The mediating role of obsessive-compulsive symptoms in the relationship between self-esteem and cyberchondria in students

Document Type : Original Article

Authors

1 Associate Professor, Department of Psychology, Shahid Madani University of Azerbaijan, Tabriz, Iran

2 Master of Psychology, Shahid Madani University of Azerbaijan, Tabriz, Iran

Abstract

Introduction: Cyberchondria can be considered one of the emerging challenges in the Internet age. Emphasizing that self-esteem and obsessive-compulsive symptoms are one of the main topics of research in young people, and it is necessary to identify the factors related to the increase of cyberchondria. For this purpose, the aim of the present study was the mediating role of obsessive-compulsive syndrome in the relationship between self-esteem and cyberchondria in students.
Method: The design of the current research was descriptive and correlational. The statistical population studied in the present study were the students of Azarbaijan Shahid Madani University, 262 of person were selected by multi-stage cluster random sampling. McElroy and Shulin's (CSS) cyberchondria questionnaire, Fua et al. (OCD-R), and Rosenberg's self-esteem questionnaire (SES) were used to collect information. Analysis of research data was done using SPSS and Lisrel software. Results: The results of structural equation modeling showed that the measured model of the research has a good fit with the conceptual model. Regarding direct effects, the results show that self-esteem has a direct relationship with cyberchondria and obsessive-compulsive symptoms. Also, obsessive-compulsive syndrome has a direct relationship with cyberchondria. As for the indirect effect, the results showed that obsessive-compulsive symptoms have a mediating effect on the relationship between self-esteem and cyberchondria. Conclusion: The results of the research showed that obsessive-compulsive disorder plays a mediating role in the relationship between self-esteem and cyberchondria. Paying attention to this impact mechanism can be effective in formulating effective preventive and therapeutic interventions for cyberchondria.

Keywords

Main Subjects

References

  1. منابع

    1.Vismara,V.,Varinelli,A.,Pellegrini,L.,Enara,A.,Fineberg,N. (2022).New challenges in facing cyberchondria during the coronavirus disease pandemic.Current Opinion in Behavioral Sciences, 46:101156.https://doi.org/10.1016/j.cobeha.2022.101156

