Health-related Internet habits and health anxiety in university students

Health-related Internet use has grown rapidly, yet little research has considered how health anxious individuals use the Internet for this purpose. Our aim was to examine the relationships between health anxiety and the extent of, reasons for, and consequences of health-related Internet usage in university students (n = 255). Responses on a purpose-made Internet use questionnaire were correlated with health anxiety scores; multiple regression analyses controlling for depression and anxiety were also conducted. Health anxiety positively correlated with (all ps < .01): frequency of health-related searching (r_s = .163), proportion of health-related information sought (r_s = .200), time spent online for health purposes (r_s = .166), and number of searches for both illness (r_s = .453) and wellness (r_s = .208) information. Health anxiety further positively correlated with advantages perceived in health-related Internet use (r_s = .183), heightened tension (r_s = .364) and relief (r_s = .174) post-search, and perceived doctor disadvantages (r_s = .306), yet a greater likelihood to visit a doctor post-search (r_s = .217). Health anxiety also correlated with six measures of possible addiction to using the Internet for health purposes (r_s range = .171 to .366, all ps < .01). Some (including several potentially dysfunctional) aspects of health-related Internet use correlate with health anxiety. Research evaluating the possible role of Internet use in the development and maintenance of health anxiety is warranted.     

How internet users find, evaluate, and use online health information: a cross-cultural review.

The Internet has become a favored source to find health information. Worldwide, about 4.5% of all Internet searches are for health-related information. However, research has found that the quality of online health information is mixed, which raises serious concerns about the impact of this information. This paper reviews relevant research to understand how health information on the Internet is retrieved, evaluated, and used. Most users of online health information are looking for information about specific health conditions because they or someone they know was diagnosed with a medical condition. They typically use general search engines to find online health information and enter short phrases, often misspelled. They seldom go beyond the first page of a search. Both their search and evaluation skills are limited although they are concerned about the quality of online health information. They avoid sites with overt commercialism, but often do not pay attention to indicators of credibility. Online health information is used to fill an information void which can enhance coping and self efficacy, affects health-related decisions and behavior of users and their friends and family, and is often discussed with health care providers. There are cross-cultural differences in the types of sites used as well as how online information is used. Based on the research reviewed in this paper, three major recommendations are suggested. Professionals should recommend sites. Professionals should promote more effective search and evaluation techniques. Professionals should be involved in developing and promoting uniform standards for health and mental health sites.     

Worried and wired: effects of health anxiety on information-seeking and health care utilization behaviors.

Although online health information-seeking has been widely studied and findings suggest a variety of motivations behind an individual's health information-seeking behavior, little is known about how this information influences health utilization behaviors. Thus, the current study investigates the relationship between online health information seeking and health care utilization such as visiting a doctor. Additionally, this project expands the literature by examining the moderating role of health anxiety. Results suggest that an individual's level of health anxiety moderates the relationship between online health information seeking and health care utilization decisions.     

Health anxiety,anxiety sensitivity,and attentional biases for pictorial and linguistic health‐threat cues

The study investigated attentional biases for pictorial and linguistic health‐threat stimuli in high and low health anxious individuals, who were selected from the upper and lower quartile ranges of a normal sample using a screening measure of health anxiety. Attentional bias was assessed using a visual probe task which presented health‐threat and neutral pictures and words at two exposure durations, 500 ms and 1250 ms. The prediction that the high health anxious group would show a greater attentional bias for health‐threat cues than the low health anxious group was not supported despite the groups being well‐differentiated on a general measure of health anxiety, the Illness Attitudes Scale (IAS). Instead, the results indicated that individuals with high levels of anxiety sensitivity showed a significantly greater initial attentional bias for threat pictures compared with those with low anxiety sensitivity, as assessed by the Anxiety Sensitivity Index (ASI).     

Health anxiety, anxiety sensitivity, and attentional biases for pictorial and linguistic health-threat cues

The study investigated attentional biases for pictorial and linguistic health-threat stimuli in high and low health anxious individuals, who were selected from the upper and lower quartile ranges of a normal sample using a screening measure of health anxiety. Attentional bias was assessed using a visual probe task which presented health-threat and neutral pictures and words at two exposure durations, 500 ms and 1250 ms. The prediction that the high health anxious group would show a greater attentional bias for health-threat cues than the low health anxious group was not supported despite the groups being well-differentiated on a general measure of health anxiety, the Illness Attitudes Scale (IAS). Instead, the results indicated that individuals with high levels of anxiety sensitivity showed a significantly greater initial attentional bias for threat pictures compared with those with low anxiety sensitivity, as assessed by the Anxiety Sensitivity Index (ASI).     

