Abstract
Purpose of Review
Cyberchondria is a problematic, i.e. distressing or anxiety-increasing pattern of online health information seeking. The development of psychometrically sound instruments for the assessment of cyberchondria is imperative for better understanding of this construct. The aim of the present article is to provide a systematic literature review of cyberchondria instruments.
Recent Findings
Although several measures of cyberchondria have been developed, the Cyberchondria Severity Scale (CSS) has been used most often. The CSS is based on a solid theoretical framework, with very good to excellent reliability and validity. It has been translated into several languages. Modifications of the original version of the CSS have been introduced to refine its conceptual foundation and improve its utility by making it shorter.
Summary
Further improvement of the CSS may boost the quality of cyberchondria research. There remains a need to test the theoretical underpinnings of the CSS and consider alternative models of cyberchondria.
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs40429-020-00308-w/MediaObjects/40429_2020_308_Fig1_HTML.png)
Similar content being viewed by others
References
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
Starcevic V, Berle D. Cyberchondria: towards a better understanding of excessive health-related Internet use. Exp Rev Neurotherap. 2013;13:205–13. https://doi.org/10.1586/ERN.12.162.
Starcevic V. Cyberchondria: challenges of problematic online searches for health-related information. Psychother Psychosom. 2017;86:129–33. https://doi.org/10.1159/000465525.
McElroy E, Shevlin M. The development and initial validation of the Cyberchondria Severity Scale (CSS). J Anxiety Disord. 2014;28:259–65. https://doi.org/10.1016/j.janxdis.2013.12.007.
Moher D, Liberati A, Tetzlaff J, Altman DG. The PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6:e1000097. https://doi.org/10.1371/journal.pmed.1000097.
Fergus TA. The Cyberchondria Severity Scale (CSS): an examination of structure and relations with health anxiety in a community sample. J Anxiety Disord. 2014;28:504–10. https://doi.org/10.1016/j.janxdis.2014.05.006.
Norr AM, Allan NP, Boffa JW, Raines AM, Schmidt NB. Validation of the Cyberchondria Severity Scale (CSS): replication and extension with bifactor modeling. J Anxiety Disord. 2015;31:58–64. https://doi.org/10.1016/j.janxdis.2015.02.001.
Norr AM, Albanese BJ, Oglesby ME, Allan NP, Schmidt NB. Anxiety sensitivity and intolerance of uncertainty as potential risk factors for cyberchondria. J Affect Disord. 2015;174:64–9. https://doi.org/10.1016/j.jad.2014.11.023.
•• McElroy E, Kearney M, Touhey J, Evans J, Cooke Y, Shevlin M. The CSS-12: development and validation of a short-form version of the Cyberchondria Severity Scale. Cyberpsychol Behav Soc Netw. 2019;22:330–5. https://doi.org/10.1089/cyber.2018.0624This study demonstrates how the identified shortcomings of the Cyberchondria Severity Scale were addressed to create a shorter and more conceptually coherent version of the instrument, without sacrificing its solid psychometric properties.
Starcevic V, Baggio S, Berle D, Khazaal Y, Viswasam K. Cyberchondria and its relationships with related constructs: a network analysis. Psychiatr Q. 2019;90:491–505. https://doi.org/10.1007/s11126-019-09640-5.
•• Newby JM, McElroy E. The impact of internet-delivered cognitive behavioural therapy for health anxiety on cyberchondria. J Anxiety Disord. 2020;69:102150. https://doi.org/10.1016/j.janxdis.2019.102150This is the first study in which the Cyberchondria Severity Scale was used to monitor changes in cyberchondria during cognitive-behavioural therapy for health anxiety. The levels of cyberchondria decreased significantly in patients whose levels of health anxiety were reduced in the course of therapy, reaffirming the relationship between cyberchondria and health anxiety in treatment-seeking individuals.
Barke A, Bleichhardt G, Rief W, Doering BK. The Cyberchondria Severity Scale (CSS): German validation and development of a short form. Int J Behav Med. 2016;23:595–605. https://doi.org/10.1007/s12529-016-9549-8.
• Bajcar B, Babiak J, Olchowska-Kotala A. Cyberchondria and its measurement. The Polish adaptation and psychometric properties of the Cyberchondria Severity Scale CSS-PL. Psychiatr Pol. 2019;53:49–60. https://doi.org/10.12740/PP/81799This is an example of a well-conducted validation study of the translated version of the Cyberchondria Severity Scale.
Uzun SU, Zencir M. Reliability and validity study of the Turkish version of Cyberchondria Severity Scale. Curr Psychol. 2018:1–7. https://doi.org/10.1007/s12144-018-0001-x.
Selvi Y, Turan SG, Sayin AA, Boysan M, Kandeger A. The Cyberchondria Severity Scale (CSS): validity and reliability study of the Turkish version. Sleep Hypn. 2018;20:241–6. https://doi.org/10.5350/Sleep.Hypn.2018.20.0157.
Zangoulechi Z, Yousefi Z, Keshavarz N. The role of anxiety sensitivity, intolerance of uncertainty, and obsessive-compulsive symptoms in the prediction of cyberchondria. Adv Biosci Clin Med (ABCmed). 2018;6(4):1–6. https://doi.org/10.7575/aiac.abcmed.v.6n.4p.1.
Fergus TA. Anxiety sensitivity and intolerance of uncertainty as potential risk factors for cyberchondria: a replication and extension examining dimensions of each construct. J Affect Disord. 2015;184:305–9. https://doi.org/10.1016/j.jad.2015.06.017.
Norr AM, Oglesby ME, Raines AM, Macatee RJ, Allan NP, Schmidt NB. Relationships between cyberchondria and obsessive-compulsive symptom dimensions. Psychiatry Res. 2015;230:441–6 https://doi.org/10.1016/j.psychres.2015.09.034.
