Cyberchondria in the age of COVID-19.

The global epidemic of (mis)information, spreading rapidly via social media platforms and other outlets, can be a risk factor for the development of anxiety disorders among vulnerable individuals. Cyberchondria can be a vulnerability factor for developing anxiety in a pandemic situation, particularly when the Internet is flooded with (mis)information. The aim of our study was to examine how cyberchondria is related to changes in levels of COVID-19 concern and safety behaviours among persons living in Croatia during the period in which the first COVID-19 case was identified and when the country recorded its first fatality. Repeated cross-sectional data collection was conducted during two waves over a period of three weeks (N1 = 888; N2 = 966). The first began on the day of the first confirmed case of COVID-19 in Croatia (February 24th, 2020) and the second wave began three weeks later, on the day the first COVID-19 fatality was recorded in Croatia (March 19th, 2020). Participants completed an online questionnaire regarding various COVID-19 concerns and safety behaviours aimed at disease prevention (information seeking, avoidance and hygiene) and a measure of cyberchondria (Short Cyberchondria Scale, SCS). We analysed whether changes to the epidemiological situation during the period between the two waves of data collection led to an increase in COVID-19 related behaviour directly and indirectly via an increase in COVID-19 concerns. The results indicated that, between the two waves of research, there was a pronounced increase in concerns regarding COVID-19 (b = 1.11, p < .001) as well as significant behavioural changes (b = 1.18-2.34, p < .001). Also, results demonstrated that cyberchondria plays a moderating role in these changes. In the first wave, persons with severe cyberchondria were already intensely concerned with safety behaviours. High cyberchondria and high levels of concern about the COVID-19 are associated with intense avoidance behaviours, R2 = .63, p < .001. A moderated partial mediation model was confirmed, in which the effect of the epidemiological situation was weaker for those with higher results on the SCS (as indicated by index of moderated mediation between -.10 and -.15, p < .05). As such, cyberchondria is a contributing factor to long-term anxiety and its impact during pandemic on the general mental health burden should therefore be further investigated.

Online Research on COVID-19—The Role of Content Ranking and COVID-19 Fear

Cyberchondria is defined as excessive online health research followed by distress. Theoretical models of cyberchondria suggest that it can be influenced by both characteristics of the internet (content, information ranking, amount and quality of information) and individual vulnerability factors (general health anxiety or COVID-19 fear). In order to simultaneously explore the role of both factors, an innovative search engine software (Foogle) was developed and used in the present study that enables manipulation of the presented content and content ranking while also recording users’ online behavior. A total of 36 participants with high and 28 participants with low COVID-19 fear searched for the long-term health effects of COVID-19 using Foogle. They were presented with search engine results that rank long-term health effects of COVID19 from more to less severe or vice versa (randomized). Results revealed that participants who were presented with articles describing more to less severe long-term COVID-19 health effects accessed articles with a higher mean severity index. In general, participants spent more time on articles depicting more severe content. Participants with high COVID-19 fear felt more anxious post-search than those with low COVID-19 fear and expressed a greater wish to continue searching. [ FROM AUTHOR]

Mental Health of Psychiatrists and Physicians of Other Specialties in Early COVID-19 Pandemic: Risk ind Protective Factors.

BACKGROUND: Many research has indicated that, during the COVID-19 pandemic, health care workers are under greatly increased pressure and at increased risk for the development of mental health problems. Furthermore, previous research has indicated that psychiatrists are exposed to a number of unique stressors that may increase their risk for poor mental health. The aims of the present study were to assess the level of COVID-19 related concerns, psychological distress and life satisfaction among psychiatrists and other physicians during the first period of the pandemic and to examine whether individual differences in COVID-19 concerns, psychological flexibility, psychological resilience and coping behaviors account for differences in mental health indicators. SUBJECTS AND METHODS: The sample consisted of N=725 physicians, among whom 22.8% were psychiatrists. This study was conducted online during the first lockdown in Croatia and collected data regarding COVID-19 related concerns, coping behaviors and mental health indicators (Psychological Distress and Life Satisfaction). RESULTS: Physicians of other specialties had higher scores on a measure of COVID-19 anxiety than psychiatrists (p=0.012). In addition, a number of differences in coping behaviors are evident. Specifically, psychiatrists were less likely than physicians of other specializations to believe that being informed about COVID-19 is an effective coping strategy (p=0.013), but more prone to using sedatives and drugs as a coping strategy (p=0.002; p=0.037). CONCLUSIONS: Psychiatrists are at special risk for substance abuse. Younger age, psychological inflexibility, low resilience and greater COVID-19 concerns might act as specific risk factors for distress. Our findings highlight the need for promoting a healthy lifestyle and psychological flexibility as universal protective factors.

Fear of Becoming Infected and Fear of Doing the Wrong Thing - Cross-Cultural Adaptation and Further Validation of the Multidimensional Assessment of COVID-19-Related Fears (MAC-RF).

