Higher Levels Of Health Anxiety Research Articles

Can’t stop, won’t stop - understanding anxiety’s role in cyberchondria among pregnant women

ABSTRACT Online health research is common during pregnancy, especially if women are facing complications. Given the unpleasant emotions women experience after research, it is surprising that cyberchondria, excessive and repeated online health research caused by anxiety that intensifies such anxiety, has not been studied in pregnant women. Therefore, the aim of this study was to examine the predictors of cyberchondria among women with and without pregnancy complications, accounting for health anxiety (a worry regarding personal health) and pregnancy-specific anxiety (concerns related to pregnancy and childbirth). A total of 360 pregnant women completed a questionnaire consisted of Short Health Anxiety Inventory, Pregnancy Concerns Scale and Short Cyberchondria Scale. The results of one-way MANOVA showed that women who had medically complicated pregnancy had higher levels of health anxiety, pregnancy-specific anxiety and cyberchondria compared to those without complications. A hierarchical multiple regression analysis showed that health anxiety and pregnancy-specific anxiety were predictors of cyberchondria but had different roles depending on complications. Pregnancy-specific anxiety predicted cyberchondria in both groups above health anxiety. Health anxiety predicted cyberchondria only in women without complications. In conclusion, women with complications have a higher chance of experiencing cyberchondria. Pregnancy-specific and health anxiety are risk factors for cyberchondria in pregnant women.

Health anxiety by proxy among parents: Measuring health anxiety for self, child and partner and its associations with family functioning

Health-related worries can be either self-directed or occur in close relationships by proxy (e.g., among parents, couples, or pet owners). Our aim was to test the feasibility of assessing health anxiety by proxy in parents and to examine the relationship of health anxiety with family well-being. Health anxiety by proxy was measured between parent-child and parent-partner relationships with adapted versions of the modified Short Health Anxiety Inventory. Parents reported significantly higher levels of health anxiety by proxy regarding their child than for themselves, t (585) = −3.61, p < .001. Exploratory factor analysis showed that each health anxiety questionnaire formed a distinct latent factor. Parenting stress and poorer family functioning had small associations with health anxiety towards one’s self, child, and partner ( r = 0.15 to r = 0.20). Further research is needed to determine clinical relevance and its impact on health behaviors and functioning within the family unit.

The role of self-compassion in loneliness during the COVID-19 pandemic: a group-based trajectory modelling approach

ABSTRACT Research has suggested an increase in loneliness during the COVID-19 pandemic, but much of this work has been cross-sectional, making causal inferences difficult. In the present research, we employed a longitudinal design to identify loneliness trajectories within a period of twelve months during the COVID-19 pandemic in Belgium (N = 2106). We were particularly interested in the potential protective role of self-compassion in these temporal dynamics. Using a group-based trajectory modelling approach, we identified trajectory groups of individuals following low (11.0%), moderate-low (22.4%), moderate (25.7%), moderate-high (31.3%), and high (9.6%) levels of loneliness. Findings indicated that younger people, women, and individuals with poor quality relationships, high levels of health anxiety, and stress related to COVID-19, all had a higher probability of belonging to the highest loneliness trajectory groups. Importantly, we also found that people high in two of the three facets of self-compassion (self-kindness and common humanity) had a lower probability of belonging to the highest loneliness trajectory groups. Ultimately, we demonstrated that trajectory groups reflecting higher levels of loneliness were associated with lower life satisfaction and greater depressive symptoms. We discuss the possibility that increasing self-compassion may be used to promote better mental health in similarly challenging situations.

Evidencing general acceptability of open-label placebo use for tackling overtreatment in primary care: a mixed methods study

