Mind
Cyberchondria and iCBT: new pathology, new intervention?

Cyberchondria and iCBT: new pathology, new intervention?

A recent study (Newby & McElroy, 2020) investigated for the first time whether cognitive-behavioral therapy via the internet (iCBT) for problems related to disease anxiety led to improvements in self-reports on cyberchondria and if the latter were associated. to improvements on disease anxiety.

 

Advertising message Having a little anxiety related to health conditions is normal and adaptive, but when it becomes persistent and excessive, it can have a negative impact on the life of the individual, his / her loved ones and also on health professionals (Tyrer et al., 2016), as well as on society in general (Bobevski et al., 2016; Tyrer, 2018).

People with excessive health-related anxiety – for which the DSM-5 (American Psychiatric Association, 2013) provides diagnoses of Disease Anxiety Disorder (IAD) or Somatic Symptom Disorder (SSD) – have a constant fear of have or may have disabling diseases in the future. As a consequence of this, these often engage in the search for excessive self-reassurances by other people (family or health) on their own health conditions: at first this manages to remove their fears; in the long run, however, concern becomes chronic and increases (Warwick & Salkovskis, 1990).

In the times of digitization, it has become a dangerous habit to expose oneself to information from online searches, often alarming, inaccurate or misleading about various diseases: this behavior can exacerbate existing health concerns and produce new ones, in a vicious circle of further related research the health conditions which is called “cyberchondria” (Starcevic & Berle, 2013).

Although more recent research has found a strong correlation between anxiety about health conditions and cyberchondria (McMullan et al., 2019), psychometric analyzes have shown that there is a significant difference between the two (Fergus & Russell, 2016) , leading to consider cyberchondria as a pattern of particular behaviors and anxieties that must be considered as a new specific target on a therapeutic level.

A recent study (Newby & McElroy, 2020) investigated for the first time whether cognitive-behavioral therapy via the internet (iCBT) for problems related to disease anxiety led to improvements in self-reports on cyberchondria and if the latter were associated. to improvements on disease anxiety.

Secondary data from a randomized controlled trial (RCT) were analyzed by comparing an iCBT group (n = 41) – who followed the specific online Health Anxiety Course (structured in six lessons) – with a control group that received psychoeducation , monitoring and clinical support (n = 41) in patients diagnosed with IAD and / or SSD (DSM-5, 2013).

Advertising message Two questionnaires were used in this research (pre and post intervention): the Short Health Anxiety Inventory (SHAI) (Salkovskis et al., 2002) for the evaluation of disease anxiety and the Cyberchondria Severity Scale (McElroy & Shevlin , 2014) for the evaluation related to cyberchondria.

The results showed that the iCBT group showed – after the intervention – a greater reduction in cyberchondria compared to the control group, with great differences especially in the CSS subscales related to compulsions, distress and excess.

In addition, all improvements related to symptoms of disease anxiety were mediated by improvements in the CSS subscales (except that related to distrust of doctors).

Although linked to a first study on the topic (and to an area still to be explored), these results have important implications for the assessment and treatment of cyberchondria: first of all they confirm that a more specific treatment also linked to an intervention that goes to undermining the problematic aspects of online health research can improve the symptoms of cyberchondria.

However, it is still not clear how much the improvement was due to the co-presence of standard cognitive-behavioral techniques (this intervention was structured for disease anxiety rather than cyberchondria).

In this sense, it is hoped that in the future research will be concerned with understanding which are the most specific critical aspects for obtaining better results on cyberchondria, also by integrating an assessment that incorporates modules for cyberchondria and disease anxiety.