    1. AlMuammar, S.A. Noorsaeed, A.S. Alafif, R.A. Kamal, Y.F. Daghistani, G.M. (2021).The use of the internet and social media for health information and its consequences among the population in Saudi Arabia. Journal of Anxiety Disorders,Cureus 2021, 13:e18338.doi.org/10.1016/j.janxdis.2022.102609.
    2. Bujnowska-Fedak, M.M. Waligóra, J. Mastalerz-Migas, A. (2019).The internet as a source of health information and services. Adv Exp Med Biol 2019, 1211:1-16.
    3. Afrin, R. Prybutok, G. Prybutok, V.R. (2022).The pathways from online health information seeking to cyberchondria: A perspective from moderated mediation.Psychiatry Research Communications 2،100069.https://doi.org/10.1016/j.psycom.2022.100069.
    4. Fergus, T.A.Spada, M.M. (2018).Moving Toward a Metacognitive Conceptualization of Cyberchondria: Examining the Contribution of Metacognitive Beliefs, Beliefs about Rituals, and Stop Signals.Journal of Anxiety Disorders,https://doi.org/10.1016/j.janxdis.2018.09.003.
    5. Newbya, J.M.McElroy, E. (2020).The impact of internet-delivered cognitive behavioural therapy for health anxiety on cyberchondria.Journal of Anxiety Disorders 69 (2020) 102150. https://doi.org/10.1016/j.janxdis.2019.102150.
    6. Mathes, B. M., Norr, A. M., Allan, N. P., Albanese, B. J., & Schmidt, N. B. (2018). Cyberchondria: Overlap with health anxiety and unique relations with impairment, quality of life, and service utilization. Psychiatry Research, 261, 204–211. https://doi.org/10.1016/j. psychres.2018.01.002.
    7. Makarla, S., Gopichandran, V., Tondare, D., 2019. Prevalence and correlates of cyberchondria among professionals working in the information technology sector in Chennai, India: a cross-sectional study. J. Postgrad. Med. 65 (2), 87–92. https://doi. org/10.4103/jpgm.JPGM_293_18.
    8. Rahme C, Akel M, Obeid S, Hallit S. Cyberchondria severity and quality of life among Lebanese adults: the mediating role of fear of COVID-19, depression, anxiety, stress and obsessive-compulsive behavior-a structural equation model approach. BMC Psychol. 2021;9(1):169. Published 2021 Oct 29. doi:10.1186/s40359-021-00674-8
    9. McMullan, R.D., Berle, D., Arnaez, ´ S., Starcevic, V., 2019. The relationships between health anxiety, online health information seeking, and cyberchondria: systematic review and meta-analysis. J. Affect. Disord. 245, 270–278. https://doi.org/10.1016/ j.jad.2018.11.037.
    10. Vismara, M., Caricasole, V., Starcevic, V., Cinosi, E., Dell’Osso, B., Martinotti, G., Fineberg, N.A., )2020(. Is cyberchondria a new transdiagnostic digital compulsive syndrome? A systematic review of the evidence. Compr. Psychiatr. 99, 152167. https://doi.org/10.1016/j.comppsych.2020.152167.
    11. Starcevic, V. (2017).Cyberchondria: Challenges of Problematic Online Searches for Health-Related Information. Psychotherapy and Psychosomatics;86:129–133.DOI: 10.1159/000465525.
    12. Starcevic, V., Berle, D., Arn´aez, S., Vismara, M., Fineberg, N., (2020). The assessment of cyberchondria: Instruments for assessing problematic online health-related research. Compr. Psychiatr. https://doi.org/10.1007/s40429-020-00308-w. Tabachnick, B.G., Fidell, L.S., 2014. Using Multivariate Statistics.
    13. Halldorsson, B., & Salkovskis, P. M. (2017). Why do people with OCD and health anxiety seek reassurance excessively? An investigation of differences and similarities in function. Cognitive Therapy and Research, 41, 619–631. https://doi.org/10.1007/s10608-016-9826- 5.
    14. Norr, A. M., Oglesby, M. E., Raines, A. M., Macatee, R. J., Allan, N. P., & Schmidt, N. B. (2015b). Relationships between cyberchondria and obsessive–compulsive symptoms. Psychiatry Research, 230, 441–446. https://doi.org/10.1016/j.psychres.2015.09.034.Pauly, P. Schwenzer, M. Brody, S. Rau, H. Birbaumer, N. (1993). Hypochondriac attitudes, Pain sensitivity, and Attentional bias. Journal of Psychosomatic Research, Vol. 37. No. 7. pp. 745-752.
    15. Fergus, T. A., & Russell, L. H. (2016). Does cyberchondria overlap with health anxiety and obsessive–compulsive symptoms? An examination of latent structure and scale interrelation. Journal of Anxiety Disorders, 38, 88–94. https://doi.org/10.1016/j.janxdis.2016.01. 009.