BackgroundOvertreatment poses a challenge to healthcare systems due to harmful consequences of avoidable side-effects and costs. This study presents the first account for examining the feasibility of placebo use for reducing overtreatment in primary care, including whether public attitudes support the use of different placebo types in place of inappropriate prescriptions of antibiotics, antidepressants, or analgesics.MethodsWe used a multi-study, mixed-methods design, including patient and public (PPI) consultations, focus groups (Study 1) and two pre-registered online experiments (Studies 2 and 3).ResultsStudy 1 (N = 16) explored everyday conceptions and practicalities of potential placebo use in the context of respiratory infections. Findings highlighted the importance of trusting doctor-patient relationships and safety-netting. Study 2 employed a randomised experiment with a representative UK sample (N = 980), investigating attitudes towards 5 different treatment options for respiratory infections: (1) blinded + pure placebo, (2) open-label + pure placebo, (3) open-label + impure placebo, (4) antibiotic treatment, and (5) no treatment. Study 2 also examined how attitudes varied based on wording and individual differences. Findings indicated general support (ηp2 = .149, large effect size) for replacing inappropriate antibiotics with open-label + impure placebos, although personal placebo acceptability was lower. Also, older people, individuals suffering from chronic illness or those showing higher levels of health anxiety appeared less amenable to placebo use. Study 3 (N = 1177) compared attitudes towards treatment options across three clinical scenarios: respiratory infection, depression and pain. Findings suggested significant differences in the acceptability of placebo options based on the clinical context. In the infection scenario, options for open-label + pure placebos, open-label + impure placebos and no treatment were rated significantly more acceptable (ηp2 = .116, medium effect size) compared to the depression and pain scenarios. Again, general support for placebos was higher than placebo acceptability for personal use.ConclusionsFindings from PPI and three studies indicate general support for combatting overprescribing in primary care through clinical placebo use. This is an indicator for wider UK public support for a novel, behavioural strategy to target a long-standing healthcare challenge. General acceptability appears to be highest for the use of open-label + impure placebos in the context of antibiotic overprescribing.

Health anxiety and the negative interpretation of children’s bodily symptoms in mothers of cancer patients

PurposeFear of progression (FoP) is a substantial concern for family caregivers of cancer survivors and is related to a number of adverse outcomes, including increased mental distress and worse quality of life. Previous research has revealed that health anxiety (HA) contributes to fear of relapse, but cognitive factors underlying establishing and maintaining FoP in mothers of cancer patients have not been examined. In this study, we were looking to investigate this association.MethodsWe used the computerized interpretation bias (IB) assessment to investigate the biased interpretation of ambiguous bodily information and its association with FoP through HA among 69 mothers of cancer patients and 42 mothers of healthy kids.ResultsMothers of cancer patients interpreted more negatively ambiguous bodily symptoms than mothers of healthy kids. Moreover, they had higher levels of HA and FoP and lower quality of life than the healthy group. Also, among mothers of cancer patients, the relationship between negative IB and FoP is mediated by their HA.ConclusionsThe findings of this study imply that negative IB may contribute to increased HA, which in turn contributes to higher levels of FoP among the mothers of cancer patients, which may reduce the quality of life of their children.Implications for Cancer SurvivorsFrom these findings, we propose that changing HA through modification of IB might lower the FoP in mothers of kids with cancer and improve the mother and child’s quality of life.

Correlation between COVID-19-related health anxiety and coping styles among frontline nurses

BackgroundThe long-term epidemic of COVID-19 and its recurrence has exposed frontline nurses to mental disorders such as stress and health anxiety. High levels of health anxiety associated with COVID-19 may lead to maladaptive behaviors. There is no agreement on which coping styles are most effective against stress. Therefore, more evidence is required to find better adaptive behaviors. The present study was conducted to investigate the correlation between the level of health anxiety and the type of coping strategies used by frontline nurses fighting COVID-19.MethodsThis is a cross-sectional study that was performed on a convenience sample of 386 nurses who are working in the COVID department from October to December 2020, coinciding with the outbreak of the third COVID-19 peak in Iran. Data were collected through a demographic questionnaire, the short version of the health anxiety questionnaire, and coping inventory for stressful situations. Data were analyzed using independent T-test, U-Mann-Whitney, and Kruskal-Wallis statistical tests with SPSS version 23 software.ResultsThe mean score of nurses’ health anxiety was 17.61 ± 9.26 which was more than the cut-off point for health anxiety and 59.1% of nurses had COVID-19-related health anxiety. The mean score of problem coping style (26.85 ± 5.19), was higher than emotion (18.48 ± 5.63) and avoidance (19.64 ± 5.88) coping styles and nurses mostly used problem-coping strategies to deal with anxiety caused by COVID-19. There was a positive significant correlation between the scores of health anxiety and emotion coping style (r = 0.54; P < 0.001).ConclusionBased on the findings of this study, COVID-19-related health anxiety was high in front-line nurses and those with high health anxiety were more likely to use emotion-based coping strategies, which are ineffective. Therefore, considering strategies to reduce nurses’ health anxiety and holding training programs on effective coping methods in epidemic conditions are recommended.

