Health anxiety in the 21st century: The use of the Internet for healthpurposes and its possible effects on health anxiety.

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Abstract

Cognitive behavioural theory suggests that excessive use of the Internet for health purposes can contribute to health anxiety but previous research examining the relationship between health anxiety and health-related Internet use is limited. This thesis aimed to explore if and how health-related Internet utilization and health anxiety are related, and whether such Internet use can exacerbate the health anxiety of health anxious individuals. Study 1 aimed to examine the possible relationship between health anxiety and the extent of, reasons for, and effects of health-related Internet use in university students, using a bespoke, theory-based questionnaire. Results suggested that health anxiety was significantly related to heightened and potentially problematic health-related Internet use, including: more frequent use, a greater proportion of health (vs. non-health) information sought, more time spent online for health purposes, more searches for illness information, and heightened tension post-search. We also found correlations between health anxiety and six-items concerning possible Internet addiction for health purposes. Study 2 sought to obtain information about health anxious individuals’ perspectives on health-related Internet use, using qualitative methodology. Themes uncovered during analysis were consistent with the results of study 1, and highlighted several other aspects of health-related Internet use that were relevant to health anxious users, including: metacognitions, Internet disadvantages, and health anxiety for others etc. Study 3 used the results of studies 1 and 2 to develop and psychometrically evaluate a new Internet use questionnaire in a large, non-clinical sample. Results suggested that the measure was both valid and reliable. Spearman correlations and simultaneous regressions substantiated previous findings from our earlier studies. Three aspects of health- related Internet use were uniquely predictive of health anxiety (illness-related Internet use: self; problematic use of the Internet for health purposes; anxiety post-search/perceived adverse consequences of searching). Study 4 aimed to determine the effects of presenting online health information in a manner designed to facilitate disconfirmatory information processing on subsequent anxiety, worry and illness beliefs. Results suggested that facilitating disconfirmatory information in this way was ineffective in reducing negative emotional outcomes post-search. Study 5 compared the frequency of ‘query escalations’ (searches for common, benign symptoms escalating to the consideration of serious causes/diseases) during online health searches between high and low health anxious students. We also examined the participants’ rationale for escalating queries and the effects of escalating on anxiety. Results found instances of query escalation in both high and low health anxious groups; though high health anxious participants were more likely to escalate their queries. Both groups reported increased anxiety post-escalation. In the final chapter I briefly summarise our studies, discuss major findings and the implications of our research, critically appraise our methodology, choices, and studies, and make recommendations for future research in this area.

Keyword(s)

Cyberchondria; Health Anxiety; Health-related Internet use; Hypochondriasis; Online health behaviour

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