Examining the relationships between internet addiction, online health information-seeking behavior and cyberchondria

Abstract

Background

This study explores the relationships among Internet addiction, online health information-seeking behavior (OHISB), and cyberchondria.

Methods

The research was conducted in Yalova Province, Türkiye, with a research sample included individuals aged 18 and over who lived in that province. Data were collected from participating individuals using an online survey.

Results

The findings demonstrated that Internet addiction had a positive effect on OHISB (β = 0.557). It was also revealed that Internet addiction (β = 0.270) and OHISB (β = 0.442) had a positive effect on cyberchondria. Furthermore, OHISB had a mediating role in the effect of Internet addiction on cyberchondria (β = 0.246).

Conclusions

This study highlights the existence of significant relationships among Internet addiction, OHISB, and cyberchondria.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40359-025-03770-1.

Background

Internet use has become increasingly widespread as technology has advanced. People now use the Internet for a wide range of purposes, including access to information, communication, education, entertainment, enjoyment, and socialization [1, 2]. The Internet is an indispensable part of daily life due to the benefits it provides. The decreasing cost of Internet access and the prevalent use of technological tools such as smartphones, tablets, and laptops have further increased society’s use of the Internet [3]. Although the rise in Internet use provides many conveniences and benefits to individuals, it has also started to cause various problems. One of these problems is Internet addiction [4]. Internet addiction refers to the individual’s inability to control Internet use, excessive use of the Internet, inability to prevent the desire to use it excessively, and this situation leads to negative consequences in the individual’s life [5].

Spending a long time on the Internet, negatively affecting social life due to this situation, and feeling unhappy when away from the Internet indicate Internet addiction [6]. Internet addiction has become an important public health problem due to its negative effects on individuals’ lives [7]. Internet addiction can lead to negative consequences such as deterioration in physical and mental health, decline in physical activity, unhealthy nutrition, obesity, deterioration in sleep quality, social isolation, loneliness, deterioration in social relationships, and decrease in academic performance [8, 9]. There are many factors that affect Internet addiction. Factors such as demographic characteristics, time spent on the Internet, ease of Internet access, lack of social support, problems in social relationships, loneliness, low self-esteem, psychological problems, and lack of self-control affect Internet addiction [1].

Individuals also use the Internet for health-related purposes, with aims that include choosing a hospital or a physician, making appointments, communicating with other patients, obtaining advice on treatment and care, purchasing health products, and accessing information about diseases, treatments, medications, and tests [10, 11]. The Internet has become a crucial source of health-related information due to its widespread availability, the low-cost and easy access to information that it offers, and the privacy concerns and other difficulties that may arise while accessing healthcare services in person [12, 13]. This development has resulted in a phenomenon known as online health information-seeking behavior (OHISB). OHISB is defined as an “individual’s active seeking of health information online” [14].

There are many reasons for individuals to engage in OHISB, including desires to acquire health-related information, protect their health, manage their health more effectively, relax themselves or reduce health-related stress and anxiety, understand diseases and other health problems, or make decisions about their health [15–17]. Information gained as a result of OHISB can support positive health-related behaviors such as the adoption of healthy eating habits and regular exercise, as well as increasing awareness and helping patients make more effective decisions or adapt more comfortably to treatment [18]. Nevertheless, apart from the benefits that OHISB provides, it may also have several drawbacks. It may lead individuals to inaccurate, contradictory, or misleading information, and individuals who trust or apply such information may experience serious problems [10, 19]. These problems include decreased trust in physicians, the unnecessary use of healthcare services, self-medication, non-adherence to treatment, and intensified anxiety [20].

One of the problems that OHISB may cause is cyberchondria. Inaccurate and low-quality online health information accessed by individuals can trigger cyberchondria [21, 22]. Cyberchondria is defined as “excessive or repeated search for health-related information on the Internet, driven by distress or anxiety about health, which only amplifies such distress or anxiety” [23]. Cyberchondria has two components; behavioral and emotional. The behavioral component includes individuals’ frequent and repeated online search for health-related information. The emotional component includes the distress, anxiety, fear caused by online searching, as well as the inability to control the search behavior [24]. Not all online health-related searches conducted by individuals should be considered within the scope of cyberchondria. If the health information accessed as a result of online searches further increases individuals’ distress, anxiety and worry and causes individuals to search more, longer and repeatedly for relief, this situation points to cyberchondria [25, 26].

Cyberchondria might cause self-diagnosis, confusion, increased fear of illness, deterioration of mental health and well-being, increased health anxiety, unnecessary use of healthcare services, problems with physicians, financial loss, decreased trust in the healthcare system, and some negative effects on daily life [27–29]. Considering the negative effects of cyberchondria on society and health system, it is believed that investigating the factors that cause cyberchondria will be useful for combating cyberchondria. Internet addiction and OHISB are thought to be precursors to cyberchondria, and these variables are related. This study explores the relationships among Internet addiction, OHISB, and cyberchondria. The research hypotheses and research model (Fig. 1), which have been developed for this purpose, are shown below:

• H₁: Internet addiction has a positive effect on OHISB.