Health anxiety and academic performance among undergraduate medical students: A correlational study

Introduction: Health anxiety is commonly overlooked as a distinct issue and a component of anxiety. Its impact on academic performance in university students has not been examined. The purpose of this study was to determine the relationship between anxiety and academic performance among medical students. Methods: A correlational study involving 600 medical undergraduate students was conducted. Results: Of the 510 students involved in the study results indicate females experienced higher levels of health anxiety than males. The prevalence of health anxiety was 13.34%. A significant association (r = -.157; p=0.002) between anxiety (M=15.31; SD=9.86) and academic performance (M=64.87; SD=7.48) was found. Conclusion: The prevalence of health anxiety among study participants was 13.34% and it was negatively associated with academic performance. Based on the study findings, it is recommended that policies and interventions aimed at educating and managing health anxiety among medical students be incorporated into medical school curriculum.

Health Locus of Control and Health Anxiety in Patients with COVID-19

IntroductionPerceived sense of control over one’s health contributes to determining health-related behaviors and an individual’s health status. Therefore, it may enhance vulnerability to health anxiety in response to COVID-19 and influence implementation of preventive strategies and adherence to them. Health anxiety may serve as one of the factors that increase the perception of COVID-19 as dangerous and life-threatening. We hypothesized that external health locus of control may demonstrate a connection with higher levels of health anxiety, whereas internal health locus of control may be considered a protective factor alongside some personality traits due to its role in determination of coping strategies.ObjectivesTo assess health locus of control (HLC) in patients with COVID-19 and evaluate its connection with the levels of health anxiety.MethodsThe study has involved 62 participants, average age is 23,4±8,2, with 36 of them being diagnosed with COVID-19 one or more times, average age is 24,5±8,9, whereas 26 of them were healthy, average age is 21,8±7,1. The following methods were used: Brief Illness Perception Questionnaire (modified for COVID-19), Perceived Stress Scale, the state scale from the State-Trait Anxiety Inventory, Short Health Anxiety Inventory, Illness- and Treatment-Related Locus of Control Scale, HEXACO-24 Personality Inventory, Self-Government Test.ResultsCOVID-19 patients differed from healthy participants by the following parameters: perceived danger of COVID-19 (31,53±9,51 vs 33,92±11,5; p&gt;0,05); perceived stress (28±8,68 vs 26,5±7,3; p&gt;0,05); state anxiety level (23,3±11,1 vs 25,1±12,5; p&gt;0,05); health anxiety (14,3±6,76 vs 13,8±5,7; p&gt;0,05); internal HLC (18,8±3,24 vs 17,8±4,67; p&gt;0,05); external HLC (5,97±1,89 vs 5,81±1,92; p&gt;0,05); extraversion (11,8±3,36 vs 13,10±3,71; p&gt;0,05).Correlation analysis has revealed mild positive correlations between health anxiety level and both external HLC (0,32; p&lt;0,05) and chance HLC (0,25; p&lt;0,05), mild negative correlation between health anxiety and internal HLC (-0,18; p&gt;0,05). Analysis of COVID-19 related variables found that health anxiety levels were positively correlated with perceived danger of coronavirus disease (0,37; p&lt;0,01), perceived stress (0,59; p&lt;0,001) in the whole sample. Negative correlation was observed between extraversion and health anxiety (-0,49; p&lt;0,05) in the group of COVID-19 patients.ConclusionsThe results obtained in our study demonstrate the connection of the higher levels of health anxiety in COVID-19 patients with more external orientation of HLC. The connection between extraversion and health anxiety is also observed. Our study indicates that participants diagnosed with COVID-19 one or more times tend to have higher health anxiety levels in comparison to healthy participants.Disclosure of InterestNone Declared

The effects of efficacy framing in news information and health anxiety on coronavirus-disease-2019-related cognitive outcomes and interpretation bias.