Imagining the future in health anxiety: the impact of rumination on the specificity of illness-related memory and future thinking

Individuals with health anxiety experience catastrophic fears relating to future illness. However, little research has explored cognitive processes involved in how health anxious individuals picture the future. Ruminative thinking has been shown to impede the ability to recall specific autobiographical memories, which in turn is related to maladaptive, categoric future thinking processes. This study examined the impact of rumination on memory and future thinking among 60 undergraduate participants with varying health anxiety (35% clinical-level health anxiety). Participants were randomized to experiential/ruminative self-focus conditions, then completed an Autobiographical Memory Test and Future Imaginings Task. Responses were coded for specificity and the presence of illness concerns. Rumination led to more specific illness-concerned memories overall, yet at the same time led to more categoric illness-related future imaginings. Rumination and health anxiety together best predicted overgeneral illness-related future imaginings. Highly specific illness-related memories may be maintained due to their personal salience. However, more overgeneral illness-related future imaginings may reflect cognitive avoidance in response to the threat of future illness. This divergent pattern of results between memory and future imaginings may exacerbate health anxiety, and may also serve to maintain maladaptive responses among individuals with realistic medical concerns, such as individuals living with chronic illness.     

Compensatory internet use among individuals higher in social anxiety and its implications for well-being

The social compensation hypothesis states that the internet primarily benefits individuals who feel uncomfortable communicating face-to-face. In the current research, we tested whether individuals higher in social anxiety use the internet as a compensatory social medium, and whether such use is associated with greater well-being. In Study 1, individuals higher in social anxiety reported greater feelings of comfort and self-disclosure when socializing online than less socially anxious individuals, but reported less self-disclosure when communicating face-to-face. However, in Study 2, social anxiety was associated with lower quality of life and higher depression most strongly for individuals who communicated frequently online. Our results suggest that, whereas social anxiety may be associated with using the internet as an alternative to face-to-face communication, such a strategy may result in poorer well-being.     

An examination of mindfulness skills in terms of affect tolerance among individuals with elevated levels of health anxiety

Background and Objectives: Affect tolerance factors, including anxiety sensitivity, intolerance of uncertainty, and emotional distress tolerance, have been implicated in the exacerbation of health anxiety. Therefore, identifying methods to improve affect tolerance in health anxious populations is imperative. Despite the link between mindfulness and greater affect tolerance in non-clinical populations, no work has examined the role of mindfulness skills in terms of affect tolerance among individuals with elevated health anxiety. The aim of the current study was to examine the unique contribution of mindfulness skills in terms of distress tolerance, anxiety sensitivity, and intolerance of uncertainty.

Methods: Participants were 218 undergraduates with clinically elevated levels of health anxiety (75.7% female; M_age?=?19.53, SD?=?3.16, Range?=?18–45) who completed self-report measures for course credit.

Results: Findings indicated that, after controlling for theoretically relevant covariates, greater acting with awareness, non-judgment, and non-reactivity were uniquely associated with greater distress tolerance, and greater non-reactivity was associated with lower levels of intolerance of uncertainty. Though none of the mindfulness skills emerged as specific individual predictors of anxiety sensitivity, these skills collectively accounted for unique variance in anxiety sensitivity.

Conclusions: These findings suggest that mindfulness skills may be helpful in targeting affect tolerance factors among individuals with elevated health anxiety.     

Health anxiety moderates the effects of distraction versus attention to pain

Little is known about the relationship between health anxiety and chronic pain. The present study explored whether individual differences in health anxiety would influence the response of chronic pain patients to physical therapy. Furthermore, the interaction of health anxiety with coping strategy usage (distraction versus attention) was studied. Participants were 81 chronic pain patients who were interviewed and completed measures of pain, anxiety and cognition following an active physiotherapy session in which they either: (1) attended to physical sensations; (2) distracted from physical sensations or (3) completed the session as usual. Health anxious, compared to non-health anxious, individuals worried more about their health and injury during the session and attended to and catastrophically misinterpreted sensations more frequently. A complex interaction between health anxiety and coping strategy emerged. Among health anxious patients, attention to sensations resulted in lower anxiety and pain than did distraction. It appears as though attention had a short-term anxiety reducing effect for health anxious patients. Among non-health anxious patients, attention resulted in greater worry about health than distraction. Clinical and theoretical implications are discussed.     

Attentional bias in anxiety: selective search or defective filtering?

