What Is Cyberchondria and How Does It Affect Health Anxiety?

What you need to know

• Cyberchondria refers to excessive online health research that increases anxiety or distress
• It is closely related to health anxiety but may be a distinct phenomenon
• Cyberchondria can lead to functional impairment and increased healthcare utilization
• More research is needed on effective prevention and treatment approaches

What is cyberchondria?

The term “cyberchondria” was coined around 20 years ago to describe a new phenomenon related to using the internet to search for health information. While looking up health information online can be helpful in many cases, for some people it can turn into an anxiety-producing cycle of excessive searching.

Most definitions of cyberchondria emphasize two key components:

1. Excessive or repetitive online health research
2. Increased anxiety or distress as a result of that research

Beyond these core features, some researchers propose that cyberchondria also involves:

• Compulsive behavior and difficulty controlling the online searching
• Interruption of other activities due to time spent researching health information online
• Seeking reassurance from doctors in response to anxiety caused by online health research

So in essence, cyberchondria describes a pattern where searching for health information online leads to more anxiety rather than reassurance, which then drives further searching in an attempt to relieve that anxiety. This can create a self-perpetuating cycle.

How does cyberchondria relate to health anxiety?

Health anxiety refers to excessive worry about one’s health and fear of having a serious illness. Cyberchondria is closely related to health anxiety, but may be a distinct phenomenon.

Research has found moderate to strong correlations between measures of cyberchondria and health anxiety. This makes sense, as people with high health anxiety are more likely to obsessively search for health information online.

However, cyberchondria appears to have some unique features beyond just health anxiety. The compulsive nature of the online searching behavior and its relationship to internet use are aspects that distinguish cyberchondria.

Some key differences between cyberchondria and traditional health anxiety:

• Cyberchondria is specifically tied to online behavior
• It may involve a wider range of health concerns that shift over time, rather than worry about one particular illness
• The wealth of online information can fuel anxiety in new ways compared to pre-internet health anxiety

So while there is significant overlap, cyberchondria is not simply the online version of hypochondria or health anxiety. It appears to be a related but potentially distinct phenomenon enabled by easy access to online health information.

What drives cyberchondria?

Researchers have proposed a few key factors that may contribute to and maintain cyberchondria:

Reassurance seeking: People engage in online health research to try to alleviate health worries and gain reassurance. However, the nature of online information often leads to increased anxiety instead.

Information overload: The vast amount of health information available online can be overwhelming and confusing.

Uncertainty: Health-related online searches often raise more questions than they answer, fueling further searching.

Questionable sources: The variable quality and reliability of online health information contributes to uncertainty and anxiety.

Metacognitive beliefs: Beliefs about the usefulness of searching online for health information, as well as beliefs about losing control over the searching behavior.

Intolerance of uncertainty: Difficulty coping with not having definitive answers about health concerns drives continued searching.

The interactions between these various factors can create a self-perpetuating cycle of online health research and anxiety.

How does cyberchondria impact people?

For those who develop more severe cyberchondria, it can have significant negative impacts:

Time consumption: Excessive online health research can take up hours of time, interfering with work, relationships, and other activities.

Distress and anxiety: Rather than providing relief, the searching often increases worry and distress about health.

Functional impairment: Cyberchondria can impair people’s ability to fulfill responsibilities at work, school, or home.

Healthcare utilization: It may lead to increased doctor visits and requests for medical tests as people seek reassurance about concerns raised by online research.

Doctor-patient relationships: Some people challenge their doctors based on online research, potentially straining the relationship.

While the full economic and public health impact is still unknown, cyberchondria clearly has the potential for significant personal and societal costs if it becomes widespread.

How does cyberchondria relate to other mental health issues?

In addition to its close relationship with health anxiety, research has found connections between cyberchondria and several other mental health constructs:

Problematic internet use: There are moderate to strong correlations between measures of cyberchondria and problematic internet use. Both involve excessive online behavior that feels difficult to control.

Obsessive-compulsive symptoms: The repetitive nature of online health searching in cyberchondria shares some similarities with OCD behaviors. Moderate correlations have been found between cyberchondria and OCD symptoms.

Intolerance of uncertainty: This trait, which involves difficulty coping with ambiguous situations, shows consistent relationships with cyberchondria across studies.

So while cyberchondria appears to be a distinct phenomenon, it has connections to several established mental health constructs. This network of relationships provides clues about the mechanisms that may drive and maintain cyberchondria.

How is cyberchondria assessed?

The most commonly used measure of cyberchondria is the Cyberchondria Severity Scale (CSS). This scale assesses five dimensions of cyberchondria:

1. Compulsion (interference with other activities)
2. Distress
3. Excessiveness
4. Reassurance seeking
5. Mistrust of medical professionals

The original CSS has 33 items, but shorter versions with 12-15 items have also been developed and validated.

While the CSS has been widely used in research, there is still some debate about whether it fully captures all relevant aspects of cyberchondria. Some researchers have suggested that future measures may need to assess additional components like:

• Perceptions of how controllable the online searching feels
• Beliefs about the amount of health information needed
• The intrusiveness of health-related thoughts that drive searching

Refining assessment tools remains an active area of cyberchondria research.

How might cyberchondria be prevented or managed?

Since research on cyberchondria is still relatively new, evidence-based prevention and treatment approaches are still being developed. However, experts have suggested some potentially helpful strategies:

Prevention approaches:

• Improve online health information literacy skills
• Learn to identify reliable vs. unreliable health websites
• Set realistic expectations about online health information
• Understand the limitations of self-diagnosis based on internet research

Management strategies:

• Limit time spent on health-related internet searches
• Consult a doctor instead of searching online when experiencing concerning symptoms
• Challenge beliefs about the need for endless online research
• Use exposure therapy techniques to tolerate uncertainty about health concerns
• Cognitive-behavioral therapy approaches adapted for cyberchondria

One randomized controlled trial found that internet-delivered cognitive behavioral therapy for health anxiety, modified to also target cyberchondria, led to improvements in cyberchondria symptoms.

However, more research is still needed to determine the most effective prevention and treatment approaches for cyberchondria.

Cyberchondria during the COVID-19 pandemic

The COVID-19 pandemic created conditions that may increase cyberchondria for many people:

• High levels of health-related fear and anxiety
• Uncertainty about a new disease
• Constant updates and changing information online
• Abundance of misinformation, especially on social media

Early research during the pandemic found that cyberchondria was associated with:

• Higher levels of anxiety about COVID-19
• Greater trust in online information
• Feeling overwhelmed by the amount of information available
• Use of social media as a primary information source

The pandemic has highlighted the importance of helping people navigate online health information without falling into patterns of excessive and anxiety-producing searching.

Conclusions

• Cyberchondria is an emerging concept describing problematic patterns of online health-related searching
• While closely related to health anxiety, cyberchondria may be a distinct phenomenon with unique features
• More research is needed to clarify the conceptual status of cyberchondria and develop evidence-based interventions
• Improving online health information literacy may help prevent cyberchondria

As the internet continues to be a primary source of health information for many people, understanding cyberchondria and its impacts remains an important area of ongoing research. Helping people benefit from online health resources without falling into anxiety-producing patterns of excessive searching is a key challenge for healthcare in the digital age.