Background: With the COVID-19 infection speeding around the world, many experience fear and anxiety. To detect those at risk of psychopathology and provide treatment, valid instruments are needed. The aim of this study was to cross-culturally validate the theory-based instrument Multidimensional Assessment of COVID-19-Related Fears (MAC-RF) in Croatian and to further examine the scale's validity by exploring its relationship with relevant constructs. Method: A total of 477 participants completed an online survey during a rapid rise in new daily COVID-19 cases in Croatia and while new restrictions were being imposed. Results: MAC-RF had a stronger association with health anxiety, cyberchondria, and anxiety sensitivity compared to depression, attesting to its convergent and divergent validity. However, a 2-factor structure was revealed in this sample: Fear of infection and Fear of using an inadequate strategy in dealing with pandemic. Fear of infection had a stronger association with health anxiety and COVID-19 anxiety and was a better predictor of COVID-19 related protective health behaviors. Fear of choosing an inadequate strategy had a stronger association with cyberchondria, fear of consequences of the epidemic on mental health, as well as financial consequences, and loss of civil liberties. Conclusion: Fear of infection captures negative emotional states due to feared consequences on personal somatic health and the health of loved ones, while Fear of choosing an inadequate strategy in dealing with the pandemic reflects a metacognitive aspect. Treatments may have to target both aspects of COVID-19 related fear.

Cyberchondria and Questionable Health Practices: The Mediation Role of Conspiracy Mentality

Cyberchondria is a pattern of repetitive search for health information online, which has adverse psychological consequences in spite of its intention to relieve anxiety. This phenomenon is particularly relevant in the current pandemic accompanied by increased levels of uncertainty and fear, which can lead to increased volume of health information search on the internet, as well as cyberchondria. The first objective of this study was to test the factor structure, reliability, and convergent validity of Serbian adaptations of the Cyberchondria Severity Scale (CSS-12) and the Short Cyberchondria Scale (SCS). The second aim was to test the direct effects of cyberchondria on pseudoscientific practices (PSP) and the use of complementary/alternative medicine (CAM) as well as its indirect effects through conspiracy mentality (CMQ). The sample included 511 participants (73.6% women) from Serbia, from the general population. The results support the adequate alpha reliabilities and four-factor structure of CSS-12 and the single-factor structure of SCS, as well as their positive correlations with health anxiety (HAQ), internet addiction (IAT), and obsessive-compulsive symptoms (OCI-R Obsessions) and a negative correlation with self-esteem (a single-item scale). Additionally, the composite cyberchondria score had both direct and indirect effects on both questionable health practices. Our results revealed conspiracy mentality as one of the possible mechanisms through which cyberchondria is related to the use of PSP/CAM. It stems from distress related to cyberchondria and leads to an increased likelihood of adopting PSPs or CAM as a tool for maintaining a sense of control in an uncertain situation.

COVID-19: Concerns and behaviours in Croatia.

OBJECTIVES: The COVID-19 pandemic has created uncertainty that has heightened fear and worry worldwide, thus elevating the potential for a growth in anxiety. This study aims to examine changes in levels of COVID-19 concern and safety behaviours among persons living in Croatia during the period in which the first COVID-19 case was identified and when the country recorded its first fatality. These changes were examined with respect to gender and family circumstances. DESIGN: The repeated cross-sectional data were conducted over two time points over the 3 weeks (N1 = 888; N2 = 966). METHODS: Participants completed online questionnaire regarding various COVID-19 concerns and safety behaviours aimed at disease prevention. RESULTS: Findings demonstrate dramatic increase in concern and safety behaviours among participants during the 3 weeks between the first identified case and the first fatality. The results suggest that parents, and mothers especially, represent the most concerned group, regardless of age. People with chronic health conditions also expressed greater concern and safety behaviour than healthy participants, but with small effect size. CONCLUSION: These findings highlight the importance of developing clear guidelines for alleviating the negative effects on mental health through effective communication strategies that minimize fear and emphasize positive behavioural change. Statement of contribution What is already known on this subject? In times of pandemic, people react with elevated levels of anxiety and some will adjust their behaviours in order to protect themselves as well as their family and friends. Some of the measures introduced to protect the spread of the COVID-19 disease have induced an atmosphere of fear, which in turn can lead to an increase in maladaptive anxiety and a greater burden on mental health. What does this study add? By conducting the research in two waves representing two critical time points in the developing COVID-19 situation in Croatia, we were able to trace a large increase in anxiety levels and safety behaviours among the general population. There is a discordance between those who are at most risk from serious consequences of the disease and those who are at greatest risk for maladaptive anxiety. Parents, and mothers in particular, represent the most concerned group, regardless of age. Lockdown measures have allowed us to ensure the safety of those vulnerable for serious COVID-19 illness. Now, we must focus on preserving the mental health of our whole community.