Health-Related Internet Use and Cyberchondria in Adolescents: Population-Based Cross-Sectional Survey

青少年健康相关互联网使用与网络疑病症:一项基于人群的横断面调查

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Abstract

BACKGROUND: Health-related internet searches are widespread among the general population. Cyberchondria, that is, excessive health-related internet research that leads to emotional stress, showed significant associations with personality traits and psychological symptoms in adult samples. Although adolescents exhibit high levels of internet use, strong interest in health topics, and heightened vulnerability to anxiety symptoms and anxiety disorders, little research has examined cyberchondria in this age group. OBJECTIVE: Based on findings from adult populations, this study is among the first to investigate cyberchondria in adolescents and its associations with psychological traits (intolerance of uncertainty and health anxiety) and symptoms (problematic internet use and compulsive behavior). In addition, we examined whether intolerance of uncertainty moderates the relationship between cyberchondria and health anxiety. METHODS: A cross-sectional, web-based survey was conducted between April and July 2023 among adolescents (N=159; 14-17 years, mean 15.9, SD 0.88 years; 54% male, 45% female, 1% diverse). Validated self-report questionnaires were used to assess cyberchondria, intolerance of uncertainty, health anxiety, problematic internet use, and compulsive symptoms. RESULTS: Overall, 83% (132/159) reported searching for health-related topics on the internet. On average, they spent 8.68 minutes per day on health-related internet use (mean 8.68, SD 11.57), within a total of 238 daily minutes per day on total internet use (mean 238.3, SD 103.84). Cyberchondria showed strong positive correlations with health anxiety (r=0.54; P≤.001), problematic internet use (r=0.50; P≤.001), compulsive behavior (r=0.47; P≤.001), and intolerance of uncertainty (r=0.55; P≤.001). The moderation analysis revealed a significant overall model (∆R2=8.08%, F3, 155=38.26; P≤.001), but intolerance of uncertainty was not a significant moderator (∆R2<.01%, F1, 155=0.79; P=.38, 95% CI -0.01 to 0.03). CONCLUSIONS: The results suggest that health-related internet research and cyberchondria seem to be as relevant in adolescence as they are in adulthood, with similar associations to psychological traits and symptoms. The findings particularly support theoretical models that emphasize the role of intolerance of uncertainty and health anxiety. From a practical perspective, recognizing cyberchondria in adolescence could inform early prevention and psychoeducational strategies, especially given the high prevalence of health-related information seeking on the internet among adolescents. Further longitudinal research is needed to clarify causal pathways and to evaluate possible intervention approaches.

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