    16. Arsenakis, S.Chatton, A.Penzenstadler, L.Billieux, J.Berle, D.Starcevic, V.Viswasam, K.Khazaal, Y. (2021). Unveiling the relationships between cyberchondria and psychopathological symptoms.Journal of Psychiatric Research 143 (2021) 254–261.https://doi.org/10.1016/j.jpsychires.2021.09.014.
    17. Chamberlain, S.R., Menzies, L.)2009(. Endophenotypes of obsessive-compulsive disorder: rationale, evidence and future potential. Expert Rev. Neurother. 9 (8), 1133–1146. https://doi.org/10.1586/ern.09.36.
    18. Basharat, M., Hosseini, S., Jahed, H. (2018). Obsessive-compulsive personality disorder and perfectionism: a review. Thought and behavior in clinical psychology (thought and behavior), 13(51), 77-88. SID. https://sid.ir/paper/366402/fa) Persian).
    19. Starcevic, V., Baggio, S., Berle, D., Khazaal, Y., Viswasam, K.)2019(. Cyberchondria and its relationships with related constructs: a network analysis. Psychiatr. Q. 90 (3), 491–505. https://doi.org/10.1007/s11126-019-09640-5.
    20. Starcevic, V., Berle, D. (2014). Cyberchondria: towards a better understanding of excessive health-related Internet use. Expert Rev. Neurother. 13 (2), 205–213. https://doi.org/10.1586/ern.12.162.
    21. Parsons, C. A., & Alden, L. E. (2022). Online reassurance-seeking and relationships with obsessive-compulsive symptoms, shame, and fear of self. Journal of Obsessive-Compulsive and Related Disorders, 33, 100714.
    22. Bora, K., Das, D., Barman, B., and Borah, P. (2018). Are internet videos useful sources of information during global public health emergencies? A case study of YouTube videos during the 2015-16 Zika virus pandemic. Pathog. Glob. Health 112, 320–328. doi: 10.1080/20477724.2018.1507784
    23. Patwary, M. M., Bardhan, M., Browning, M. H. E. M., Disha, A. S., Haque, M. Z., Billah, S. M., et al. (2021). Association between perceived trusted of COVID-19 information sources and mental health during the early stage of the pandemic in Bangladesh. Healthcare 10:24. doi: 10.3390/ healthcare10010024
    24. Bajcar, B.Babiak, J. (2021).Self-esteem and cyberchondria: The mediation effects of health anxiety and obsessive–compulsive symptoms in a community sample.Current Psychology (2021) 40:2820–2831.
    25. Fergus, T. A., & Dolan, S. L. (2014). Problematic Internet use and Internet searches for medical information: The role of health anxiety. Cyberpsychology, Behavior and Social Networking, 17, 761–765. https://doi.org/10.1089/cyber.2014.0169.
    26. Fergus, T. A., & Spada, M. M. (2017). Cyberchondria: Examining relations with problematic Internet use and metacognitive beliefs. Clinical Psychology & Psychotherapy, 24, 1322–1330. https://doi. org/10.1002/cpp.2102.
    27. Armstrong, L., Phillips, J. G., & Saling, L. L. (2000). Potential determi-nants of heavier internet usage. International Journal of Human-Computer Studies, 53, 537–55
    28. Widyanto, L., & Griffith, M. D. (2011). An empirical study of problematic Internet use and self-esteem. International Journal of Cyber Behavior, Psychology and Learning, 1, 13–24. https://doi.org/10. 4018/ijcbpl.2011010102.
    29. Bulut Serin, N. (2011). An examination of predictor variables for problematic Internet use. Turkish Online Journal of Educational Technology-TOJET, 10, 54–62.
    30. Durak, M., & Senol-Durak, E. (2014). Which personality traits are associated with cognitions related to problematic Internet use? Asian Journal of Social Psychology, 17, 206–218.
    31. Kim, H.-K., & Davis, K. E. (2011). Toward a comprehensive theory of problematic Internet use: Evaluating the role of self-esteem, anxiety, flow, and the self-rated importance of Internet activities. Computers in Human Behavior, 25, 490–500. https://doi.org/10.1016/j.chb. 2008.11.001.
    32. Mei, S., Yau, Y. H., Chai, J., Guo, J., & Potenza, M. N. (2016). Problematic Internet use, well-being, self-esteem and self-control: Data from a high-school survey in China. Addictive Behaviors, 61, 74–79. https://doi.org/10.1016/j.addbeh.2016.05.009.