Two experimental tasks were used to investigate the nature of a previously documented bias in attention associated with anxiety. Results from the first task failed to reveal any differences between anxious and nonanxious subjects, either in attention focusing or selective search for letters. The second task, with words as targets and distractors, suggested that selective search was less efficient in anxious subjects when distractors were present. Currently anxious subjects were slower than controls when required to search for the target among distractors of any type, whereas both currently anxious and recovered subjects were slower when the distractors were threatening words. It was therefore suggested that a bias favoring threat cues during perceptual search is an enduring feature of individuals vulnerable to anxiety, rather than a transient consequence of current mood state alone.     

Processing efficiency in anxiety: Evidence from eye-movements during visual search

It is generally held that anxiety is characterized by an attentional bias for threatening information. In recent years there has been an important debate whether these biases reside at the level of attentional selection (threat detection) or attentional processing after threat detection (attentional disengagement). In a visual search task containing emotional facial expressions, eye-movements were examined before and after threat detection in high and low trait anxious individuals to further elucidate the temporal unfolding of attentional bias. Results indicated that high-anxious individuals neither showed facilitated orienting to threat nor impaired disengagement of visual attention from threat. Interestingly, the presence of threat in the visual search display was associated with increased decision times in high-anxious individuals. These results challenge some of the current views on attentional bias to threat but indicate that emotional information reduces processing efficiency in anxiety.     

Selective processing of threat cues in anxiety states: a replication

A replication of Mathews and MacLeod's (Behav. Res. Ther. 23, 563-569, 1985) study, using a modified Stroop task, confirmed that threat words selectively interfere with the colour-naming performance of generally anxious patients, compared with normal controls. Clearer evidence was obtained of a highly specific interference effect of threat words that were congruent with the predominant worries reported by anxious patients. However, there was no evidence of a subsequent recognition memory bias for the threat words in anxious Ss. These results are discussed in relation to findings from other recent experiments investigating attentional and memory biases for threat-related information in anxiety states, and their implications for cognitive theories of anxiety are considered.     

Attentional bias to threat in clinical anxiety states

Abstract

Attentional responses to threat stimuli were assessed in anxious patients, normal controls, and subjects who had recovered from a clinical anxiety state. The main aims of the study were: (1) to replicate MacLeod, Mathews, and Tata's (1986) finding of an attentional bias to threat in currently anxious patients compared with normal control subjects; (2) to assess whether the bias is related to the predominant worries of anxious patients; and (3) to investigate whether the bias is present in recovered anxious patients. The original finding of an anxiety-related attentional bias was replicated. The results indicated that the extent to which anxious patients selectively attended to social threat words was associated with the seventy of their social worries. The attentional responses of the recovered anxious group were not significantly differentiated from those of the currently anxious or normal control groups.     

Comparison of problematic internet and alcohol use and attachment styles among industrial workers in Korea

The objective of this article is to fully understand Internet addiction, we aimed to compare the attachment styles and psychopathologies associated with problematic Internet use with those related to alcohol use. Through the participation of 141 male participants, the present study assessed problematic Internet and alcohol use, attachment, psychopathology, and demographic data via the use of self-rating questionnaires. We explored the significant predictors among avoidant and anxious attachments, depression, anxiety, and phobia to explain problematic Internet and alcohol use. The results showed that anxious attachment, depression, and anxiety could explain problematic alcohol use. In contrast, both anxious and avoidant attachment as well as depression and phobia explained problematic Internet use. Additionally, depression moderated the effects of avoidant attachment on problematic Internet use. We demonstrated that the interaction of attachment and psychopathology predicts problematic Internet use originating from an earlier stage of life than that associated with problematic alcohol use.     

Selective Exposure in the Internet Age: The Interaction between Anxiety and Information Utility

The rise of the Internet forces scholars to reevaluate the frequency and nature of political information seeking in the contemporary period. The functionality of the Internet makes passive exposure more difficult, and selective information seeking easier, than in the past. However, people may also use the Internet in a new and directed way—to arm themselves with information to express and defend their views either online or in the real world. The central question we explore in this paper is what explains balanced versus biased information seeking in the era of the Internet? We combine insights from Sears and Freedman (1967 ) with newer work on emotion to predict motivated selectivity: focusing specifically on the interaction between anxiety and information utility. Our central theoretical claim is that anxiety does not simply boost any information seeking; it triggers information seeking that is useful for addressing the problem at hand. Anxiety alone, therefore, does not guarantee a balanced information search. When counterattitudinal information is useful for some reason—for example, to defend their own opinions to others who may disagree—anxious citizens should seek it out. As a consequence, these subjects should learn more specific information about where each candidate stands on the issues. In an experiment we find support for these hypotheses. We conclude that while today's flexible Internet environment may permit selectivity, balanced seeking should still occur under a fairly common set of circumstances.     

