Understanding cyberchondria in pregnant women: longitudinal assessment of risk factors, triggers, and outcomes

Figures & data

Table 1. Descriptive statistics by measurement points.

		1.early pregnancy		2. mid-pregnancy		3. late pregnancy
N		149		100		82
		M	SD	M	SD	M	SD
Age		30.1	4.7	30.2	4.5	30.7	4.4
Pregnancy weeks		16.7	1.3	27.3	1.6	37.2	1.5
Education level		n	%	n	%	n	%
	Elementary and high school	62	41.6	40	40.0	28	34.1
	University	87	58.4	60	60.0	54	65.9
Parity	Primiparous	60	40.3	39	39.0	36	43.9
	Multiparous	89	59.7	61	61.0	46	56.1

Figure 1. Cross lagged models of sequential mediation: health anxiety (a)/anxiety sensitivity (b).

Only paths significant at p < .05 and standardized loadings are displayed. Thick lines represent expected regressions, and thin ones reciprocal (R). Full lines represent paths from first to second time point (1-2), and dashed lines paths from second to third (2-3). Variance explained in each variable is shown below it for the second (2)/third (3) time point. Suppressor paths are marked by s.

Read the detailed description of this figure

HA = Health Anxiety: Illness Likelihood (IL), Negative Consequences (NC); AS = Anxiety Sensitivity: Physical (PHY), Cognitive (COG), Social Concerns (SOC); PC = Pregnancy Concerns: Health (HEALTH), Motherhood (MOTHER), Financial (FIN), Concerns about Looks (LOOKS); CYB = Cyberchondria; FOB = Fear of Birth.

Table 2. Fit and differences between cross lagged models of sequential mediation in three time points (N = 149).

Predictors	Model	Model fit					Model difference
		χ^2	df	CFI	RMSEA [90% CI]	SRMR	χ^2	df
Health anxiety	Autoregressions	297.50***	176	.917	.069 [.055, .082]	.135
	Lag −2 autoregressions	250.25***	168	.945	.057 [.042, .072]	.115	37.60***	8
	Mediation	172.96***	126	.968	.05 [.029, .067]	.078	76.98***	42
	Reciprocal	134.18***	84	.968	.062 [.041, .081]	.056	41.13	42
Anxiety sensitivity	Autoregressions	463.44***	225	.883	.083 [.072, .094]	.148
	Lag −2 autoregressions	389.33***	216	.917	.071 [.06, .083]	.131	48.55***	9
	Mediation	274.10***	162	.947	.066 [.052, .079]	.109	114.72***	54
	Reciprocal	202.39***	108	.957	.072 [.057, .088]	.066	74.19*	54

*** p < .001. * p < .05.

Table

Variable	Time point	N	ωtot/α	M (SD)	Median	Friedman χ² (p)
HA IL	1	135	.86/ .86	0.7 (0.4)	0.6	.01 (.996)
	2	97	.88/ .88	0.7 (0.4)	0.7
	3	77	.87/ .86	0.7 (0.4)	0.7
HA NC	1	128	.80/ .79	0.7 (0.6)	0.7	1.73 (.422)
	2	95	.80/ .80	0.7 (0.5)	0.8
	3	77	.79/ .79	0.7 (0.5)	0.5
AS PHY	1	123	.89/ .88	0.8 (0.8)	0.5	4.22 (.121)
	2	95	.89/ .89	0.8 (0.7)	0.5
	3	77	.91/ .90	0.8 (0.8)	0.5
AS COG	1	123	.91/ .91	0.6 (0.8)	0.3	1.53 (.465)
	2	95	.89/ .89	0.6 (0.7)	0.3
	3	77	.93/ .93	0.6 (0.8)	0.3
AS SOC	1	123	.81/ .80	0.9 (0.8)	0.7	4.29 (.117)
	2	95	.83/ .83	1.0 (0.7)	0.8
	3	77	.88/ .88	1.1 (0.8)	0.8
PC HEALTH	1	149	.87/ .87	1.6 (0.7)	1.5	3.83 (.148)
	2	98	.88/ .88	1.5 (0.7)	1.3
	3	77	.88/ .87	1.4 (0.7)	1.3
PC MOTHER	1	149	.70/ .70	0.9 (0.7)	1.0	7.14 (.028)
	2	98	.63/ .62	1.1 (0.7)	1.0
	3	77	.73/ .73	1.2 (0.8)	1.0
PC FIN	1	149	.74/ .74	0.9 (0.7)	0.5	2.70 (.26)
	2	98	.80/ .80	1.0 (0.8)	0.8
	3	77	.82/ .82	1.0 (0.9)	1.0
PC SOC	1	148	.48/ .48	0.4 (0.5)	0.0	.22 (.894)
	2	98	.55/ .55	0.5 (0.7)	0.0
	3	77	.58/ .58	0.5 (0.7)	0.5
PC LOOKS	1	149	.82/ .82	0.6 (0.8)	0.5	.53 (.767)
	2	98	.72/ .72	0.6 (0.7)	0.5
	3	77	.84/ .84	0.6 (0.7)	0.5
CYB	1	141	.85/ .84	2.3 (1.0)	2.3	1.55 (.46)
	2	98	.84/ .83	2.2 (0.8)	2.3
	3	77	.88/ .87	2.4 (1.0)	2.3
FOB	1	119	.89/ .89	0.5 (0.3)	0.5	7.64 (.022)
	2	95	.95/ .95	0.5 (0.3)	0.5
	3	76	.93/ .93	0.6 (0.3)	0.6

Note. The theoretical range for HA and PC was 0-3, for AS 0-4, for CYB 1-5, and for FOB 0-1. HA = Short Health Anxiety Inventory dimensions: Illness Likelihood (IL) and Negative Consequences (NC); AS = Anxiety Sensitivity Index dimensions: Physical (PHY), Cognitive (COG), and Social Concerns (SOC); PC = Pregnancy Concerns Scale dimensions: Health (HEALTH), Motherhood (MOTHER), Financial (FIN), Social Relations Concerns (SOC), and Concerns about Looks (LOOKS); CYB = Short Cyberchondria Scale; FOB = Fear of Birth Scale.