Within the coronavirus-disease-2019 (COVID-19) pandemic, disease-related information is omnipresent in the media, whereas information about how to manage the pandemic is less often covered. Under the context where threat is present, this study investigated whether and how the strength of efficacy framing (i.e., the perspective adopted by a communicating text that emphasizes one's possibilities to cope with an external threat) of COVID-19-related news, as well as its interaction with trait health anxiety under the COVID-19 context, related to people's COVID-19-related cognitive outcomes. One hundred and ninety-three participants reported demographics, trait health anxiety, and COVID-19-related behaviors (e.g., precautionary measures, information-seeking behaviors). They then either read high-efficacy (n = 112; e.g., cure rate) or low-efficacy (n = 81; e.g., mortality rate) information about COVID-19. Afterward, their tendency to interpret illness- and COVID-19-related information more negatively, and other COVID-19-related cognitions (e.g., risk perception, behavioral change intentions) were assessed. High-efficacy framing resulted in lower-risk perception and marginally weaker COVID-19-related interpretation bias, compared with low-efficacy framing. There was some evidence of an interaction with health anxiety such that high-efficacy framing, compared with low-efficacy framing, was associated with greater intention to adopt protective behaviors, particularly for individuals with higher levels of health anxiety. Media framing of COVID-19 information affects how people respond to the pandemic; a high-efficacy communication style might more effectively encourage healthy behaviors than a low-efficacy narrative, particularly for people who are already anxious about their health. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Psychological predictors of health anxiety and pain in ambulatory presentations in a hospital emergency department.

Health anxiety in attendees of out-patient medical clinics is well established; however, there has been a lack of research into health anxiety within emergency settings. This study explored the prevalence of health anxiety in ambulatory presentations in a tertiary emergency department (ED) as well as the factors associated with pain and health anxiety in this setting. A cross-sectional questionnaire design was used to gather data from adult ED ambulatory attendees across a 4-day sampling period to assess psychological and physical health variables. Number of attendances to ED over the previous 12 months was accessed through healthcare records. Of the final sample (n = 106), 77% were white British, 54% were male, and 14% presented with severe health anxiety as measured by the Short Health Anxiety Inventory (≥18). Participants with pre-existing health conditions had significantly higher levels of health anxiety (M = 12.36, SE = 1.59) compared with those without (M = 7.79, SE = 0.66). Stepwise multiple regression analyses identified anxiety sensitivity and pain catastrophizing as significant independent predictors of health anxiety, explaining 51% of the variance in health anxiety. Pain catastrophizing was also a significant independent predictor of pain level, accounting for 20% of the variance. This study provides insight into the prevalence of health anxiety in ED ambulatory presentations and key psychological predictors of health anxiety and pain. This has implications for treatment in an ED setting whereby patients may benefit from referral to medical psychology or mental health services.

Assessment of the Level of Health Anxiety among College Students in a Private Higher Educational Institution during COVID-19

Background: Worldwide, people who were exposed to the virus reported heightened health anxiety compared to the individuals with the absence of exposure related to the COVID-19 during the pandemic. Young adults reported higher levels of health anxiety when compared to other groups. To a certain extent, health anxiety serves a protective role until it becomes perseverate and dysfunctional. The researchers aim to describe the level of anxiety of college students by utilizing the COVID-19 Anxiety Syndrome Scale to form a foundation for programs and policies that would address dysfunctional health anxiety. Methods: The researchers used a quantitative, non-experimental, descriptive online survey research design to describe the level of COVID-19 health anxiety among college students in a private higher educational institution in Central Luzon, Philippines. Results: A total of 378 college students completed the survey. Analysis revealed that participants checked for symptoms of COVID-19 and were worried about possibly contracting COVID-19 for more than 7 days within two weeks (M=3.9; SD=1.5). It also revealed that the participants avoided situations that put them at risk for COVID-19 at a similar frequency (M=4.1; SD=0.4). Conclusion: The study reveals the sampled college students manifested COVID-19 anxiety for more than 7 days in a 2-week timeframe. This means that the students spend a significant amount of their time, in a two-week timeframe, worrying, checking, and avoiding situations that may put them at risk for COVID-19. These anxiety-induced behaviors may hinder the accomplishment of their activities of daily living or productive pursuits.

