Levels and predictors of anxiety, depression and health anxiety during COVID-19 pandemic in Turkish society: The importance of gender

BACKGROUND

The COVID-19 pandemic is having negative effects on societies' mental health. Both the pandemic and the measures taken to combat it can affect individuals' mental health.

AIMS

The purpose of this study was to evaluate the levels of depression, anxiety and health anxiety in Turkish society during the COVID-19 pandemic, and to examine the factors affecting these.

METHOD

The study was performed using an online questionnaire. Participants were asked to complete a sociodemographic data form, the Hospital Anxiety and Depression Scale (HADS) and the Health Anxiety Inventory (HAI). The effects on depression, anxiety and health anxiety levels of factors such as age, sex, marital status, living with an individual aged above 60, the presence of a new Coronavirus+ patient among friends or relatives, previous and current psychiatric illness and presence of accompanying chronic disease were then investigated.

RESULTS

In terms of HADS cut-off points, 23.6% (n = 81) of the population scored above the depression cut-off point, and 45.1% (n = 155) scored above the cut-off point for anxiety. In regression analysis, female gender, living in urban areas and previous psychiatric illness history were found as risk factors for anxiety; living in urban areas was found as risk factor for depression; and female gender, accompanying chronic disease and previous psychiatric history were found as risk factors for health anxiety.

CONCLUSION

The results of this cross-sectional study suggest that the groups most psychologically affected by the COVID-19 pandemic are women, individuals with previous psychiatric illness, individuals living in urban areas and those with an accompanying chronic disease. Priority might therefore be attached to these in future psychiatric planning.

Functional Fear Predicts Public Health Compliance in the COVID-19 Pandemic

In the current context of the global pandemic of coronavirus disease-2019 (COVID-19), health professionals are working with social scientists to inform government policy on how to slow the spread of the virus. An increasing amount of social scientific research has looked at the role of public message framing, for instance, but few studies have thus far examined the role of individual differences in emotional and personality-based variables in predicting virus-mitigating behaviors. In this study, we recruited a large international community sample (N = 324) to complete measures of self-perceived risk of contracting COVID-19, fear of the virus, moral foundations, political orientation, and behavior change in response to the pandemic. Consistently, the only predictor of positive behavior change (e.g., social distancing, improved hand hygiene) was fear of COVID-19, with no effect of politically relevant variables. We discuss these data in relation to the potentially functional nature of fear in global health crises.

Fear of the coronavirus (COVID-19): Predictors in an online study conducted in March 2020

Fear is an adaptive response in the presence of danger. However, when threat is uncertain and continuous, as in the current coronavirus disease (COVID-19) pandemic, fear can become chronic and burdensome. To identify predictors of fear of the coronavirus, we conducted an online survey (N = 439) three days after the World Health Organization declared the coronavirus outbreak a pandemic (i.e., between March 14 and 17, 2020). Fear of the coronavirus was assessed with the newly developed Fear of the Coronavirus Questionnaire (FCQ) consisting of eight questions pertaining to different dimensions of fear (e.g., subjective worry, safety behaviors, preferential attention), and an open-ended question. The predictors included psychological vulnerability factors (i.e., intolerance of uncertainty, worry, and health anxiety), media exposure, and personal relevance (i.e., personal health, risk for loved ones, and risk control). We found four predictors for the FCQ in a simultaneous regression analysis: health anxiety, regular media use, social media use, and risks for loved ones (R² = .37). Furthermore, 16 different topics of concern were identified based participants' open-ended responses, including the health of loved ones, health care systems overload, and economic consequences. We discuss the relevance of our findings for managing people's fear of the coronavirus.

Psychological Outcomes Associated with Stay-at-Home Orders and the Perceived Impact of COVID-19 on Daily Life

The COVID-19 pandemic has resulted in the widespread implementation of extraordinary physical distancing interventions (e.g., stay-at-home orders) to slow the spread of the virus. Although vital, these interventions may be socially and economically disruptive, contributing to adverse psychological outcomes. This study examined relations of both stay-at-home orders and the perceived impact of COVID-19 on daily life to psychological outcomes (depression, health anxiety, financial worry, social support, and loneliness) in a nationwide U.S. community adult sample (N = 500; 47% women, mean age = 40). Participants completed questionnaires assessing psychological outcomes, stay-at-home order status, and COVID-19's impact on their daily life. Being under a stay-at-home order was associated with greater health anxiety, financial worry, and loneliness. Moreover, the perceived impact of COVID-19 on daily life was positively associated with health anxiety, financial worry, and social support, but negatively associated with loneliness. Findings highlight the importance of social connection to mitigate negative psychological consequences of the COVID-19 pandemic.

