title: The Cyberchondria Severity Scale (CSS): German Validation and Development of a Short Form.
abstract: 'Cyberchondria' describes a pattern of researching health information online motivated by distress or anxiety about health, which becomes excessive and in turn increases distress. The Cyberchondria Severity Scale (CSS) assesses this construct. The aims of the present study were to validate a German version of the CSS and to propose a short form.
  
  
  
  The CSS was translated and posted online. Inclusion criteria were fulfilled by n = 500 participants (age 29.1 ± 10.4 years, 73.6 % women). Item analyses, an exploratory factor analysis and correlations with health anxiety, somatic symptoms, health-care utilization and depression were calculated. A brief version with 15 items was developed (CSS-15) and validated in a second sample (n = 292; age 24.2 ± 4.1 years, 76.4 % women).
  
  
  
  The internal consistency of the CSS was α = .93 and its split-half reliability α = .95. The mean item-total correlation was r itc = .51, the mean inter-item correlation r = .29 and the mean item difficulty p i = .36. The principal component analysis extracted five factors. The CSS score correlated highly with health anxiety and moderately with somatic symptoms and health-care utilization. The CSS-15 still had an internal consistency of α = .82 and the confirmatory factor analysis confirmed the five factors. The correlation coefficients with health-related measures were unaffected.
  
  
  
  The German version of the CSS possesses very good psychometric characteristics, which were preserved in a short version. The factorial structure was replicated. The correlations with health anxiety and depression for both scales underscore their validity and clinical relevance.
authors.affiliation: Department of Psychology, Division of Clinical Psychology and Psychotherapy, Philipps University Marburg, Gutenbergstraße 18, D-35037, Marburg, Germany. abarke@gwdg.de.
authors.forename: Antonia
authors.identifier: 0000-0002-6863-3213
authors.initials: A
authors.lastname: Barke
authors.affiliation: Department of Psychology, Division of Clinical Psychology and Psychotherapy, Philipps University Marburg, Gutenbergstraße 18, D-35037, Marburg, Germany.
authors.forename: Gaby
authors.initials: G
authors.lastname: Bleichhardt
authors.affiliation: Department of Psychology, Division of Clinical Psychology and Psychotherapy, Philipps University Marburg, Gutenbergstraße 18, D-35037, Marburg, Germany.
authors.forename: Winfried
authors.initials: W
authors.lastname: Rief
authors.affiliation: Department of Psychology, Division of Clinical Psychology and Psychotherapy, Philipps University Marburg, Gutenbergstraße 18, D-35037, Marburg, Germany.
authors.forename: Bettina K
authors.initials: BK
authors.lastname: Doering
mesh_terms: D000328:Adult; D001007:Anxiety / Q000175:diagnosis*; D003863:Depression / Q000175:diagnosis*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D057226:Information Seeking Behavior; D020407:Internet; D008297:Male; D010342:Patient Acceptance of Health Care; D025341:Principal Component Analysis; D011594:Psychometrics; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Cyberchondria; German; Health anxiety; Online search; Questionnaire; Validation