Negative interpretation of ambiguous bodily information by patients with relapsing-remitting multiple sclerosis

Relapsing-remitting MS (RRMS) is characterised by the patients' experience of periods of exacerbation in symptoms. The fear associated with the relapse influence the quality of life in patients and their relationship with bodily experiences. Previous studies suggested that health anxiety (HA) contributes to fear of relapse but have not investigated cognitive mechanisms involved in developing and maintaining the fear of relapse in patients and we were interested to test this relationship. We used the online interpretation paradigm to investigate biased interpretation of ambiguous bodily information and its relationship to HA among patients and healthy controls (65 subjects in each group). Patients had higher levels of HA than controls. Patients also interpreted ambiguous bodily information more negatively than controls. There was a significant positive correlation between HA and negative interpretation of information in the whole sample. Among patients, HA mediated the relationship between interpretation bias and fear of relapse. Findings of this study suggest that negative interpretation bias can contribute to higher HA which in turn contributed to more fear of relapse among patients with RRMS. These findings have important implications for improving the quality of life in patients suffering from MS.

Health anxiety and associated constructs in school-age children and adolescents with congenital heart disease and their parents: A children's healthy-heart activity monitoring program in Saskatchewan cohort study.

Youth with congenital heart disease (CHD) have been found to experience higher levels of health anxiety and associated constructs than typically developing peers. The association between youth and parent health anxiety has been explored in typically developing youth but this association remains unknown in youth with CHD. This association was explored using a prospective, cross-sectional study that included 36 school-age children and adolescents with CHD (median age =10.5 years, IQR = 4) and 35 parents (median age = 44 years, IQR = 10.5). Participants completed a demographic form and measures of health anxiety, anxiety sensitivity, intolerance of uncertainty, and anxiety disorder symptom categories (youth) or general anxiety (parent). Associations were observed between child and adolescent panic/agoraphobia symptoms and parent state anxiety (r = .41), child and adolescent intolerance of uncertainty and parent state and trait anxiety (r = .37; r = .46, respectively), and child and adolescent anxiety sensitivity and parent state anxiety (r = .40). No association was observed between health anxiety in children and adolescents and parents nor between child and adolescent health anxiety and parent associated constructs. For parents, associations between health anxiety and all measures of associated constructs of interest were observed. Study findings will facilitate improved understanding of the psychological needs of school-age children and adolescents with CHD.

INVESTIGATION OF THE FACTORS AFFECTING THE QUALITY OF LIFE OF ELDERLY INDIVIDUALS IN CONTEXT OF HEALTH PERCEPTION AND HEALTH ANXIETY

Objective:This study was planned to examine the factors affecting the quality of life of elderly individuals in the context of health perception and health anxiety. Method: The study is of descriptive type and was conducted with the participation of 374 elderly individuals. In the study, data were collected using the General Information Form, the Elderly Quality of Life Scale, the Health Perception Scale(SAS), and the Health Anxiety Scale. Data, number, percentage and mean values were evaluated using multiple linear regression analysis. The level of significance was accepted as p&lt;0.05 in the statistical analysis. Results: The mean age of the participants was 71.18±5.74. Participants got 28.92±8.13 points from the Quality of Life Scale Total, 54.87±9.58 points from the Health Perception Scale Total, and 43.57±10.53 points from the Health Anxiety Scale Total. It explains the participants' Quality of Life (32.1% of total variance) and sub-dimensions (Control 24.4%; Autonomy 20.2%; Pleasure 21.7%; Self-Realization 19.8%). Conclusion:It was found that the elderly individuals participating in the study had a moderate quality of life, had higher than average health perceptions and had high levels of health anxiety. As a result of the established multiple linear regression, it was found that health perception sub-dimensions and health anxiety were effective/predicted on quality of life. In particular, it is recommended that public health nurses pay attention to these issues in education and quality of life studies to be carried out for elderly individuals, and that studies based on health perception and health anxiety should be carried out with individual and collective organizations(congress, conference).