Health anxiety, cyberchondria, and coping in the current COVID-19 pandemic: Which factors are related to coronavirus anxiety?

According to cognitive-behavioral models, traits, triggering events, cognitions, and adverse behaviors play a pivotal role in the development and maintenance of health anxiety. During virus outbreaks, anxiety is widespread. However, the role of trait health anxiety, cyberchondria, and coping in the context of virus anxiety during the current COVID-19 pandemic has not yet been studied. An online survey was conducted in the German general population (N = 1615, 79.8 % female, Mage = 33.36 years, SD = 13.18) in mid-March 2020, which included questionnaires on anxiety associated with SARS-CoV-2, trait health anxiety, cyberchondriaPandemic (i.e. excessive online information search), and emotion regulation. The participants reported a significantly increasing virus anxiety in recent months (previous months recorded retrospectively), especially among individuals with heightened trait health anxiety. CyberchondriaPandemic showed positive correlations with current virus anxiety (r = .09-.48), and this relationship was additionally moderated by trait health anxiety. A negative correlation was found between the perception of being informed about the pandemic and the current virus anxiety (r=-.18), with adaptive emotion regulation being a significant moderator for this relationship. The findings suggest that trait health anxiety and cyberchondria serve as risk factors, whereas information about the pandemic and adaptive emotion regulation might represent buffering factors for anxiety during a virus pandemic.

The Short Health Anxiety Inventory: Psychometric Properties and Construct Validity in a Non-clinical Sample

Contemporary conceptualizations of hypochondriasis (HC) as severe health anxiety have led to the development of cognitive-behavioral approaches to understanding, assessing, and treating this problem. The Short Health Anxiety Inventory (SHAI) is a new instrument that measures cognitive factors associated with HC. In the present study, we examined the psychometric properties and factor structure of the SHAI in a large sample of medically healthy university students. We also examined the scale’s convergent, divergent, and predictive validity. Results indicated that the SHAI has good psychometric properties and contains three factors that assess the perceived likelihood and perceived severity of becoming ill, and body vigilance. Facets of health anxiety uniquely predicted increased safety-seeking behavior and medical utilization, behaviors that are commonly observed in HC. Results are discussed in terms of the cognitive-behavioral model of HC.

The relationships between health anxiety, online health information seeking, and cyberchondria: Systematic review and meta-analysis

BACKGROUND

Cyberchondria refers to an abnormal behavioral pattern in which excessive or repeated online searches for health-related information are distressing or anxiety-provoking. Health anxiety has been found to be associated with both online health information seeking and cyberchondria. The aims of the present systematic review and meta-analysis were to examine the magnitude of these associations and identify any moderator variables.

METHODS

A systematic literature search was performed across several databases (PsycINFO, PubMed, Embase) and reference lists of included studies.

RESULTS

Twenty studies were included across two independent meta-analyses, with 7373 participants. Random effects meta-analyses showed that there was a positive correlation between health anxiety and online health information seeking [r = 0.34, 95% CI (0.20, 0.48), p < .0001], and between health anxiety and cyberchondria [r = 0.62, 95% CI (0.52, 0.71), p < .0001]. A meta-regression indicated that the age of study participants [Q(1) = 4.58, p = .03] was partly responsible for the heterogeneity found for the relationship between health anxiety and cyberchondria.

LIMITATIONS

The generalizability and validity of our findings are restricted by the methodological limitations of the primary studies, namely, an over-reliance on a single measure of cyberchondria, the Cyberchondria Severity Scale.

CONCLUSIONS

Our review found a positive correlation between health anxiety and online health information seeking, and between health anxiety and cyberchondria. Further research should aim to explore the contexts for these associations as well as address the identified limitations of the extant literature.

