Corresponding author. This article has been cited by signals for binary options nvestn articles in PMC. Abstract Background The rapid expansion of the Internet has increased the ease with which the public can obtain medical information. Most research on the utility of the Internet for health purposes has evaluated the quality of the information itself or examined its impact on clinical populations.
Little is known about the consequences of its use by the general population. Objective Is use of the Internet by the general population for health purposes associated with a subsequent change in psychological well-being and health? Are the effects different for healthy versus ill individuals? Does the impact of using the Internet for health purposes differ from the impact of other types of Internet use? Methods Data come from a national US panel survey of individuals conducted from to Across three surveys, respondents described their use of the Internet for different purposes, indicated whether they had any of 13 serious illnesses or were taking care of someone with a serious illnessand reported their depression.
In the initial and final surveys they also reported on their physical health. Lagged dependent variable regression analysis was used to predict changes in depression and general health reported on a later survey from frequency of different types of Internet use at an earlier period, holding constant prior depression and general health, respectively. Statistical interactions tested whether uses real earnings on the Internet 7 091 the Internet predicted depression and general health differently for people who initially differed real earnings on the Internet 7 091 their general health, chronic illness, and caregiver status.
Results Health-related Internet use was associated with small but reliable increases in depression ie, increasing use of the Internet for health purposes from 3 to 5 days per week to once a day was associated with.
In contrast, using the Internet for communication with friends and family was associated with small but reliable decreases in depression ie, increasing use of the Internet for communication with friends and family purposes from 3 to 5 days per week to once a day was associated with.
Conclusions Using the Internet for health purposes was associated with increased depression. The increase may be due to increased rumination, unnecessary alarm, or over-attention to health problems.
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Additionally, those with unmeasured problems or those more prone to health anxiety may self-select online health resources. In contrast, using the Internet to communicate with friends and family was associated with declines in depression.
This finding is comparable to other studies showing that social support is beneficial for well-being real earnings on the Internet 7 091 lends support to the idea that the Internet is a way to strengthen and maintain social ties.
Keywords: Depression, health, social support, Internet, longitudinal survey Introduction The rapid expansion of the Internet has greatly increased the amount of health information available to the general public. With millions using the Internet, and a large proportion of the population explicitly using it for health purposes, it is important to assess how this particular use of the Internet is affecting people's well-being, especially their physical and mental health.
Although prior research has shown that use of the Internet to communicate with friends real earnings on the Internet 7 091 family is associated with declines in depression [ 5 ], little reliable information exists about the impact of using the Internet to obtain health resources, especially in nonclinical populations [ 6 - 8 ]. The current study used data from a national US random household sample survey to address the impact of Internet use to obtain health information and support on well-being and health.
We also examined whether these effects differed for people with differing levels of health and caregiver status, and whether these well-being associations were present for other types of Internet use.
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Health Resources Online Traditionally, physicians held and filtered health information for the general public [ 9 ].
Given the easy availability of health information online, people can now bypass medical professionals entirely and find information, advice, support, and even treatments eg, pharmaceuticals and herbal remedies on the Internet [ 6 ].
Online communities and support groups allow people to talk about their health problems with others and are popular both as a source of social support and as a primary source of information [ 10 - 12 ]. Online communities and support groups also provide support to caregivers and the families of people with serious health problems [ 13 ].
Much intrinsic option the research examining the effects of these online health resources has examined its use by groups with a specific illness or disease [ 14 ].
However, they are one source for the popular belief that use of the Internet for health purposes can improve well-being. Many studies of online health resources include the caregivers of the chronically ill in the sample [ 21 ] because of the high levels of stress experienced by this population as well as their strong interest in the health of those they care for [ 22 ].
Overall, little is known about the extent to which individuals with health problems or caregivers of the ill benefit from having unfettered access to online health information and support.
Effects of Internet Use on Health and Depression: A Longitudinal Study
Although having a serious illness is one factor that leads people to use the Internet for medical purposes [ 23 ], there are also millions of healthy individuals who use online health resources [ 2425 ].
About three-quarters of visitors to one health website had no particular health condition or illness, and half of searches concerned another person [ 18 ]. They may also be seeking information about their own minor or ambiguous symptoms or looking into other health-relevant concerns such as baldness or weight loss.
While this type rating of strategies on binary options Internet use in healthy individuals seems harmless, these individuals may receive unnecessary or alarming information about minor problems [ 26 ] and may focus too much attention on disease processes and symptoms, leading them to ruminate about their health [ 27 ].
Rumination increases pessimism [ 28 ] and increases depression symptoms [ 29 ].