• H₂: Internet addiction has a positive effect on cyberchondria.

• H₃: OHISB has a positive effect on cyberchondria.

• H₄: OHISB has a mediating role in the effect of Internet addiction on cyberchondria.

Fig. 1.

Research Model

Methods

The research was conducted in Yalova Province, Türkiye, between March and May 2025. The research sample included individuals aged 18 and over who lived in this province. Data were obtained from the individuals reached within the scope of the research using an online survey. Participants have provided informed consent electronically.

Participants

Convenience sampling was used in the study. Within the scope of the study, data were obtained from 345 individuals and 55.1% (n = 190) of these individuals were female and their mean age was 35.08 ± 12.02 years. Of the individuals, 41.4% (n = 143) were high school graduates and 55.4% (n = 191) were married. Of the individuals, 64.1% (n = 221) were employed (Table 1).

Table 1.

Demographic characteristics (n = 345)

Demographic Characteristics		n	%
Gender	Female	190	55.1
	Male	155	44.9
Educational Status	High School Degree	143	41.4
	Associate Degree	53	15.4
	Undergraduate Degree	105	30.4
	Postgraduate Degree	44	12.8
Marital Status	Single	154	44.6
	Married	191	55.4
Employment Status	Yes	221	64.1
	No	124	35.9
Age	Mean ± SD	35.08 ± 12.02

Data collection tools

The survey form used to collect research data included questions regarding demographic characteristics and the following scales:

Internet addiction scale

The scale used to determine the Internet addiction level of individuals was developed by Taş and Bilgin [30]. The scale consists of a single dimension and nine items, and the items were evaluated with Likert-type scale options (“1 = never”, “5 = always”). The study determined the scale’s Cronbach’s alpha value to be 0.821.

OHISB scale

The scale used to determine the OHISB level of individuals was developed by Ünal and Deniz [31]. The scale consists of a single dimension with five items; the items were evaluated with Likert-type scale options (“1 = never”, “5 = always”). The study determined the scale’s Cronbach’s alpha value to be 0.825.

Short cyberchondria scale

This scale, used to assess levels of cyberchondria, was developed by Jokić-Begić et al. [32]. It consists of a single dimension with four items and it was adapted to Turkish by Özişli [33]. The scale’s items are evaluated using Likert-type scoring, where 1 = “strongly disagree” and 5 = “strongly agree”. The study determined the scale’s Cronbach’s alpha value to be 0.820.

Data analysis

In data analysis, descriptive statistics, correlations, and effects were analyzed. The statistical programs SPSS 22.0 and Process Macro Model 4 were used for the analysis, and the findings were examined at a 95% confidence interval and a 5% significance level. In the bootstrap technique used in the analyses conducted with the Process Macro, a sample size of 5,000 and a 95% bias-corrected confidence interval were selected.

Ethical approval

Ethical approval for the study was granted by Yalova University Social and Human Sciences Scientific Research Ethics Committee (Date: 27.02.2025, Protocol No: 2025/70).

Results

The findings from the data analysis are reported below:

The results of the study indicated a positive correlation between Internet addiction and OHISB (r = 0.466). It also indicated a positive correlation between Internet addiction as well as cyberchondria (r = 0.417) and between OHISB and cyberchondria (r = 0.528) (Table 2).

Table 2.

Correlation analyses

Variables	Mean	SD	Internet Addiction	OHISB
Internet Addiction	2.301	0.680
OHISB	3.300	0.812	0.466*
Cyberchondria	2.976	0.841	0.417*	0.528*

*p < 0.01

The findings of the study demonstrated that Internet addiction had a positive effect on OHISB (β = 0.557, p = 0.000). It also showed that Internet addiction (β = 0.270, p = 0.000) and OHISB (β = 0.442, p = 0.000) had a positive effect on cyberchondria (Table 3). Furthermore, the findings also indicated that OHISB had a mediating role in the effect of Internet addiction on cyberchondria (β = 0.246). This finding indicated that OHISB indirectly led to an increase in the positive effect of Internet addiction on cyberchondria (β = 0.516, p = 0.000) (Table 4). The findings of the effect analyses are summarized in Fig. 2, and these findings supported all the hypotheses of the study.

Table 3.

Effect analyses

Effects	β	R2	S.E.	t	p	LLCI	ULCI
Constant	2.019	0.217	0.137	14.750	0.000	1.750	2.288
IA → OHISB	0.557		0.057	9.760	0.000	0.445	0.669
Constant	0.897	0.316	0.170	5.293	0.000	0.564	1.231
IA → Cyberchondria	0.270		0.063	4.317	0.000	0.147	0.393
OHISB → Cyberchondria	0.442		0.052	8.443	0.000	0.339	0.545

IA Internet Addiction, OHISB Online Health Information-Seeking Behavior

Table 4.

