CYBERCHONDRIA: A survey for people who check physical symptoms online

1. CYBERCHONDRIA: A survey for people who check their symptoms online

Welcome to the Cyberchondria survey!

This is a shortened version of a longer survey given to subjects with Heightened Illness Concern. There are 19 items to answer and will take about 5-10 minutes of your time.

Please answer this quick survey and let me know what you think! Thanks!

Please understand that the information you provide will be kept confidential by the research staff at the Columbia University Heightened Illness Concern program. We will not collect any identifying information from you, we will not contact you [unless you contact us first by email (illnessconcern@aol.com) or phone (212-5435542)], and we will not collect any computer information such as an IP address or URL.

1. What is your age, ethnic background, and gender?

	Age	Ethnic Background/ Race	Gender
Demographic Information	What is your age, ethnic background, and gender? Demographic Information Age	Ethnic Background/ Race	Gender

2. Do you have health insurance?

Do you have health insurance? Yes

3. Do you live in the United States of America? If so, what state? Is your community type urban, suburban, or rural?

	USA or International?	State in the USA	Community type
Residency Information	Do you live in the United States of America? If so, what state? Is your community type urban, suburban, or rural? Residency Information USA or International?	State in the USA	Community type

4. How many years of education have you had?

Examples:
Sixth grade=6
High school diploma or equivalent=12
Completed post high school technical training=14
Three years of college=15
Bachelor's degree=16
Master's degree=18
Doctorate=20

	Years
Years of Education	How many years of education have you had? Examples: Sixth grade=6 High school diploma or equivalent=12 Completed post high school technical training=14 Three years of college=15 Bachelor's degree=16 Master's degree=18 Doctorate=20 Years of Education Years

5. Have you completed any formal health related program (e.g. nursing, medicine, public health, nutrition)?

Have you completed any formal health related program (e.g. nursing, medicine, public health, nutrition)? Yes

6. What illnesses have you worried about excessively? (Check all that apply)

What illnesses have you worried about excessively? (Check all that apply) HIV/AIDS

Hepatitis

Lyme Disease

Mad Cow Disease

SARS

Bird Flu

Staph Infection/MRSA

Lung Cancer

Leukemia

Bone Cancer

Breast Cancer

Stomach Cancer

Colorectal Cancer

Ovarian Cancer

High Blood Pressure

Heart Attack

Arrhythmia

Multiple sclerosis/MS

Brain tumor

Alzheimers

Lou Gehrig's/ALS

Meningitis or Encephalitis

Herpes or HPV

Other (please specify)

7. On a day during the past year when you went online to check your symptoms, how much TOTAL TIME did you spend online checking?

On a day during the past year when you went online to check your symptoms, how much TOTAL TIME did you spend online checking? Less than 1 hour

1-3 hours

3-5 hours

More than 5 hours

8. During the last month, what is the MOST time you've spent in a single day on the internet to check your symptoms or to seek reassurance?

During the last month, what is the MOST time you've spent in a single day on the internet to check your symptoms or to seek reassurance? Less than 1 hour

1-3 hours

3-5 hours

More than 5 hours

9. On the worst day in the last 12 months, how many SEPARATE times did you check the internet for reassurance?

On the worst day in the last 12 months, how many SEPARATE times did you check the internet for reassurance? Less than 1 time a day

Only 1 time a day

A few times a day (2-4 times)

Often (5-10 times)

Too many times to count

10. When you check the internet for reassurance about your symptoms or illness worries, DURING THE TIME YOU ARE ON THE COMPUTER do you feel MORE or LESS anxious?

When you check the internet for reassurance about your symptoms or illness worries, DURING THE TIME YOU ARE ON THE COMPUTER do you feel MORE or LESS anxious? Significantly LESS anxious

Moderately LESS anxious

Slightly LESS anxious

No change in anxiety

Slightly MORE anxious

Moderately MORE anxious

Significantly MORE anxious

11. When you check the internet for reassurance about your symptoms or illness worries, AFTER YOU LEAVE THE COMPUTER BECAUSE YOU ARE DONE CHECKING or turn the computer off, do you feel MORE or LESS anxious?