The development and initial validation of the cyberchondria severity scale (CSS)

Cyberchondria is a form of anxiety characterised by excessive online health research. It may lead to increased levels of psychological distress, worry, and unnecessary medical expenses. The aim of the present study was to develop a psychometrically sound measure of this dimension. A sample of undergraduate students (N = 208; 64% female) completed a pilot version of the cyberchondria severity scale (CSS) along with the short form version of the depression, anxiety and stress scale (DASS-21). Exploratory factor analysis identified a correlated five factor structure that were labelled 'Compulsion', 'Distress', 'Excessiveness', 'Reassurance Seeking' and 'Mistrust of Medical Professional'. The CSS demonstrated good psychometric properties; the subscales had high internal consistency, along with good concurrent and convergent validity. The CSS may prove useful in a wide variety of future research activities. It may also facilitate the development and validation of interventions for cyberchondria.

Dementia worry: a psychological examination of an unexplored phenomenon

According to recent surveys, dementia worry (DW) is a widespread phenomenon in mid-life and old age, at least in Western populations. DW has been shown to be only loosely related to sociodemographic factors. Unfortunately, the concept of DW has found only very little conceptual and empirical attention in previous research. In this conceptual review, we take (mostly) a psychological approach to DW. First, we define DW as an emotional response to the perceived threat of developing dementia. We then conceptualise DW as a hybrid, combining elements of ageing anxiety and health anxiety. On the population level, we argue that the high prevalence of DW may be reflective of the increasing awareness of dementia in times of increasing ''dementia encounters', widespread misperceptions of risks and consequences of dementia and a perceived lack of coping resources. Finally, we propose that DW may affect a range of important behaviours, such as how people interpret evidence of their own or others' age-related cognitive changes, how they interact with people with dementia, how they anticipate and plan for their future, how they engage in screening and prevention behaviours and how they exploit healthcare resources. We conclude with suggestions for future research, including a further in-depth investigation of psychological and micro-/macrosocial factors associated with DW.

Eating in the lockdown during the Covid 19 pandemic; self-reported changes in eating behaviour, and associations with BMI, eating style, coping and health anxiety

The global coronavirus pandemic (Covid 19) resulted in national lockdowns where individuals were asked to isolate in their homes to stop the spread of the disease. Using a cross-sectional survey, the current paper aimed to examine self-reported changes in eating patterns and behaviour during the lockdown in the UK, and associations with BMI, demographic variables, eating styles, health anxiety, food insecurity and coping strategies. Participants (N = 620) were recruited online through social media advertising. The results showed that there were self-reported changes to food consumption during the lockdown across the sample. Increases in consumption of HED (high energy density) snack foods during the lockdown was associated with sex, pre-lockdown eating behaviour (emotional eating and uncontrolled eating), and Covid-specific health anxiety. Increases in positive eating practices such as eating more home prepared foods, and fruits and vegetables, were associated with adaptive coping strategies. Higher emotional eating (EE) during the lockdown was associated with a higher BMI, higher pre-lockdown EE and maladaptive coping strategies. Maladaptive coping strategies moderated the relationship between BMI and EE during the lockdown. In particular a higher BMI was associated with higher EE during the lockdown if an individual also had higher maladaptive coping strategies. These findings suggest that changes to eating behaviour may be part of a wider style of maladaptive or adaptive coping, particularly in those with a history of EE or uncontrolled eating. Preparing individuals to adopt more adaptive coping strategies during lockdown situations may be crucial to improving health during subsequent the lockdown events.

Tracing "Fearbola": Psychological Predictors of Anxious Responding to the Threat of Ebola

Serious illnesses such as Ebola are often highly publicized in the mass media and can be associated with varying levels of anxiety and compensatory safety behavior (e.g., avoidance of air travel). The present study investigated psychological processes associated with Ebola-related anxiety and safety behaviors during the outbreak in late 2014. Between October 30 and December 3, 2014, which encompassed the peak of concerns and of the media's attention to this particular outbreak, 107 university students completed a battery of measures assessing fear of Ebola, performance of safety behaviors, factual knowledge of the virus, and psychological variables hypothesized to predict Ebola-related fear. We found that while our sample was generally not very fearful of contracting Ebola, the fear of this disease was correlated with general distress, contamination cognitions, disgust sensitivity, body vigilance, and anxiety sensitivity-related physical concerns. Regression analyses further indicated that anxiety sensitivity related to physical concerns and the tendency to overestimate the severity of contamination were unique predictors of both Ebola fear and associated safety behaviors. Implications for how concerns over serious illness outbreaks can be conceptualized and clinically managed are discussed.