    33. Niemz, K., Griffiths, M., & Banyard, P. (2005). Prevalence of pathological Internet use among university students and correlations with self-esteem, the General Health Questionnaire (GHQ), and disinhibition. Cyberpsychology & Behavior, 8, 562–570. https://doi.org/10. 1089/cpb.2005.8.562.
    34. Sideli, L., La Cascia, C., Sartorio, C., Tripoli, G., Mulè, A., Taffaro, L., Ruggirello, I., Mangiapane, D., Piro, E., Inguglia, M., & La Barbera, D. (2017). Internet out of control: The role of self-esteem and personality traits in pathological Internet use. Clinical Neuropsychiatry, 14, 88–93.
    35. Hamzezadeh, S; Shalchi, B; Salehi, A; Abdulpour, AH (1398). The mediating role of self-esteem in the relationship between self-compassion and difficulty in emotion regulation with Internet use. Journal of Cognitive Psychology and Psychiatry. 1398; 6 (3): 129-143. (Persiayn).
    36. Tsai, H. F., Cheng, S. H., Yeh, T. L., Shih, C. C., Chen, K. C., Yang, Y. C., & Yang, Y. K. (2009). The risk factors of Internet addiction – A survey of university freshmen. Psychiatry Research, 167, 294–299. https://doi.org/10.1016/j.psychres. 2008.01.015.
    37. Aydin, B., & Sari, S. V. (2011). Internet addiction among adolescents: The role of self-esteem. Procedia - Social and Behavioral Sciences, 15, 3500–3505. https://doi.org/10.1016/j.sbspro.2011.04.325.
    38. Bozoglan, B., Demirer, V., & Sahin, I. (2013). Loneliness, self-esteem, and life satisfaction as predictors of internet addiction: A crosssectional study among Turkish university students. Scandinavian Journal of Psychology, 54, 313–319. https://doi.org/10.1111/sjop. 12049.
    39. Ivanova, E. (2013). Internet addiction and cyberchondria—their relationship with well-being. Journal of Education Culture and Society, 1, 57–70. https://doi.org/10.15503/jecs20131.57.70
    40. Blachnio, A., Przepiórka, A., Senol-Durak, E., Durak, M., & Sherstyuk, L. (2016). The role of personality traits in Facebook and internet addictions: A study on polish, Turkish, and Ukrainian samples. Computers in Human Behavior, 68, 269–275. https://doi.org/10. 1016/j.chb.2016.11.037.
    41. Salkovskis, P. M. (1989). Cognitive-behavioural factors and the persistence of intrusive thoughts in obsessional problems. Behaviour Research and Therapy, 27, 677–682. DOI: 10.1016/0005-7967(89)90152-6
    42. Salkovskis, P. M. (1999). Understanding and treating obsessive– compulsive disorder. Behaviour Research and Therapy, 37, 29–52. doi.org/10.1016/S0005-7967(99)00049-2
    43. Rachman S. (1993). Obsessions, responsibility and guilt. Behaviour research and therapy, 31(2), 149–154. https://doi.org/10.1016/0005-7967(93)90066-4
    44. Ehntholt, K. A., Salkovskis, P. M., & Rimes, K. A. (1999). Obsessive–compulsive disorder, anxiety disorders, and self-esteem: An exploratory study. Behaviour Research and Therapy, 37, 771–781. DOI: 10.1016/s0005-7967(98)00177-6
    45. Husain, N., Chaughry, I., Raza-ur-Rehman, & Ahmed, G. R. (2014). Selfesteem and obsessive–compulsive disorder. Journal of the Pakistan Medical Association, 64, 64–68.
    46. Wu, K. D., Clark, L. A., & Watson, D. (2006). Relations between obsessive–compulsive disorder and personality: Beyond axis I-axis 2830 Curr Psychol (2021) 40:2820–2831 II comorbidity. Journal of Anxiety Disorders, 20, 695–717. https:// doi.org/10.1016/j.janxdis.2005.11.001.
    47. McElroy, E., & Shevlin, M. (2014). The development and initial validation of the Cyberchondria Severity Scale (CSS). Journal of Anxiety Disorders, 28, 259–265. https://doi.org/10.1016/j.janxdis.2013.12. 007.
    48. Foa, E.B., Huppert, J.D., Leiberg, S., Hajcak, G., Langner, R., et al. (2002). The Obsessive-Compulsive Inventory: Development and validation of a short version. Psychological Assessment. 14(4):485-496.DOI:10.1037/1040-3590.14.4.485
    49. Foa, E. B., Kozak, M. J., Salkovskis, P. M., Coles, M. E., & Amir, N. (1998). The Validation of a New Obsessive-Compulsive Disorder Scale: The Obsessive-Compulsive Inventory. Psychological Assessment, 10, 206-214.http://dx.doi.org/10.1037/1040-3590.10.3.206