When you check the internet for reassurance about your symptoms or illness worries, AFTER YOU LEAVE THE COMPUTER BECAUSE YOU ARE DONE CHECKING or turn the computer off, do you feel MORE or LESS anxious? Significantly LESS anxious

Moderately LESS anxious

Slightly LESS anxious

No change in anxiety

Slightly MORE anxious

Moderately MORE anxious

Significantly MORE anxious

12. What are the 3 main internet sites that you have used in the past 12 months to check for health information?

What are the 3 main internet sites that you have used in the past 12 months to check for health information? 1
2
3
Other: (only if 1-3 are full)

13. Do you find yourself going to sites on the internet even though you know the information may not be completely trustworthy?

Do you find yourself going to sites on the internet even though you know the information may not be completely trustworthy? Yes

Sometimes

If "yes" or "sometimes" PLEASE explain

14. When you use a search engine (e.g. Google, Yahoo, Ask, Wikipedia, etc) to check your symptoms, which subcategory of information is the most interesting for you?

	MOST interesting	LEAST interesting
Images or Pictures of Disease	When you use a search engine (e.g. Google, Yahoo, Ask, Wikipedia, etc) to check your symptoms, which subcategory of information is the most interesting for you? Images or Pictures of Disease MOST interesting	LEAST interesting
News Articles or Media about Disease	News Articles or Media about Disease MOST interesting	LEAST interesting
Books about Disease	Books about Disease MOST interesting	LEAST interesting
Blogs about Disease	Blogs about Disease MOST interesting	LEAST interesting
Treatment of Disease	Treatment of Disease MOST interesting	LEAST interesting
Symptom Descriptions of Disease	Symptom Descriptions of Disease MOST interesting	LEAST interesting
Tests for Diagnosis of Disease	Tests for Diagnosis of Disease MOST interesting	LEAST interesting
Causes/ Risk Factors of Disease	Causes/ Risk Factors of Disease MOST interesting	LEAST interesting
Information intended for patients	Information intended for patients MOST interesting	LEAST interesting
Information intended for Doctors or health professionals	Information intended for Doctors or health professionals MOST interesting	LEAST interesting
Alternative Medicine suggestions	Alternative Medicine suggestions MOST interesting	LEAST interesting

15. When you have a medical symptom that concerns you, where do you go for evaluation? (Check all that apply)

When you have a medical symptom that concerns you, where do you go for evaluation? (Check all that apply) I go to my primary care doctor

I go to an Urgent Care Center that is not attached to a hospital

I go to a hospital emergency room (E.R.)

I don't go to get evaluated, because it is too expensive to get evaluated

I don't go to get evaluated because I'm afraid of doctors or what they might find

16. If you have current (or recent) physical symptoms that are concerning to you, have you been evaluated by a physician?

If you have current (or recent) physical symptoms that are concerning to you, have you been evaluated by a physician? Yes

17. When you last had your physical symptoms evaluated by a medical professional, what did the doctor tell you?

When you last had your physical symptoms evaluated by a medical professional, what did the doctor tell you? The doctor said my symptoms are not due to a medical illness or a bodily problem, but could be due to something else like excessive worry, stress, depression etc

The doctor said I do have a medical illness, but that it is stable and I am worried too much

The doctor said I have a serious, unstable medical illness

The doctor said he/she was not sure whether I have a medical illness

18. Below is a list of questions about your health. For each one, please indicate how much this is true for you in the last 2 weeks. (Whitely Index)

