Distinguishing Cyberchondria from Adaptive Online Health Research: Clinical and Rehabilitative Advancements

Authors

  • Sean Hill <em>Department of Experimental Psychology, University of Oxford, Anna Watts Building, Woodstock Road, Oxford, OX2 6GG, UK </em>
  • Emanuele Maria Merlo <em>Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Italy</em>
  • Liam Alexander MacKenzie Myles <em>Department of Experimental Psychology, University of Oxford, Anna Watts Building, Woodstock Road, Oxford, OX2 6GG, UK </em>

DOI:

https://doi.org/10.13129/3035-062X/prnr-5328

Keywords:

Clinical Psychology, Cognitive rehabilitation, Cyberchondria, Diagnosis, Health anxiety, Psychopathology

Abstract

The use of new technologies within healthcare practices is constantly growing. While these innovations represent clear progress, facilitating and improving care, in some cases they are a concern. The autonomous use by patients of technologies that can answer clinical questions is a source of apprehension. In this sense, cyberchondria represents a problematic pattern of behavior through which subjects seek information related to existing or plausible medical conditions. This is done in the absence of scientific training that can discriminate against the information received. Such behavior consistently has a negative impact on the clinical and rehabilitation pathways. This phenomenon is attracting increasing attention, yet clear definitions and distinctions are needed. Apart from a clear definition of cyberchondria, it should be distinguished from adaptive online health research. This paper aims to produce clear definitions, to relate cyberchondria with health anxiety and other related phenomena, as well as to produce a representation of current etiological theories and future clinical and rehabilitative implications. A better understanding and analysis of the state of the art would in fact produce improvement on clinical activities and on the classification of phenomena.

References

Bailey, R. (2024). Why health anxiety needs NICE clinical guidelines. Lancet Psychiatry, 11(3), 164-165. https://doi.org/10.1016/S2215-0366(23)00404-2

Blakey, S. M., & Abramowitz, J. S. (2016). The effects of safety behaviors during exposure therapy for anxiety: Critical analysis from an inhibitory learning perspective. Clinical Psychology Review, 49, 1-15. https://doi.org/10.1016/j.cpr.2016.07.002

Bronfenbrenner, U. (1994). Ecological models of human development. International encyclopedia of education, 3(2), 37-43.

Brown, R. J., Skelly, N., & Chew‐Graham, C. A. (2020). Online health research and health anxiety: A systematic review and conceptual integration. Clinical psychology: Science and practice, 27(2), e12299. https://doi.org/10.1111/cpsp.12299

Caputo, A., Vicario, C. M., Cazzato, V., & Martino, G. (2022). Psychological Factors as Determinants of Medical Conditions, Volume II. Frontiers in Psychology, 13. https://doi.org/10.3389/fpsyg.2022.865235

Casula, A., Massimino S., Sgandurra, M. L., Lucifora, C., Travaglino G., Craparo, G., Martino, G., Nitsche, M. A., Vicario, C. M. (2025) Moral predictors of antivaccination attitude in the Italian COVID-19 post pandemic era. Preliminary Reports and Negative Results in Life Science and Humanities 2(1). https://doi.org/10.13129/3035-062X/prnr-4981

Di Giuseppe, M. (2024). Transtheoretical, transdiagnostic, and empirical-based understanding of defense mechanisms. Mediterranean Journal of Clinical Psychology, 12(1). https://doi.org/10.13129/2282-1619/mjcp-4036

Foucault, M. (2019). Power: the essential works of Michel Foucault 1954-1984. Penguin UK.