    50. Mohammadi, A., Zamani, R., and Fathi, L. (1387). Validation of the Persian version of the revised obsessive-compulsive questionnaire in the student population. Psychological research, 11(1-2 (21 series)), 66-78. SID. https://sid.ir/paper/66317/fa(Persian).
    51. Makikangas,A., Kinnunen, U., Feldt, T. (2004).Self-esteem, dispositional optimism, and health: Evidence from cross-lagged data on employees,Journal of Research in Personality,Volume 38, Issue 6,Pages 556-575,ISSN 0092-6566,https://doi.org/10.1016/j.jrp.2004.02.001.
    52. Chou, C.P., Bentler, P. M. (1995). Estimates and tests in structural equation modeling. In R. H. Hoyle, Structural equation modeling: Concepts, issues and applications. California: Sage.
    53. Wells, A. (2000). Emotional disorders and metacognition: Innovative cognitive therapy. New York, NY: Wiley.
    54. Yang, Y.,Ta, N.,Li, Z. (2022).Investigating the Obsessive and Compulsive Features of Cyberchondria: A Holistic Review.Front. Psychol. 13:897426. doi: 88 10.3389/fpsyg.2022.897426.
    55. Aryapouran, S.; Ashrafi, F., Yadaleh, Q. (2019). The relationship between demographic variables and the amount of use of social networks with obsessive-compulsive symptoms, health anxiety and stress related to the Corona virus. Master's thesis, Malayer University, Faculty of Literature and Humanities(Persian).
    56. Tolin, D. F., Abramowitz, J. S., Przeworski, A., & Foa, E. B. (2002). Thought suppression in obsessive-compulsive disorder. Behaviour research and therapy, 40(11), 1255–1274. https://doi.org/10.1016/s0005-7967(01)00095-x
    57. Sarawgi, S., Oglesby, M. E., & Cougle, J. R. (2013). Intolerance of uncertainty and obsessivecompulsive symptom expression. Journal of behavior therapy and experimental psychiatry, 44(4), 456-462.
    58. Carleton, R. N., Mulvogue, M. K., Thibodeau, M. A., McCabe, R. E., Antony, M. M., & Asmundson, G. J. (2012). Increasingly certain about uncertainty: Intolerance of uncertainty across anxiety and depression. Journal of anxiety disorders, 26(3), 468–479. https://doi.org/10.1016/j.janxdis.2012.01.011
    59. Ambrosini, F., Truzoli, R., Vismara, M., Vitella, D., & Biolcati, R. (2022). The effect of cyberchondria on anxiety, depression and quality of life during COVID-19: the mediational role of obsessive-compulsive symptoms and Internet addiction. Heliyon, 8(5), e09437. https://doi.org/10.1016/j.heliyon.2022.e09437
    60. Toledano,S., Guzick, A. G., McCarty, R. J., Browning, M. E., Downing, S. T., Geffken, G. R., & McNamara, J. P. H. (2020). An investigation of self-esteem in the treatment of OCD. Journal of Obsessive-Compulsive and Related Disorders, 100563. doi:10.1016/j.jocrd.2020.100563
    61. Doron, G., & Kyrios, M. (2005). Obsessive compulsive disorder: a review of possible specific internal representations within a broader cognitive theory. Clinical psychology review, 25(4), 415–432. https://doi.org/10.1016/j.cpr.2005.02.002
    62. Salkovskis P. M. (1985). Obsessional-compulsive problems: a cognitive-behavioural analysis. Behaviour research and therapy, 23(5), 571–583. https://doi.org/10.1016/0005-7967(85)90105-6
    63. Ünal A.T., Ekinci Y., Tarhan N. Handbook of Research on Cyberchondria, Health Literacy, and the Role of Media in Society’s Perception of Medical Information. IGI Global; 2022. Health literacy and cyberchondria; pp. 276–297. DOI: 10.4018/978-1-7998-8630-3.ch015
    64. Kalantari A., Valizadeh-Haghi S., Shahbodaghi A., Zayeri F. Opportunities and challenges of consumer health information on the internet: is cyberchondria an emerging challenge. Libr Philos. Pract. 2021:4990.
    65. Kline, R. B. (2016). Principles and practice of structural equation modeling (4th Ed.), New York: The Guilford Press.Ditommaso, E., Brannen, C. & Best, L. A. (2004). "Measurement and validity characteristics of the short version of the social and emotional loneliness scale for adults". Educational and Psychological Measurement. No. 1, 99-119. DOI:10.1177/0013164403258450

Files

History

  • Receive Date: 09 July 2023
  • Revise Date: 01 December 2023
  • Accept Date: 30 December 2023

Share

How to cite

Statistics