Cyberchondria and Chinese Adolescent Mental Health in the Age of COVID-19 Pandemic
Publication: Cyberpsychology, Behavior, and Social Networking
Volume 26, Issue Number 8
Abstract
One of the far-reaching impacts of the COVID-19 pandemic is that it has become the fertile soil of cyberchondria. Adolescents' mental health was severely hit by this by-product of the COVID-19 pandemic both due to the direct effects and its indirect effects on security. This study investigated whether and how cyberchondria was associated with Chinese adolescents' mental health (i.e., well-being and depressive symptoms). Based on a large Internet sample (N = 1,108, 67.5 percent female, Mage = 16.78 years), cyberchondria, psychological insecurity, mental health, and a series of covariates were assessed. Preliminary analyses were conducted in SPSS Statistics software and main analyses were conducted in Mplus. Path analyses indicated that (a) cyberchondria was negatively associated with well-being (b = −0.12, p = 0.001) and positively associated with depressive symptoms (b = 0.17, p < 0.001); (b) psychological insecurity could fully mediate the association between cyberchondria and mental health (indirect effect well-being = −0.15, 95% confidence interval [CI −0.19 to −0.12] and indirect effect depressive symptoms = 0.15, 95% CI [0.12 to 0.19]); (c) the two dimensions (social insecurity and uncertainty) of psychological insecurity could play the mediating role in the associations between cyberchondria and mental health, uniquely and parallelly; and (d) these results did not vary by gender. This study suggests that cyberchondria may arouse individuals' psychological insecurity about interpersonal interaction and the development of events, which ultimately decreases their well-being and increases the risk of depressive symptoms. These findings facilitate the establishment and implementation of relevant prevention and intervention programs.
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References
1. China Internet Network Information Center. The 49th China statistical report on Internet development. 2022. Available from: https://cnnic.cn/NMediaFile/old_attach/P020220721404263787858.pdf [Last accessed: June 24, 2023].
2. Maftei A, Holman AC. Cyberchondria during the coronavirus pandemic: The effects of neuroticism and optimism. Front Psychol 2020;11:567345;
3. Starcevic V. Cyberchondria: Challenges of problematic online searches for health-related information. Psychother Psychosom 2017;86(3):129–133;
4. Mathes BM, Norr AM, Allan NP, et al. Cyberchondria: Overlap with health anxiety and unique relations with impairment, quality of life, and service utilization. Psychiatry Res 2018;261:204–211;
5. Starcevic V, Berle D. Cyberchondria: Towards a better understanding of excessive health-related Internet use. Expert Rev Neurother 2013;13(2):205–213;
6. Starcevic V, Berle D, Arnáez S. Recent insights into cyberchondria. Curr Psychiat Rep 2020;22(11):1–8;
7. Keyes CL. Mental illness and/or mental health? Investigating axioms of the complete state model of health. J Consult Clin Psych 2005;73(3):539–548;
8. Renshaw TL, Cohen AS. Life satisfaction as a distinguishing indicator of college student functioning: Further validation of the two-continua model of mental health. Soc Indic Res 2014;117(1):319–334;
9. Chakhssi F, Kraiss JT, Sommers-Spijkerman M, et al. The effect of positive psychology interventions on well-being and distress in clinical samples with psychiatric or somatic disorders: A systematic review and meta-analysis. BMC Psychi 2018;18(1):1–17;
10. Lamers SM, Westerhof GJ, Glas CA, et al. The bidirectional relation between positive mental health and psychopathology in a longitudinal representative panel study. J Posit Psychol 2015;10(6):553–560;
11. Westerhof GJ, Keyes CL. Mental illness and mental health: The two continua model across the lifespan. J Adult Dev 2010;17:110–119;
12. Warwick HM. A cognitive-behavioural approach to hypochondriasis and health anxiety. J Psychosom Res 1989;33(6):705–711;
13. Witthöft M, Hiller W. Psychological approaches to origins and treatments of somatoform disorders. Annu Rev Clin Psycho 2010;6:257–283;
14. Jungmann SM, Witthöft M. Health anxiety, cyberchondria, and coping in the current COVID-19 pandemic: Which factors are related to coronavirus anxiety? J Anxiety Disord 2020;73:102239;
15. Singh K, Brown RJ. Health-related Internet habits and health anxiety in university students. Anxiety Stress Copin 2014;27(5):542–554;
16. Bajcar B, Babiak J. Self-esteem and cyberchondria: The mediation effects of health anxiety and obsessive–compulsive symptoms in a community sample. Curr Psychol 2021;40(6):2820–2831;
17. Ambrosini F, Truzoli R, Vismara M, et al. The effect of cyberchondria on anxiety, depression and quality of life during COVID-19: The mediational role of obsessive-compulsive symptoms and Internet addiction. Heliyon 2022;8(5):e09437;
18. Bessière K, Pressman S, Kiesler S, et al. Effects of internet use on health and depression: A longitudinal study. J Med Internet Res 2010;12(1):e6;
19. McElroy E, Shevlin M. The development and initial validation of the cyberchondria severity scale (CSS). J Anxiety Disord 2014;28(2):259–265;
20. Vismara M, Caricasole V, Starcevic V, et al. Is cyberchondria a new transdiagnostic digital compulsive syndrome? A systematic review of the evidence. Compr Psychiatry 2020;99:152167;
21. Maslow AH. The dynamics of psychological security-insecurity. J Pers 1942;10:331–344;
22. An L, Feng J. The situation of rural junior high school students' parents working outside and its impact on their psychological security [in Chinese]. Educ Res Exper 2015;4:82–85.