Mediating effect

Effects		β	S.E.	t	p	LLCI	ULCI
Direct Effect	IA→Cyberchondria	0.270	0.063	4.317	0.000	0.147	0.393
Indirect Effect	IA→OHISB→Cyberchondria	0.246	0.038			0.175	0.325
Total Effect	IA→Cyberchondria	0.516	0.061	8.499	0.000	0.396	0.635

IA Internet Addiction, OHISB Online Health Information-Seeking Behavior

Fig. 2.

Model Output

Discussion

The Internet is widely used by both patients and healthy individuals as a significant source of information on health-related issues [34]. Individuals frequently use online health information to find answers to their health-related questions [35]. Individuals can access a wide range of health-related information by exhibiting OHISB. Factors such as demographic characteristics of individuals, health literacy levels, psychological factors, and characteristics of diseases affect OHISB [36, 37]. The current study has shown that Internet addiction is one of the factors affecting OHISB. According to the results of the current study, Internet addiction positively affects OHISB. Individuals with high Internet addiction mostly obtain the health information they need from the Internet because the Internet is a part of their daily lives [38]. This situation increases OHISB. In this context, it can be argued that as individuals’ Internet addiction levels increase, their OHISB will also increase.

The current study revealed that OHISB positively impacts cyberchondria. This finding supports the results of previous studies [39, 40]. OHISB serves as the basis for cyberchondria. Individuals can access large volumes of beneficial health-related information as a result of OHISB, but in some cases, OHISB may become harmful rather than helpful. OHISB increases the risk of encountering conflicting, incorrect, or outdated information on the Internet [18]. Individuals who believe or trust false or misleading information may experience increased levels of anxiety and worry, leading them to conduct further online searches in an attempt to relieve that anxiety. This, in turn, triggers cyberchondria.

Individuals with Internet addiction may search the Internet regularly for health-related information, and they may also encounter health-related information incidentally, in the course of other online browsing. Thus, due to the large amount of time spent online, these individuals encounter a wide variety and large volume of information. Incorrect or contradictory health-related information can particularly cause confusion, anxiety, fear, or worry. This may lead individuals to continue searching for more health-related information, a process resulting in cyberchondria. The results of the present study demonstrate that Internet addiction positively affects cyberchondria, and similar results have been reported in previous studies [41–43]. These results indicate that internet addiction is associated with cyberchondria. Finally, the present study has shown that OHISB plays a mediating role in the effect of Internet addiction on cyberchondria by increasing the impact of Internet addiction on cyberchondria. In other words, the behaviors of Internet-addicted individuals seeking health-related information online increase their likelihood of developing cyberchondria. These results highlight the need to consider internet usage duration or the use of the internet for health purposes when assessing individuals’ health-related concerns and anxieties.

Limitations and future research

This study makes an important contribution to the literature by revealing the relationships among Internet addiction, OHISB, and cyberchondria. However, the research was conducted in a single province of Türkiye and the number of participants was relatively low, limiting the generalizability of the results. The fact that the research data is based on participants’ statements and that control variables (such as age, education, gender) are disregarded also limits the generalizability of the research results. Future studies should include longitudinal or experimental research to test whether reducing internet addiction or promoting e-health literacy lowers levels of cyberchondria.

Conclusion

This study has demonstrated that Internet addiction and OHISB are predictors of cyberchondria. OHISB partially explains the link between problematic Internet use and cyberchondria. Frequent online health searches may increase psychological distress in individuals who are highly addicted to the Internet. Accordingly, it is recommended that training sessions and other activities be organized to increase health literacy, create health awareness, and support individuals in the search for safe health information to prevent or reduce cyberchondria, an important social problem. Individuals should be encouraged to access the websites of government institutions or healthcare organizations to access up-to-date and accurate health information, and call centers and support units should be established to answer their questions. To reduce Internet addiction, it is recommended that public awareness be raised, time limits be imposed on Internet use by age groups, and public service announcements be broadcasted addressing the harmful effects of Internet addiction.

Abbreviations

SD

Standard Deviation

S.E

Standard Error

IA

Internet Addiction

OHISB

Online Health Information-Seeking Behavior

SPSS

Statistical Package for the Social Sciences

Author’s contributions

This article was prepared by a single author. The article was written by Serkan DENİZ. The author has read and approved the article version.

Funding

The author received no financial support for the research, authorship, and/or publication of this article.

Data availability

The dataset for this study can be available upon reasonable request to the author.

Declarations

Ethics approval and consent to participate

Ethical approval for the study was granted by Yalova University Social and Human Sciences Scientific Research Ethics Committee (Date: 27.02.2025, Protocol No: 2025/70). The study was conducted in accordance with the Helsinki Declaration. The author confirms that informed consent was obtained from the participants in the study.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.