Table

Model	Variable	Time points
		2 - 1	3 - 2	3 - 1
Health anxiety as the predictor	HA IL	.74***	.55***	.30**
	HA NC	.72***	.52***	.29**
	PC HEALTH	.63***	.62***	.15
	PC MOTHER	.61***	.43***	.24*
	PC FIN	.65***	.57***	.17
	PC LOOKS	.70***	.21	.52***
	CYB	.54***	.25**	.41***
	FOB	.50***	.58***	.05
Anxiety sensitivity as the predictor	AS PHY	.71***	.39***	.36***
	AS COG	.58***	.38***	.39***
	AS SOC	.61***	.55***	.19*
	PC HEALTH	.50***	.69***	.09
	PC MOTHER	.51***	.38***	.29**
	PC FIN	.66***	.58***	.15
	PC LOOKS	.72***	.31*	.44**
	CYB	.61***	.24*	.43***
	FOB	.51***	.66***	.07

Note. HA = Short Health Anxiety Inventory dimensions: Illness Likelihood (IL) and Negative Consequences (NC); AS = Anxiety Sensitivity Index dimensions: Physical (PHY), Cognitive (COG), and Social Concerns (SOC); PC = Pregnancy Concerns Scale dimensions: Health (HEALTH), Motherhood (MOTHER), Financial (FIN), and Concerns about Looks (LOOKS); CYB = Short Cyberchondria Scale; FOB = Fear of Birth Scale.

*** p < .001. ** p < .01. * p < .05.

Table

Variables	Predictors					First mediator				Second mediator		Outcome
	HA IL	HA NC	AS PHY	AS COG	AS SOC	PC HEALTH	PC MOTHER	PC FIN	PC LOOKS	CYB	CYB +1	FOB	FOB +1
HA IL		.30***	.49***	.45***	.42***	.50***	.38***	.17*	.29***	.60***	.43***	.48***	.35***
HA NC	.34***/ .28*		.11	.27**	.33***	.21*	.22*	.14	.33***	.35***	.25*	.24**	.16
AS PHY	.44***/ .54***	.33**/ .35**		.56***	.41***	.29**	.12	.19*	.15	.34***	.18	.26**	.36***
AS COG	.49***/ .46***	.36***/ .31**	.57***/ .59***		.59***	.24**	.19*	.20*	.27**	.39***	.27**	.31***	.36***
AS SOC	.41***/ .34**	.30**/ .39***	.52***/ .51***	.57***/ .73***		.10	.30***	.20*	.44***	.31***	.28**	.22*	.19
PC HEALTH	.38***/ .43***	.08/ .13	.29**/ .45***	.26**/ .38***	.08/ .24*		.48***	.30***	.27**	.43***	.33***	.41***	.31**
PC MOTHER	.31**/ .40***	.21*/ .17	.28**/ .49***	.26*/ .47***	.16/ .29*	.50***/ .52***		.09	.52***	.26**	.34***	.59***	.34***
PC FIN	.01/ .12	.13/ .19	.05/ .31**	.12/ .32**	.09/ .30**	.42***/ .45***	.14/ .28*		.19*	.14	.04	.18	.23*
PC LOOKS	.34***/ .17	.2/ .29*	.12/ .17	.32**/ .21	.14/ .16	.30**/ .16	.35***/ .37**	.22*/ .20		.20*	.22*	.35***	.12
CYB	.51***/ .50***	.31**/ .21	.26*/ .33**	.41***/ .34**	.26*/ .37***	.31**/ .37**	.33***/ .31**	.12/ .10	.23*/ .10		.61***	.38***	.34***
CYB + 1	.51***/—	.29*/—	.28*/—	.46***/—	.44***/—	.22/—	.24*/—	.07/—	.10/—	.62***/—		.29**	.38***
FOB	.39***/ .43***	.22*/ .26*	.26*/ .51***	.37***/ .51***	.29**/ .35**	.41***/ .43***	.45***/ .60***	.20*/ .21	.33**/ .17	.38***/ .46***	.41***/—		.59***
FOB + 1	.52***/—	.26*/—	.38**/—	.45***/—	.33**/—	.34**/—	.44***/—	.16/—	.29*/—	.29*/—	.46***/—	.72***/—

Note. HA = Short Health Anxiety Inventory dimensions: Illness Likelihood (IL) and Negative Consequences (NC); AS = Anxiety Sensitivity Index dimensions: Physical (PHY), Cognitive (COG), and Social Concerns (SOC); PC = Pregnancy Concerns Scale dimensions: Health (HEALTH), Motherhood (MOTHER), Financial (FIN), and Concerns about Looks (LOOKS); CYB = Short Cyberchondria Scale; FOB = Fear of Birth Scale; +1 = variable measured in the following time point.

*** p < .001. ** p < .01. * p < .05.

Data availability statement

The data that support the findings of this study are available at Zenodo (doi:10.5281/zenodo.8146859) upon reasonable request.