Hill, S., & Watts, D. (2024). Googling and health anxiety in older age—A case study of CBT incorporating a single case experimental design. Clinical Case Reports, 12(8), e9316. https://doi.org/10.1002/ccr3.9316

Jamalamadaka, T., Griffith, E., Steer, H., & Salkovskis, P. (2020). Fear of illness recurrence and mental health anxiety in people recovering from psychosis and common mental health problems. British journal of clinical psychology, 59(3), 403-423. https://doi.org/10.1111/bjc.12253

Jiakponna, E. C., Agbomola, J. O., Ipede, O., Karakitie, L., Ogunsina, A. J., Adebayo, K. T., & Tinuoye, M. O. (2024). Psychosocial factors in chronic disease management: Implications for health psychology. International Journal of Science and Research Archive, 12(02), 117-128. https://doi.org/10.30574/ijsra.2024.12.2.1219

Jokić-Begić, N., Mikac, U., Čuržik, D., & Sangster Jokić, C. (2019). The development and validation of the short cyberchondria scale (SCS). Journal of Psychopathology and Behavioral Assessment, 41, 662-676. https://doi.org/10.1007/s10862-019-09744-z

Kellerman, H., & Burry, A. (2007). Reality Testing and Cognitive Functioning: Personality Disorders and Neuroses. In Handbook of Psychodiagnostic Testing: Analysis of Personality in the Psychological Report (pp. 43-52). Springer. https://doi.org/10.1007/978-0-387-71370-0_5

Kennerley, H., Kirk, J., & Westbrook, D. (2016). An Introduction to Cognitive Behaviour Therapy: Skills and Applications. SAGE.

Kim, N. S., & Lee, K. E. (2017). Comparison of health anxiety and health information seeking behavior on the internet depending upon personality traits. Journal of Health Informatics and Statistics, 42(3), 259-268. https://doi.org/10.21032/jhis.2017.42.3.259

Kosic, A., Lindholm, P., Järvholm, K., Hedman-Lagerlöf, E., & Axelsson, E. (2020). Three decades of increase in health anxiety: Systematic review and meta-analysis of birth cohort changes in university student samples from 1985 to 2017. Journal of anxiety disorders, 71, 102208. https://doi.org/10.1016/j.janxdis.2020.102208

Lagoe, C., & Atkin, D. (2015). Health anxiety in the digital age: An exploration of psychological determinants of online health information seeking. Computers in Human Behavior, 52, 484-491. https://doi.org/10.1016/j.chb.2015.06.003

Lebel, S., Mutsaers, B., Tomei, C., Leclair, C. S., Jones, G., Petricone-Westwood, D., Rutkowski, N., Ta, V., Trudel, G., Laflamme, S. Z., Lavigne, A. A., & Dinkel, A. (2020). Health anxiety and illness-related fears across diverse chronic illnesses: A systematic review on conceptualization, measurement, prevalence, course, and correlates. Plos one, 15(7), e0234124. https://doi.org/10.1371/journal.pone.0234124

Lee, K., Hoti, K., Hughes, J. D., & Emmerton, L. M. (2015). Consumer use of “Dr Google”: a survey on health information-seeking behaviors and navigational needs. Journal of medical Internet research, 17(12), e288. https://doi.org/10.2196/jmir.4345

Maloney-Krichmar, D., & Preece, J. (2005). A multilevel analysis of sociability, usability, and community dynamics in an online health community. ACM Transactions on Computer-Human Interaction (TOCHI), 12(2), 201-232. https://doi.org/10.1145/1067860.1067864

McCormack, M., Tierney, K., Brennan, D., Lawlor, E., & Clarke, M. (2014). Lack of insight in psychosis: theoretical concepts and clinical aspects. Behavioural and cognitive psychotherapy, 42(3), 327-338. https://doi.org/10.1017/S1352465813000155

McElroy, E., & Shevlin, M. (2014). The development and initial validation of the cyberchondria severity scale (CSS). Journal of anxiety disorders, 28(2), 259-265. https://doi.org/10.1016/j.janxdis.2013.12.007

McMullan, R. D., Berle, D., Arnáez, S., & Starcevic, V. (2019). The relationships between health anxiety, online health information seeking, and cyberchondria: Systematic review and meta-analysis. Journal of Affective Disorders, 245, 270-278. https://doi.org/10.1016/j.jad.2018.11.037

Menon, V., Kar, S. K., Tripathi, A., Nebhinani, N., & Varadharajan, N. (2020). Cyberchondria: conceptual relation with health anxiety, assessment, management and prevention. Asian Journal of Psychiatry, 53, 102225. https://doi.org/10.1016/j.ajp.2020.102225

