title: Internet Searching About Disease Elicits a Positive Perception of Own Health When Severity of Illness Is High: A Longitudinal Questionnaire Study.
abstract: BACKGROUND
  The Internet is one of the primary sources for health information. However, in research, the effects of Internet use on the perception of one's own health have not received much attention so far.
  
  
  OBJECTIVE
  This study tested how Internet use for acquiring health information and severity of illness influence patients with a chronic disease with regard to the perception of their own health. Negative psychological states are known to lead to preferential processing of positive information. In particular, the self-directed nature of Internet use provides room for such biases. Therefore, we predicted that patients experiencing negative health states more frequently, due to more frequent episodes of a chronic illness, will gain a more positive perception of their health if they use the Internet frequently to gain health information, but not if they use the Internet rarely. This effect was not expected for other sources of information.
  
  
  METHODS
  A longitudinal questionnaire study with two measurement points-with a 7-month time lag-tested the hypothesis in a sample of patients with chronic inflammatory bowel disease (n=208). This study assessed patients' frequency of Internet use, their participation in online social support groups, their use of other sources of health information, and several indicators of the participants' perceptions of their own health. A structure equation model (SEM) was used to test the predictions separately for Internet searches and other sources of information.
  
  
  RESULTS
  Data analysis supported the prediction; the interaction between frequency of health-related information searches and frequency of episodes at the first measurement point (T1) was related to participants' positive perceptions of their own health at the second measurement point (T2) (B=.10, SE=.04, P=.02) above and beyond the perceptions of their own health at T1. When participants used the Internet relatively rarely (-1 SD), there was no relationship between frequency of episodes and positive perceptions of their own health (B=-.11, SE=.14, t203=-0.82, P=.41). In contrast, when participants used the Internet relatively often (+1 SD), the more frequently they had those episodes the more positive were the perceptions of their own health (B=.36, SE=.15, t203=2.43, P=.02). Additional SEM analyses revealed that this effect occurs exclusively when information is searched for on the Internet, but not when other sources of information are consulted, nor when online social support groups are joined.
  
  
  CONCLUSIONS
  The results of this study suggest that patients might process information from the Internet selectively, in an unbalanced, biased fashion, with the formation of a self-serving (ie, positive) perception of own health. At the same time, this bias contributes to the ability of patients to cope psychologically with their disease.
authors.affiliation: Leibniz-Institut für Wissensmedien, Social Processes Lab, Tübingen, Germany. k.sassenberg@iwm-tuebingen.de.
authors.forename: Kai
authors.identifier: http://orcid.org/0000-0001-6579-8250
authors.initials: K
authors.lastname: Sassenberg
authors.forename: Hannah
authors.identifier: http://orcid.org/0000-0001-5487-9506
authors.initials: H
authors.lastname: Greving
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D054626:Consumer Health Information; D005260:Female; D006304:Health Status; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000523:psychology*; D057226:Information Seeking Behavior; D020407:Internet; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010465:Perception; D012657:Self-Help Groups; D012720:Severity of Illness Index; D012944:Social Support; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Internet search; chronic inflammatory bowel disease; health information; perception of own health; threat