23. Cong Z, An L. Developing of security questionnaire and its reliability and validity. Chinese Mental Health J 2004;18:97–99;
24. Webb D, Wills-Herrera E (eds). Subjective Well-Being and Security (Vol. 46). Springer Science and Business Media: New York, NY; 2012.
25. Fowler JC, Allen JG, Oldham JM, et al. Exposure to interpersonal trauma, attachment insecurity, and depression severity. J Affective Disord 2013;149(1–3):313–318;
26. Starcevic V, Schimmenti A, Billieux J, et al. Cyberchondria in the time of the COVID-19 pandemic. Hum Behav Emerg Tech 2021;3(1):53–62;
27. Schoemann AM, Boulton AJ, Short SD. Determining power and sample size for simple and complex mediation models. Soc Psychol Personal Sci 2017;8(4):379–386;
28. Jokić-Begić N, Mikac U, Čuržik D, et al. The development and validation of the short cyberchondria scale (SCS). J Psychopathol Behav 2019;41(4):662–676;
29. Jokic-Begic N, Lauri Korajlija A, Mikac U. Cyberchondria in the age of COVID-19. PLoS One 2020;15(12):e0243704;
30. Zheng H, Jiang S. Linking the pathway from exposure to online vaccine information to cyberchondria during the COVID-19 pandemic: A moderated mediation model. Cyberpsychol Behav Soc Netw 2022;25(10):625–633;
31. Li ZY, Wu MZ. Relationship between social support and subjective well-being: Mediator role of self-consistency and congruence. Chinese J Clin Psychol 2010;18(3):346–348;
32. Campbell A, Converse PE, Rodgers WL. The Quality of American Life: Perceptions, Evaluations, and Satisfactions. Russell Sage Foundation: New York, NY, USA; 1976.
33. Liu J, Li D, Jia J, et al. Peer victimization and subjective well-being among Chinese adolescents: Moderated mediation by forgiveness and self-esteem. J Interpers Violence 2023;38(11–12):7355–7382;
34. Andresen EM, Malmgren JA, Carter WB, et al. Screening for depression in well older adults: Evaluation of a short form of the CES-D. Am J Prev Med 1994;10(2):77–84;
35. Radloff LS. The CES-D scale: A self-report depression scale for research in the general population. Appl Psych Meas 1977;1(3):385–401;
36. Crockett LJ, Randall BA, Shen YL, et al. Measurement equivalence of the Center for Epidemiological Studies Depression Scale for Latino and Anglo adolescents: A national study. J Consult Clin Psych 2005;73(1):47–58;
37. Ni Y, Tein JY, Zhang M, et al. Changes in depression among older adults in China: A latent transition analysis. J Affective Disord 2017;209:3–9;
38. Busch PA, McCarthy S. Antecedents and consequences of problematic smartphone use: A systematic literature review of an emerging research area. Comput Hum Behav 2021;114:106414;
39. Mertens G, Gerritsen L, Duijndam S, et al. Fear of the coronavirus (COVID-19): Predictors in an online study conducted in March 2020. J Anxiety Disord 2020;74:102258;
40. Muthén LK, Muthén BO. Mplus User's Guide (8th ed.). Muthén & Muthén: Los Angeles; 2017.
41. Kline RB. Principles and Practice of Structural Equation Modeling (4th Ed.). Guilford: New York, NY; 2016.
42. Laato S, Islam AN, Islam MN, et al. What drives unverified information sharing and cyberchondria during the COVID-19 pandemic? Eur J Inform Syst 2020;29(3):288–305;
43. Slavich GM. Social safety theory: A biologically based evolutionary perspective on life stress, health, and behavior. Annu Rev Clin Psycho 2020;16:265–295;
44. Varma R, Das S, Singh T. Cyberchondria amidst COVID-19 pandemic: Challenges and management Strategies. Front Psychiatry 2021;12:618508;
45. Tull MT, Barbano AC, Scamaldo KM, et al. The prospective influence of COVID-19 affective risk assessments and intolerance of uncertainty on later dimensions of health anxiety. J Anxiety Disord 2020;75:102290;
46. Starcevic V, Baggio S, Berle D, et al. Cyberchondria and its relationships with related constructs: A network analysis. Psychiatr Q 2019;90(3):491–505;
Information & Authors
Information
Published In
Cyberpsychology, Behavior, and Social Networking
Volume 26 • Issue Number 8 • August 2023
Pages: 631 - 639
PubMed: 37406285
Copyright
Copyright 2023, Mary Ann Liebert, Inc., publishers.
History
Published in print: August 2023
Published online: 31 July 2023
Published ahead of print: 5 July 2023
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Data Sharing Statement
The data that support the findings of this study are available from the corresponding author, Dr. Zhou (E-mail: [email protected]), upon reasonable request.
Authors
Author Disclosure Statement
All authors declare that they have no conflict of interests.
Funding Information
They also would like to express their gratitude for the support from the Collaborative Innovation Center of Assessment toward Basic Education Quality at Beijing Normal University in China (No. 2021-04-003-BZPK01). This research was supported by the Research Program Funds of the Collaborative Innovation Center of Assessment toward Basic Education Quality at Beijing Normal University in China “Database for Personality Development of Children and Adolescents” (No. 2021-04-003-BZPK01). This study was not preregistered before. The data in this article have not been used in previous research.
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