Mograbi, D. C., & Morris, R. G. (2018). Anosognosia. Cortex, 103, 385-386. https://doi.org/10.1016/j.cortex.2018.04.001

Morahan-Martin, J. M. (2004). How internet users find, evaluate, and use online health information: a cross-cultural review. CyberPsychology & Behavior, 7(5), 497-510. https://doi.org/10.1089/cpb.2004.7.497

Myles, L. A. M. (2021). Opinion article: The emerging role of computational psychopathology in clinical psychology. Mediterranean Journal of Clinical Psychology, 9(1). https://doi.org/10.6092/2282-1619/mjcp-2895

Myles, L. A. M. (2025). An evaluation of the ‘social graces’ in systemic thinking and practice. Context, 197. https://www.aft.org.uk/page/Context

Myles, L. A. M., & Johnson, P. G. B. (2023). Parsimony: A Forgotten Principle in Clinical Psychology and Classics. Mediterranean Journal of Clinical Psychology, 11(1). https://doi.org/10.13129/2282-1619/mjcp-3715

Pearce, W. B. (2005). The coordinated management of meaning (CMM). Theorizing about intercultural communication, 35-54.

Rachmad, Y. E. (2024). From Emotional Triggers To Social Media Algorithms. In: Yoesoep Edhie Rachmad Publication.

Rimvall, M. K., Jespersen, C. P., Clemmensen, L., Munkholm, A., Skovgaard, A. M., Verhulst, F., ... & Jeppesen, P. (2019). Psychotic experiences are associated with health anxiety and functional somatic symptoms in preadolescence. Journal of Child Psychology and Psychiatry, 60(5), 524-532. https://doi.org/10.1111/jcpp.12986

Salkovskis, P. M., Thorpe, S. J., Wahl, K., Wroe, A. L., & Forrester, E. (2003). Neutralizing increases discomfort associated with obsessional thoughts: An experimental study with obsessional patients. Journal of Abnormal Psychology, 112(4), 709. https://doi.org/10.1037/0021-843X.112.4.709

Scull, A. (2021). American psychiatry in the new millennium: a critical appraisal. Psychological medicine, 51(16), 2762-2770. https://doi.org/10.1017/S0033291721001975

Shafiq, M. N. (2024). Does Cultural Communication Strategy in Metaverse affect International Students’ Mental Health? Moderating effects of Cyberchondria and Healthcare Disparity. iRASD Journal of Management, 6(1), 21-40. https://doi.org/10.52131/jom.2024.0601.0120

Skjernov, M., Bach, B., Fink, P., Fallon, B., Soegaard, U., & Simonsen, E. (2020). DSM-5 personality disorders and traits in patients with severe health anxiety. The Journal of Nervous and Mental Disease, 208(2), 108-117. https://doi.org/10.1097/NMD.0000000000001108

Starcevic, V., & Berle, D. (2013). Cyberchondria: towards a better understanding of excessive health-related Internet use. Expert review of neurotherapeutics, 13(2), 205-213. https://doi.org/10.1586/ern.12.162

Starcevic, V., Berle, D., & Arnáez, S. (2020). Recent insights into cyberchondria. Current Psychiatry Reports, 22(11), 56. https://doi.org/10.1007/s11920-020-01179-8

Starcevic, V., Berle, D., Arnáez, S., Vismara, M., & Fineberg, N. A. (2020). The assessment of cyberchondria: instruments for assessing problematic online health-related research. Current Addiction Reports, 7, 149-165. https://doi.org/10.1007/s40429-020-00308-w

Warwick, H. M., & Salkovskis, P. M. (1990). Hypochondriasis. Behaviour Research and Therapy, 28(2), 105-117. https://doi.org/10.1016/0005-7967(90)90023-c

Zheng, H., Sin, S.-C. J., Kim, H. K., & Theng, Y.-L. (2021). Cyberchondria: a systematic review. Internet Research, 31(2), 677-698. https://doi.org/10.1108/INTR-03-2020-0148

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Published

2025-12-31

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Opinion articles