Psychological Predictors of Health Anxiety in Response to the Zika Virus

The threat of a United States (U.S.) Zika virus pandemic during 2015-2016 was associated with public anxiety. Such threats represent opportunities to examine hypotheses about health anxiety. The present study investigated psychological predictors of Zika-related anxiety during the 2015-2016 outbreak. U.S. adults (N = 216) completed a battery of measures assessing Zika-related anxiety as well as psychological variables hypothesized to predict anxious responding to the threat of a domestic Zika outbreak. Contrary to hypotheses, regression analyses indicated that only contamination severity overestimates and greater Zika knowledge significantly predicted Zika-related anxiety. Study limitations and clinical implications are discussed.

Cognitive-behavioral therapy for hypochondriasis/health anxiety: a meta-analysis of treatment outcome and moderators

The present investigation employed meta-analysis to examine the efficacy of cognitive-behavioral therapy (CBT) for hypochondriasis/health anxiety as well as potential moderators that may be associated with outcome. A literature search revealed 15 comparisons among 13 randomized-controlled trials (RCTs) with a total sample size of 1081 participants that met inclusion criteria. Results indicated that CBT outperformed control conditions on primary outcome measures at post-treatment (Hedges's g = 0.95) and at follow-up (Hedges's g = 0.34). CBT also outperformed control conditions on measures of depression at post-treatment (Hedges's g = 0.64) and at follow-up (Hedges's g = 0.35). Moderator analyses revealed that higher pre-treatment severity of hypochondriasis/health anxiety was associated with greater effect sizes at follow-up visits and depression symptom severity was significantly associated with a lower in effect sizes at post-treatment. Although effect size did not vary as a function of blind assessment, smaller effect sizes were observed for CBT vs. treatment as usual control conditions than for CBT vs. waitlist control. A dose response relationship was also observed, such that a greater number of CBT sessions was associated with larger effect sizes at post-treatment. This review indicates that CBT is efficacious in the treatment of hypochondriasis/health anxiety and identifies potential moderators that are associated with outcome. The implications of these findings for further delineating prognostic and prescriptive indicators of CBT for hypochondriasis/health anxiety are discussed.

DSM-5 illness anxiety disorder and somatic symptom disorder: Comorbidity, correlates, and overlap with DSM-IV hypochondriasis

OBJECTIVE

To investigate the reliability, validity and utility of DSM-5 illness anxiety disorder (IAD) and somatic symptom disorder (SSD), and explore their overlap with DSM-IV Hypochondriasis in a health anxious sample.

METHODS

Treatment-seeking patients with health anxiety (N=118) completed structured diagnostic interviews to assess DSM-IV Hypochondriasis, DSM-5 IAD, SSD, and comorbid mental disorders, and completed self-report measures of health anxiety, comorbid symptoms, cognitions and behaviours, and service utilization.

RESULTS

IAD and SSD were more reliable diagnoses than Hypochondriasis (kappa estimates: IAD: 0.80, SSD: 0.92, Hypochondriasis: 0.60). 45% of patients were diagnosed with SSD, 47% with IAD, and 8% with comorbid IAD/SSD. Most patients with IAD fluctuated between seeking and avoiding care (61%), whereas care-seeking (25%) and care-avoidant subtypes were less common (14%). Half the sample met criteria for DSM-IV Hypochondriasis; of those, 56% met criteria for SSD criteria, 36% for IAD, and 8% for comorbid IAD/SSD. Compared to IAD, SSD was characterized by more severe health anxiety, somatic symptoms, depression, and higher health service use, and higher rates of major depressive disorder, panic disorder and agoraphobia.

CONCLUSIONS

DSM-5 IAD and SSD classifications reliably detect more cases of clinically significant health anxiety than DSM-IV Hypochondriasis. The differences between IAD and SSD appear to be due to severity. Future research should explore the generalizability of these findings to other samples, and whether diagnostic status predicts treatment response and long-term outcome.