Health anxiety During COVID-19: Predictive Roles of Health Promoting Behaviors and Sensory Processing Sensitivity

Objective The emergence of the COVID-19 pandemic resulted in major changes in daily life and economic conditions while heightening physical and mental health problems, including health anxiety. Health authorities and elected officials have encouraged individuals to engage in health behaviors. Perceptions of and reactions to these changes could be subject to individual differences. In this line, the current study investigated the predictive roles of health promoting behaviors, sensory processing sensitivity, and their interactions with health anxiety. Design and measures: In this cross-sectional study, 355 participants (73% female, 25.9% male) whose ages range from 19 to 72 (M = 25.91, SD = 9.80) filled out self-reported measures on health promoting behaviors, sensory processing sensitivity, and health anxiety via an online platform between April and May 2020. Results It was revealed that caring for a healthy diet, taking responsibility for health and sensory processing sensitivity, but not physical activity and stress management, were associated with health anxiety. Diagnoses and perceptions of physical and mental health problems also contributed to health anxiety during the COVID-19 pandemic. Conclusion Individuals with higher levels of sensory processing sensitivity and health responsibility were more likely to experience higher levels of health anxiety, while typical physical activities and stress management behaviors were less likely to have an impact during the COVID-19 pandemic. These results highlight the importance of having a healthy diet and the need for pandemic-specific interventions for stress management and sport activities.

Health anxiety is associated with fearful imagery of contracting COVID-19: An experimental study

BackgroundAversive mental images of contracting or having a severe disease are assumed to contribute to the development and maintenance of health anxiety (HA) via the elicitation of fear, arousal and defensive mobilization. The current COVID-19 pandemic is known to trigger fears of contracting COVID-19. MethodsIn this study, we used an experimental approach to investigate whether COVID-19-related mental images lead to a fearful response and whether this is associated with levels of HA. 139 participants vividly imagined neutral, standard fear and COVID-19 related narrative scenes. ResultsStandard fear and COVID-19 scripts prompted higher anxiety, arousal, displeasure and avoidance tendencies as compared to neutral scripts. HA was associated with higher anxiety, arousal, displeasure, imagery vividness and stronger avoidance tendencies during imagery of COVID-19 scenes. No associations were found for anxiety sensitivity, trait anxiety as well as depressive and anxiety symptoms. Moreover, there was no association of HA with emotional responses during imagery of standard fear scenes. LimitationsFear responses were assessed via verbal reports. Future studies should also assess behavioral and physiological correlates of fear. ConclusionsThe present results indicate that individuals with high levels of HA are prone to fearful mental imagery of contracting COVID-19 which might be crucial factor contributing to the exacerbation and chronicity of excessive HA in times of a pandemic.

Number of musculoskeletal pain sites leads to increased long-term healthcare contacts and healthcare related costs \u2013 a Danish population-based cohort study

BackgroundPeople with musculoskeletal pain seek more healthcare than the general population, however little is known about the long-term effect on healthcare use. The aim of this study was to examine the consequences of number of musculoskeletal pain sites on long-term care-seeking and healthcare-related costs and explore how health anxiety influences this relationship.MethodsWe conducted a Danish population-based longitudinal cohort study of 4883 participants combining self-reported survey data from 2008 with ten-year follow-up data from national health registers. Using a causal inference framework, we examined associations between number of pain sites (range 0–7)/level of health anxiety (high/low level) and face-to-face healthcare contacts/healthcare-related costs. Data were analyzed using negative binomial regression with generalized estimating equations. Regression models were adjusted for sex, age, duration of pain, level of education, comorbidity, personality traits, risk of depression, marital status, physical job exposure, and previous healthcare utilization.ResultsFor each additional pain site general healthcare contacts (Incidence Rate Ratio (IRR): 1.04 (95% CI: 1.03–1.05)), healthcare-related costs (IRR: 1.06 (95% CI: 1.03–1.08) and musculoskeletal healthcare contacts (IRR: 1.11 (95% CI:1.09–1.14) increased. Those with high levels of health anxiety at baseline had a slightly higher number of general healthcare contacts (IRR 1.06 (1.01–1.11), independent of number of pain sites. However, level of anxiety did not influence the effect of number of pain sites on any healthcare use or cost outcomes.ConclusionsWe found evidence for a causal association between increasing number of pain sites and greater healthcare use and cost, and high levels of health anxiety did not increase the strength of this association. This suggests that number of pain sites could be a potential target for biopsychosocial interventions in order to reduce the need for future care-seeking.