Anxiety,Immigration, and the Search for Information

In this article, we use the issue of immigration to explore the role of anxiety in responses to political appeals. According to previous literature, anxiety motivates citizens to learn and pay more attention to news coverage. Literature in psychology demonstrates that anxiety is associated with a tendency to pay closer attention to threatening information. We predict that anxious citizens will seek more information but that they will seek out and be attracted to threatening information. In an experiment, we induce anxiety about immigration and then subjects have the opportunity to search for additional information in a website designed to mimic online news sources. The website has both immigration and nonimmigration stories, and the immigration stories are split between threatening coverage and nonthreatening coverage. We find that anxious subjects exhibit biased information processing; they read, remember, and agree with threatening information.     

For whom is social-network usage associated with anxiety? The moderating role of neural working-memory filtering of Facebook information

Is Facebook usage bad for mental health? Existing studies provide mixed results, and direct evidence for neural underlying moderators is lacking. We suggest that being able to filter social-network information from accessing working memory is essential to preserve limited cognitive resources to pursue relevant goals. Accordingly, among individuals with impaired neural social-network filtering ability, enhanced social-network usage would be associated with negative mental health. Specifically, participants performed a novel electrophysiological paradigm that isolates neural Facebook filtering ability. Participants’ actual Facebook behavior and anxious symptomatology were assessed. Confirming evidence showed that enhanced Facebook usage was associated with anxious symptoms among individuals with impaired neural Facebook filtering ability. Although less robust and tentative, additional suggestive evidence indicated that this specific Facebook filtering impairment was not better explained by a general filtering deficit. These results involving a neural social-network filtering moderator, may help understand for whom increased online social-network usage is associated with negative mental health.     

Adverse psychological outcomes in colorectal cancer screening: does health anxiety play a role?

People who are anxious about their health are more likely to misinterpret health information as personally threatening and less likely to be reassured by medical investigations that show they are free from disease. Consequently, health anxious people would be expected to react more adversely to cancer screening, but this possibility has rarely been explored. The moderating role of health anxiety on the psychological impact of participating in colorectal cancer screening was examined among a sub-sample of 3535 participants in a large, community-based trial of colorectal cancer screening in the UK. The screening modality was flexible sigmoidoscopy, which examines the bowel for pre-cancerous polyps. It was predicted that health anxiety would be associated with more worry about cancer before screening, a greater increase in worry if polyps were detected, and less reassurance after a clear result. As expected, health anxious participants were more anxious and more worried about bowel cancer both before and after screening. However, they experienced greater reductions in anxiety and worry about cancer following the examination. They reported lower levels of reassurance following screening, but also expressed more positive reactions to the experience. The positive psychological benefits of attending medical investigations should be examined in future work, because this may go some way towards explaining why health anxious people repeatedly seek medical interventions.     

Romantic relationships: do socially anxious individuals benefit?

Psychological health and interpersonal functioning mutually influence each other. Social anxiety has a pervasive effect on interpersonal functioning, resulting in smaller social networks, increased likelihood of being single or divorced, and less intimacy in relationships. However, little is known about how relationships affect socially anxious individuals in return. We utilized a structured interview to assess how romantic relationships were perceived as influencing three aspects of psychological health (well-being, social anxiety and comfort in social situations) and whether these patterns differed as a function of social anxiety in an undergraduate sample. The perceived importance of several reasons for these effects, including those that could be characterized as both protective and harmful, was also assessed. Relationships were perceived as having contributed positively in each domain. However, when positive and negative reasons were examined separately, socially anxious individuals reported benefiting more from the positive reasons and being harmed more by negative reasons. Further, social anxiety was associated with endorsing certain reasons as important.     

How do I appear to others? Social anxiety and processing of the observable self

Two information processing biases that could maintain social anxiety were investigated. High and low socially anxious individuals encoded positive and negative trait words in one of three ways: public self-referent, private self-referent, and other-referent. Half were then told they would soon have to give a speech. As predicted, compared to low socially anxious individuals, high socially anxious individuals recalled less positive public self-referent words, but only when both groups were anticipating giving a speech. No memory biases were observed for private self-referent or other-referent words. Next all participants gave a speech. Correlational analyses suggested that high socially anxious individuals may use the somatic concomitants of anxiety to overestimate how anxious they appear and underestimate how well they come across.