The Cyberchondria Severity Scale (CSS): German Validation and Development of a Short Form

PURPOSE

'Cyberchondria' describes a pattern of researching health information online motivated by distress or anxiety about health, which becomes excessive and in turn increases distress. The Cyberchondria Severity Scale (CSS) assesses this construct. The aims of the present study were to validate a German version of the CSS and to propose a short form.

METHOD

The CSS was translated and posted online. Inclusion criteria were fulfilled by n = 500 participants (age 29.1 ± 10.4 years, 73.6 % women). Item analyses, an exploratory factor analysis and correlations with health anxiety, somatic symptoms, health-care utilization and depression were calculated. A brief version with 15 items was developed (CSS-15) and validated in a second sample (n = 292; age 24.2 ± 4.1 years, 76.4 % women).

RESULTS

The internal consistency of the CSS was α = .93 and its split-half reliability α = .95. The mean item-total correlation was r itc = .51, the mean inter-item correlation r = .29 and the mean item difficulty p i = .36. The principal component analysis extracted five factors. The CSS score correlated highly with health anxiety and moderately with somatic symptoms and health-care utilization. The CSS-15 still had an internal consistency of α = .82 and the confirmatory factor analysis confirmed the five factors. The correlation coefficients with health-related measures were unaffected.

CONCLUSION

The German version of the CSS possesses very good psychometric characteristics, which were preserved in a short version. The factorial structure was replicated. The correlations with health anxiety and depression for both scales underscore their validity and clinical relevance.

Anxiety sensitivity and intolerance of uncertainty as potential risk factors for cyberchondria

BACKGROUND

Online medical information seeking has become an increasingly common behavior. Despite the benefits of easily accessible medical information on the Internet, researchers have identified a vicious cycle of increased physical health concerns and online medical information seeking known as "cyberchondria". Despite proposed theoretical models of cyberchondria, there is a dearth of research investigating risk factors for the development of cyberchondria. Two potential risk factors are anxiety sensitivity (AS) and intolerance of uncertainty (IU).

METHODS

The current study investigated the relationships among AS, IU, and cyberchondria in a large community sample. Participants (N=526) completed self-report questionnaires via online crowdsourcing.

RESULTS

Structural equation models utilizing latent variables revealed a significant unique positive relationship between AS, as well as the IU Inhibitory lower-order factor, and cyberchondria, controlling for the effects of health anxiety. Additionally, results revealed a significant unique relationship between the IU Inhibitory factor and mistrust of medical professionals, a proposed cyberchondria-relevant construct.

LIMITATIONS

The cross-sectional data in the current study do not offer a true test of AS and IU as risk factors. However, establishing these unique relationships is an important step forward in the literature.

CONCLUSIONS

The results of the current study suggest the potential importance of both AS and IU in the development of cyberchondria. Future research is needed to establish the temporal precedence of elevated AS and/or IU to determine if they are true risk factors or simply correlates of cyberchondria.

The curious case of cyberchondria: A longitudinal study on the reciprocal relationship between health anxiety and online health information seeking

The current study is the first to longitudinally investigate the reciprocal relationship between online health information seeking and health anxiety, i.e., cyberchondria. Expectations were that health anxious individuals who go online to find health information, experience an increase in health anxiety, which in turn will reinforce online seeking. A 4-wave longitudinal survey study among 5322 respondents aged 16-93 was conducted. Our results showed that individuals who are more health anxious than others, search online for health information more. Moreover, the results provided initial evidence for the expected reciprocal relationship between health anxiety and online health information seeking in respondents with non-clinical levels of health anxiety at the start of the study. However, this reciprocal relationship could not be found in a subsample of clinically health anxious individuals. Although for these individuals online health information seeking did not seem to exacerbate health anxiety levels, it might still serve as a maintaining factor of clinical health anxiety.

