and two underlying mechanisms: communication overload and self-esteem. It is the first study, to our knowledge, that examines how communication overload mediates the mental health implications of social media. Frequent Facebook interaction is associated with greater distress directly and indirectly via a two-step pathway that increases communication overload and reduces self-esteem. The research sheds light on new directions for understanding psychological well-being in an increasingly mediated social world as users share, like, and comment more and more.

Impact of internet use on loneliness and contact with others among older adults: cross-sectional analysis

Background

Older adults are at increased risk of experiencing loneliness and depression, particularly as they move into different types of care communities. Information and communication technology (ICT) usage may help older adults to maintain contact with social ties. However, prior research is not consistent about whether ICT use increases or decreases isolation and loneliness among older adults.

Objective

The purpose of this study was to examine how Internet use affects perceived social isolation and loneliness of older adults in assisted and independent living communities. We also examined the perceptions of how Internet use affects communication and social interaction.

Methods

One wave of data from an ongoing study of ICT usage among older adults in assisted and independent living communities in Alabama was used. Regression analysis was used to determine the relationship between frequency of going online and isolation and loneliness (n=205) and perceptions of the effects of Internet use on communication and social interaction (n=60).

Results

After controlling for the number of friends and family, physical/emotional social limitations, age, and study arm, a 1-point increase in the frequency of going online was associated with a 0.147-point decrease in loneliness scores (P=.005). Going online was not associated with perceived social isolation (P=.14). Among the measures of perception of the social effects of the Internet, each 1-point increase in the frequency of going online was associated with an increase in agreement that using the Internet had: (1) made it easier to reach people (b=0.508, P<.001), (2) contributed to the ability to stay in touch (b=0.516, P<.001), (3) made it easier to meet new people (b=0.297, P=.01, (4) increased the quantity of communication with others (b=0.306, P=.01), (5) made the respondent feel less isolated (b=0.491, P<.001), (6) helped the respondent feel more connected to friends and family (b=0.392, P=.001), and (7) increased the quality of communication with others (b=0.289, P=.01).

Conclusions

Using the Internet may be beneficial for decreasing loneliness and increasing social contact among older adults in assisted and independent living communities.