	Not at all	A little bit	Moderately	Quite a bit	A great deal
Do you worry a lot about your health?	Below is a list of questions about your health. For each one, please indicate how much this is true for you in the last 2 weeks. (Whitely Index) Do you worry a lot about your health? Not at all	A little bit	Moderately	Quite a bit	A great deal
Do you think there is something seriously wrong with your body?	Do you think there is something seriously wrong with your body? Not at all	A little bit	Moderately	Quite a bit	A great deal
Is it hard for you to forget about yourself and think about all sorts of other things?	Is it hard for you to forget about yourself and think about all sorts of other things? Not at all	A little bit	Moderately	Quite a bit	A great deal
If you feel ill and someone tells you that you are looking better, do you become annoyed?	If you feel ill and someone tells you that you are looking better, do you become annoyed? Not at all	A little bit	Moderately	Quite a bit	A great deal
Do you find that you are often aware of various things happening in your body?	Do you find that you are often aware of various things happening in your body? Not at all	A little bit	Moderately	Quite a bit	A great deal
Are you bothered by many aches and pains?	Are you bothered by many aches and pains? Not at all	A little bit	Moderately	Quite a bit	A great deal
Are you afraid of illness?	Are you afraid of illness? Not at all	A little bit	Moderately	Quite a bit	A great deal
Do you worry about your health more than most people?	Do you worry about your health more than most people? Not at all	A little bit	Moderately	Quite a bit	A great deal
Do you get the feeling that people are not taking your illnesses seriously enough?	Do you get the feeling that people are not taking your illnesses seriously enough? Not at all	A little bit	Moderately	Quite a bit	A great deal
Is it hard for you to believe the doctor when he/she tells you there is nothing for you to worry about?	Is it hard for you to believe the doctor when he/she tells you there is nothing for you to worry about? Not at all	A little bit	Moderately	Quite a bit	A great deal
Do you often worry about the possibility that you have a serious illness?	Do you often worry about the possibility that you have a serious illness? Not at all	A little bit	Moderately	Quite a bit	A great deal
If a disease is brought to your attention (by the radio/ TV/ newspapers/ internet/ someone you know), do you worry about getting it yourself?	If a disease is brought to your attention (by the radio/ TV/ newspapers/ internet/ someone you know), do you worry about getting it yourself? Not at all	A little bit	Moderately	Quite a bit	A great deal
Do you find that you are bothered by many different symptoms?	Do you find that you are bothered by many different symptoms? Not at all	A little bit	Moderately	Quite a bit	A great deal
Do you often have the symptoms of a very serious disease?	Do you often have the symptoms of a very serious disease? Not at all	A little bit	Moderately	Quite a bit	A great deal

19. Sheehan Disability Scale
Choose one answer for each scale thinking about your answer within the last 2 weeks.

	Not at all	Mildly	Moderately	Marketdly	Extremely
1 Work/School: To what extent have symptoms disrupted your work/school? Work includes paid, unpaid, and volunteer work or training.	Sheehan Disability Scale Choose one answer for each scale thinking about your answer within the last 2 weeks. 1 Work/School: To what extent have symptoms disrupted your work/school? Work includes paid, unpaid, and volunteer work or training. Not at all	Mildly	Moderately	Marketdly	Extremely
2 Social Life: To what extent have symptoms disrupted your social life/leisure activities?	2 Social Life: To what extent have symptoms disrupted your social life/leisure activities? Not at all	Mildly	Moderately	Marketdly	Extremely
3 Family Life/Home Responsibilities: To what extent have symptoms disrupted your family life/home responsibilities?	3 Family Life/Home Responsibilities: To what extent have symptoms disrupted your family life/home responsibilities? Not at all	Mildly	Moderately	Marketdly	Extremely

Thank you for participating! We truly appreciate your response.

If you would like to know more information about our treatment research program at the Columbia University Medical Center in New York City, or to find out if you qualify, please visit our website at www.illnessworry.cumc.columbia.edu, email us at illnessconcern@aol.com, or call (212) 543-5542.

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