The Cyberchondria Severity Scale (CSS): an examination of structure and relations with health anxiety in a community sample

McElroy and Shevlin (2014) developed the 33-item Cyberchondria Severity Scale (CSS) to allow for a multidimensional assessment of cyberchondria (compulsion, distress, excessiveness, reassurance, and mistrust of medical professional). The present study evaluated psychometric properties of the CSS, including its factor structure, internal consistency, convergent validity, and incremental validity, using a large sample of community adults located in the United States (N=539). Results from a confirmatory factor analysis (CFA) supported the adequacy of the five-factor structure of the CSS. However, results from a higher-order CFA indicated that the mistrust of medical professional factor does not assess the same construct as the other factors of the CSS. The CSS scales evidenced adequate internal consistency and significantly correlated with health anxiety. The distress, excessiveness, and mistrust of medical professional scales correlated significantly more strongly with health anxiety than obsessive-compulsive symptoms and these three scales were the only CSS scales to share unique variance with health anxiety. Implications of these results for future research are discussed.

Intolerance of uncertainty as a factor linking obsessive-compulsive symptoms, health anxiety and concerns about the spread of the novel coronavirus (COVID-19) in the United States

The novel coronavirus disease (COVID-19) has had a significant impact on public health, economic activity, and mental health as it spread across the globe. Research from past pandemics links excessive anxiety about illness-related threats with symptoms of health anxiety and obsessive-compulsive disorder (OCD). In the present study, we investigated whether intolerance of uncertainty (IU), a psychological vulnerability factor involved in both OCD and health anxiety, accounts for a portion of the relationship between these symptoms and fear of COVID-19 during the early stages of the outbreak in the Unites States. We administered measures of concern about the spread of COVID-19 (Coronavirus Threat Scale; CTS), health anxiety, and OCD symptoms to a large sample of community adults in the United States (n = 738) recruited through Amazon MTurk. Results revealed that concern about COVID-19 was moderately and positively correlated with both OCD and health anxiety symptoms, as well as IU. Moreover, regression analyses found that IU partially accounted for the connections between concern about the spread of COVID-19 and OCD and health anxiety symptoms. These results highlight IU as a potential mechanism connecting OCD and health anxiety to anxiety about pandemic threats. Clinical implications, limitations, and future directions for research are discussed.

The prospective influence of COVID-19 affective risk assessments and intolerance of uncertainty on later dimensions of health anxiety

The COVID-19 pandemic is likely to increase risk for the development of health anxiety. Given that elevated health anxiety can contribute to maladaptive health behaviors, there is a need to identify individual difference factors that may increase health anxiety risk. This study examined the unique and interactive relations of COVID-19 affective risk assessments (worry about risk for contracting/dying from COVID-19) and intolerance of uncertainty to later health anxiety dimensions. A U.S. community sample of 364 participants completed online self-report measures at a baseline assessment (Time 1) and one month later (Time 2). Time 1 intolerance of uncertainty was uniquely associated with the Time 2 health anxiety dimension of body vigilance. Time 1 affective risk assessments and intolerance of uncertainty were uniquely associated with later perceived likelihood that an illness would be acquired and anticipated negative consequences of an illness. The latter finding was qualified by a significant interaction, such that affective risk assessments were positively associated with anticipated negative consequences of having an illness only among participants with mean and low levels of intolerance of uncertainty. Results speak to the relevance of different risk factors for health anxiety during the COVID-19 pandemic and highlight targets for reducing health anxiety risk.

Recent Insights Into Cyberchondria

PURPOSE OF REVIEW

The construct of cyberchondria was introduced relatively recently. This article aims to review the conceptualization, theoretical basis and correlates of cyberchondria, as well as its prevention and management.

RECENT FINDINGS

Although there is no consensus, most definitions of cyberchondria emphasize online health research associated with heightened distress or anxiety. The two theoretical models of cyberchondria involve reassurance seeking and specific metacognitive beliefs. Cyberchondria has relationships with health anxiety, problematic Internet use and symptoms of obsessive-compulsive disorder, with public health implications pertaining to functional impairment and altered healthcare utilization. Suggestions about prevention and management of cyberchondria have been put forward, but not tested yet. Research interest in cyberchondria has steadily increased. It is uncertain whether cyberchondria can be considered a distinct entity. Future research should aim to clarify the conceptual status of cyberchondria, quantify its impact and develop evidence-based approaches for a better control of cyberchondria.