Psychological distress in the context of the COVID-19 pandemic: the joint contribution of intolerance of uncertainty and cyberchondria

Objective To explore the direct and indirect associations between intolerance of uncertainty, health anxiety (HA), and psychological distress through problematic internet use (PIU) and cyberchondria, both before and during the first months of the COVID-19 pandemic. Design Two Italian samples were enrolled via an online questionnaire. Sample 1 (N = 556; 69.3% females, Mage 29.6 years, SD = 13.2) was recruited in non-pandemic times, whereas Sample 2 (N = 575; 74% females, Mage 31.9 years, SD = 13.4) was recruited during the COVID-19 lockdown. Main outcome measures Self-report measures assessing HA and psychological distress. Results Two distinct path analyses showed that intolerance of uncertainty was directly associated with HA and psychological distress in both samples. Moreover, cyberchondria partially mediated the relationship between intolerance of uncertainty and HA and PIU partially mediated the relationship between intolerance of uncertainty and psychological distress in both samples. The link between cyberchondria and psychological distress was significant in Sample 2 but non-significant in Sample 1. The model accounted for a substantial variance of HA and psychological distress in both samples. Conclusion Our findings suggest that problematic online behaviors might exacerbate the negative consequences of intolerance of uncertainty in terms of higher levels of HA and psychological distress both in pandemic and non-pandemic contexts.

Health anxiety, perceived stress, and coping styles in the shadow of the COVID-19

BackgroundIn the case of people who carry an increased number of anxiety traits and maladaptive coping strategies, psychosocial stressors may further increase the level of perceived stress they experience. In our research study, we aimed to examine the levels of perceived stress and health anxiety as well as coping styles among university students amid the COVID-19 pandemic.MethodsA cross-sectional study was conducted using an online-based survey at the University of Debrecen during the official lockdown in Hungary when dormitories were closed, and teaching was conducted remotely. Our questionnaire solicited data using three assessment tools, namely, the Perceived Stress Scale (PSS), the Ways of Coping Questionnaire (WCQ), and the Short Health Anxiety Inventory (SHAI).ResultsA total of 1320 students have participated in our study and 31 non-eligible responses were excluded. Among the remaining 1289 participants, 948 (73.5%) and 341 (26.5%) were Hungarian and international students, respectively. Female students predominated the overall sample with 920 participants (71.4%). In general, there was a statistically significant positive relationship between perceived stress and health anxiety. Health anxiety and perceived stress levels were significantly higher among international students compared to domestic ones. Regarding coping, wishful thinking was associated with higher levels of stress and anxiety among international students, while being a goal-oriented person acted the opposite way. Among the domestic students, cognitive restructuring as a coping strategy was associated with lower levels of stress and anxiety. Concerning health anxiety, female students (domestic and international) had significantly higher levels of health anxiety compared to males. Moreover, female students had significantly higher levels of perceived stress compared to males in the international group, however, there was no significant difference in perceived stress between males and females in the domestic group.ConclusionThe elevated perceived stress levels during major life events can be further deepened by disengagement from home (being away/abroad from country or family) and by using inadequate coping strategies. By following and adhering to the international recommendations, adopting proper coping methods, and equipping oneself with the required coping and stress management skills, the associated high levels of perceived stress and anxiety could be mitigated.

Physical activity and health anxiety in people with and without spinal pain during the COVID-19 lockdown: A comparison study.

In the coronavirus disease 2019 (COVID-19) pandemic, physical inactivity and health anxiety which are common risk factors for musculoskeletal pain have become widespread due to strict precautions and isolation. Thus, we aimed to com-pare physical activity, health anxiety, and spinal pain history in people experiencing and not experiencing spinal pain during the COVID-19 lockdown. This study was designed as a case-control study. Assessments including the Nordic Musculoskeletal Questionnaire (NMQ), the International Physical Activity Questionnaire-Short Form, and the Short Health Anxiety Inventory were performed through an online questionnaire using Google forms during the COVID-19 lockdown. We reached 494 volunteers, and 348 were eliminated by the exclusion criteria. One hundred and fifty-six participants were classified as the spinal pain group (n=70) and the asymptomatic group (n=86) based on the NMQ. The total amount of physical activity was less in the spinal pain group than the asymptomatic group (p<0.05). The spi-nal pain group had higher levels of health anxiety than the asymptomatic group (p<0.05). Further, the percentage of people who experienced spinal pain in the past year was higher in the spinal pain group (p<0.05). People experiencing spinal pain during the COVID-19 lockdown were physically less active and more concerned about their health. These results may be useful to improve the management of spinal pain during the lockdown or possible pandemic wave scenarios.