Validation of the Cyberchondria Severity Scale (CSS): replication and extension with bifactor modeling

Area of Science:

• Psychology
• Health Informatics
• Behavioral Science

Background:

• Internet help-seeking behaviors are prevalent.
• Cyberchondria, or increased health anxiety from online medical searches, is a growing concern.
• The Cyberchondria Severity Scale (CSS) measures cyberchondria across multiple dimensions.

Purpose of the Study:

• To examine the bifactor model of the Cyberchondria Severity Scale (CSS).
• To refine the understanding of cyberchondria's dimensional structure.
• To investigate the relationship between cyberchondria factors and health anxiety.

Main Methods:

• A community sample of 526 participants completed the CSS online.
• Confirmatory factor analysis was used to test a bifactor model.
• The factor structure of the CSS was evaluated for goodness of fit.

Main Results:

• The bifactor model demonstrated superior fit to the data.
• A General Cyberchondria factor, orthogonal to subfactors, is a useful conceptualization.
• The CSS Mistrust factor was not found to be essential to the construct.
• General and specific cyberchondria factors uniquely related to lower-order health anxiety dimensions.

Conclusions:

• The bifactor model provides a robust structure for the CSS.
• Cyberchondria can be understood through a general factor and specific dimensions.
• Findings enhance the measurement and understanding of cyberchondria and its link to health anxiety.