Mental Health Screening for COVID-19: a Proposed Cutoff Score for the Greek Version of the Fear of COVID-19 Scale (FCV-19S)

The COVID-19 pandemic elicited fear. The Fear of COVID-19 Scale (FCV-19S) is a newly developed self-reported measure, originally developed in Persian to assess COVID-19-related fear. To date, the scale has been translated and validated in 19 other languages, among which Greek. This study, conducted through an online survey, aimed to further explore the validity of the Greek FCV-19S version, as well as to identify appropriate cutoff scores. A total of 538 respondents completed the sociodemographic data sheet, the Generalized Anxiety Disorder 7-item scale, the Short Health Anxiety Inventory, and the Posttraumatic Stress Disorder-8 inventory. According to the results, a cutoff point score of 16.5 or higher revealed a significant predictive power for anxiety, health anxiety, and posttraumatic stress symptoms. Altogether, although the cutoff scores of the Greek FCV-19S version were explored to further evaluate the scale's validity, they may facilitate discrimination of adults with extreme COVID-19-related fear from those with normal fear reactions.

Cyberchondria and its Relationships with Related Constructs: a Network Analysis

Cyberchondria denotes repeated online searches for health information that are associated with increasing levels of health anxiety. The aims of this study were to apply network analysis to investigate the extent to which cyberchondria is a distinct construct, ascertain which of the related constructs have the strongest relationships with cyberchondria and investigate whether some of the symptoms of cyberchondria are more central to the construct of cyberchondria. Questionnaires assessing the severity of cyberchondria, health anxiety, obsessive-compulsive disorder symptoms, intolerance of uncertainty, problematic Internet use, anxiety, depression and somatic symptoms were administered to 751 participants who searched for health information online during a previous 3-month period and were recruited from an online crowdsourcing platform. Network analyses were used to compute the networks, perform community detection tests and calculate centrality indices. Results suggest that cyberchondria is a relatively specific syndrome-like construct, distinct from all related constructs and consisting of interrelated symptoms. It has the strongest relationships with problematic Internet use and health anxiety. No symptom of cyberchondria emerged clearly as more central to the construct of cyberchondria. Future research should aim to deepen our understanding of cyberchondria and its links with psychopathology, especially its close relationship with problematic Internet use.

Does cyberchondria overlap with health anxiety and obsessive-compulsive symptoms? An examination of latent structure and scale interrelations

Searching for medical information online is a widespread activity that increases distress for many individuals. Researchers have speculated that this phenomenon, referred to as cyberchondria, overlaps substantially with both health anxiety and obsessive-compulsive symptoms. This study sought to examine: (1) the distinguishability of cyberchondria from health anxiety and obsessive-compulsive symptoms and (2) the components of health anxiety and obsessive-compulsive symptoms that cluster most strongly with cyberchondria. The sample consisted of community adults in the United States with no current reported medical problems (N=375). Results from confirmatory factor analyses (CFAs) support the idea that cyberchondria is distinct from, yet related to, health anxiety and obsessive-compulsive symptoms. Results from zero-order correlations and regression analyses suggest that cyberchondria clusters with the affective (health worry) component of health anxiety. Regression results diverged from prior findings, as obsessive-compulsive symptoms did not share associations with cyberchondria after accounting for negative affect and health anxiety. The present results indicate that cyberchondria is possibly discernible from both health anxiety and obsessive-compulsive symptoms, while also providing insight into areas of potential overlap.

Validation of the Cyberchondria Severity Scale (CSS): replication and extension with bifactor modeling

Internet help seeking behaviors are increasingly common. Despite the positives associated with technology, cyberchondria, or the process of increased anxiety in response to internet medical information seeking, is on the rise. The Cyberchondria Severity Scale (CSS) was recently developed to provide a valid measure of cyberchondria across multiple dimensions. The current study sought to extend previous work on the CSS factor structure by examining a bifactor model. Participants (N=526) from a community sample completed the CSS via online crowd sourcing. Results revealed that the bifactor model of the CSS provided superior fit to the data, suggesting that it is useful to conceptualize the CSS as containing a General Cyberchondria factor that is orthogonal to its subfactors. Similar to previous work, the CSS Mistrust factor does not appear to be necessary to this construct. Finally, results revealed unique relations between General and Specific Cyberchondria factors with lower-order health anxiety dimensions.