Fergus TA, Spada MM. Cyberchondria: examining relations with problematic internet use and metacognitive beliefs. Clin Psychol Psychother. 2017;24:1322–30. https://doi.org/10.1002/cpp.2102.
Fergus TA, Spada MM. Moving toward a metacognitive conceptualization of cyberchondria: examining the contribution of metacognitive beliefs, beliefs about rituals, and stop signals. J Anxiety Disord. 2018;60:11–9. https://doi.org/10.1016/j.janxdis.2018.09.003.
Fergus TA, Russell LH. Does cyberchondria overlap with health anxiety and obsessive-compulsive symptoms? An examination of latent structure and scale interrelations. J Anxiety Disord. 2016;38:88–94. https://doi.org/10.1016/j.janxdis.2016.01.009.
Mathes BM, Norr AM, Allan NP, Albanese BJ, Schmidt NB. Cyberchondria: overlap with health anxiety and unique relations with impairment, quality of life, and service utilization. Psychiatry Res. 2018;261:204–11. https://doi.org/10.1016/j.psychres.2018.01.002.
Gibler RC, Jastrowski Mano KE, O’Bryan EM, Beadel JR, McLeish AC. The role of pain catastrophizing in cyberchondria among emerging adults. Psychol Health Med. 2019;24:1267–76. https://doi.org/10.1080/13548506.2019.1605087.
Bajcar B, Babiak J. Self-esteem and cyberchondria: the mediation effects of health anxiety and obsessive-compulsive symptoms in a community sample. Curr Psychol. 2019. https://doi.org/10.1007/s12144-019-00216-x.
Durak-Batigun A, Gor N, Komurcu B, Senkal-Erturk I. Cyberchondria Scale (CS): development, validity and reliability study Dusunen Adam. J Psychiatry Neurol Sci. 2018;31:148–62. https://doi.org/10.5350/DAJPN2018310203.
Jokić-Begić N, Mikac U, Čuržik D, Jokić CS. The development and validation of the Short Cyberchondria Scale (SCS). J Psychopathol Behav Assess. 2019;41:662–76. https://doi.org/10.1007/s10862-019-09744-z.
González-Rivera JA, Santiago-Olmo KL, Cruz-Rodríguez AS, Pérez-Ojeda RJ, Torres-Cuevas H. Development and validation of the Brief Cyberchondria Scale in Puerto Rico. Int J Recent Sci Res. 2020;11:36734–7. https://doi.org/10.24327/ijrsr.2020.1101.4984.
Tatli Z, Tatli O, Kokoc M. Development and validity of Cyberchondria Tendency Scale. World J Educ Technol: Current Issues. 2019;11:001–9.
Singh K, Brown RJ. Health-related internet habits and health anxiety in university students. Anxiety Stress Coping. 2014;27:542–54. https://doi.org/10.1080/10615806.2014.888061.
Vismara M, Caricasole V, Starcevic V, Cinosi E, Dell’Osso B, Martinotti G, et al. Is cyberchondria a new transdiagnostic digital compulsive syndrome? A systematic review of the evidence. Compr Psychiatry. 2020;99:152167. https://doi.org/10.1016/j.comppsych.2020.152167.
da Silva FG, Andrade R, Silva I, Cardoso A. Cross-cultural adaptation of the Cyberchondria Severity Scale for Brazilian Portuguese. Trends Psychiatry Psychother. 2016;38:90–5. https://doi.org/10.1590/2237-6089-2015-0063.
Aulia A, Marchira CR, Supriyanto I, Pratiti B. Cyberchondria in first year medical students of Yogyakarta. J Consum Health Internet. 2020;24:1–9. https://doi.org/10.1080/15398285.2019.1710096.
Malik MN, Mustafa MAT, Yaseen M, Ghauri SK, Javaeed A. Assessment of cyberchondria among patients presenting to the emergency department of three hospitals in Islamabad, Pakistan. South Asian J Emerg Med (SAJEM). 2019;2:19–23. https://doi.org/10.5455/sajem.020207.
Akhtar M, Fatima T. Exploring cyberchondria and worry about health among individuals with no diagnosed medical condition. J Pak Med Assoc. 2020;70:90–5. https://doi.org/10.5455/JPMA.8682.
Makarla S, Gopichandran V, Tondare D. Prevalence and correlates of cyberchondria among professionals working in the information technology sector in Chennai, India: a cross-sectional study. J Postgrad Med. 2019;65:87–92. https://doi.org/10.4103/jpgm.JPGM_293_18.
Dagar D, Kakodkar P, Shetiya SH. Evaluating the cyberchondria construct among computer engineering students in Pune (India) using Cyberchondria severity scale (CSS-15). Indian J Occup Environ Med. 2019;23:117–20. https://doi.org/10.4103/ijoem.IJOEM_217_19.
Wijesinghe CA, Liyanage ULNS, Kapugama KGCL, Warsapperuma WANP, Williams SS, Kuruppuarachchi KALA, et al. “Muddling by googling” – cyberchondria among outpatient attendees of two hospitals in Sri Lanka. SL J Psychiatry. 2019;10:11–5. https://doi.org/10.4038/sljpsyc.v10i1.8202.
Smith GT, McCarthy DM, Anderson KG. On the sins of short-form development. Psychol Assess. 2000;12:102–11.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
This article is part of the Topical Collection on Technology Addiction
Rights and permissions
About this article
Cite this article
Starcevic, V., Berle, D., Arnáez, S. et al. The Assessment of Cyberchondria: Instruments for Assessing Problematic Online Health-Related Research. Curr Addict Rep 7, 149–165 (2020). https://doi.org/10.1007/s40429-020-00308-w
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40429-020-00308-w