Online health websites might even lead people to purchase harmful drugs or engage in risky health practices. Given some poor quality health information available online and the possibility that reading about health online may induce unnecessary health-related concerns, the use of online health information by healthy people may harm their psychological well-being.
Nonmedical Internet Use In addition to providing health-related information and access to online health support groups, the Internet may influence health and well-being by influencing the ease with which people can access social support from family and friends. Social communication with friends and family is arguably the most important use of the Internet [ 31 ].
For example, on a typical day Americans are more likely to use the Internet to send and receive email than for any other type of Internet use eg, search engines, news, medical and weather [ 4 ]. Researchers have argued that communication on the Internet augments social resources by providing an added avenue for interaction, that is, a way to keep up with distant friends real earnings on the Internet 7 091 family, and that this could lead to a larger social network [ 32 - 37 ]. The implication is that those who use the Internet to communicate with friends how to make legally big money family will show well-being benefits, which is consistent with work showing that communication and the ensuing social resources is associated with better psychological functioning, lower stress, and greater positive affect [ 3839 ].
By contrast, those who communicate little and have fewer social resources have poorer psychological functioning and higher levels of depression [ 4041 ]. While some research has suggested that Internet communication is also associated with better psychological well-being [ 42 ], interacting with strangers online may harm psychological well-being, especially among those who have already-existing social support and other social resources [ 43 ], perhaps by displacing strong social ties with weaker ones.
Excessive use of the Internet for gaming and gambling has been tied to increased depression [ 4445 ], as has use of the Internet for shopping [ 46 ].
It is not clear whether less excessive amounts of Internet use for these purposes would have similar negative outcomes. Finally, use of the Internet for escape may have both positive and negative outcomes, resulting in the overall impact on well-being remaining relatively neutral. Going online to escape and relax has been shown to be a source of gratification to Internet users and is a predictor of heavier Internet usage [ 47 ]. Current Study The purpose of the current research was to determine whether using the Internet for health purposes is beneficial or harmful to physical and psychological well-being.
We were also interested in real earnings on the Internet 7 091 this association would be moderated by people's health or care-giving status. Specifically, we examined whether individuals with a good reason for searching the Internet for medical information would fare differently from their healthy or non care-giving counterparts.
We were also interested in whether the impact on well-being of using the Internet for medical purposes could be isolated from the effects of other types of Internet use ie, is harm to well-being simply a function of time spent online? We anticipated that using the Internet for health purposes would lead to better health and less depression among participants in poor health and in their caregivers, but that the direction of these effects would be the opposite among healthy people.
We also hypothesized that using the Internet for communication with friends and family would be associated with well-being benefits, consistent with previous work showing the positive effects of social support and relationships. We did not predict that using the Internet in other ways would have any impact on well-being.
Methods Procedure and Participants Inwe conducted a national sample survey of US households using random digit dialing and a panel design with three questionnaires delivered over an month period. Those answering the phone were asked to list members of their household and specify if they had Internet access; all persons 19 years and older were solicited for the survey. We then sent surveys to all respondents who agreed to participate. To encourage responses, participants had a choice of taking the survey in paper or electronic form [ 53 ].
Binary option iq option demo account research has shown that electronic and paper versions of standard survey instruments are comparable [ 54 ].
We also mailed a paper survey to any participant with an invalid email address and to those requiring a third reminder.
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Sixty percent of the participants completed the surveys online. Participants completed their first survey from June to Septemberand their final survey 12 to 18 months later. Approximately six months after they responded, we sent those who completed the first survey a follow-up survey, which These respondents were sent a third survey approximately 6 months later.
Of the people who completed the initial survey, Internet users in this sample were younger and wealthier than nonusers, mirroring national trends among Internet users [ 3 ].
These differences in our sample compared with characteristics of the US population as a whole suggest caution in generalizing our findings to real earnings on the Internet 7 091 restrictions on trader trading as a whole.
Illness Presence of a serious illness was measured by asking the participants whether they had any of the following health problems: heart disease or serious heart problem, liver disease eg, cirrhosiscancer, disabling arthritis, stroke, serious immune disease eg, multiple sclerosis or lupuslong term injury from an accident, Alzheimer's or dementia, clinical depression or mental illness, alcohol or drug problem, disability or developmental disorder, lung problem eg, emphysema or asthmaserious digestive system problems such as Crohn's disease, and nervous system or seizure disorder.
Sixteen percent of participants in the first questionnaire reporting taking care of someone with a serious illness. The CES-D was designed to measure current levels of depressive symptomatology, including depressed mood, feelings of guilt and worthlessness, feelings of helplessness and hopelessness, loss of appetite, sleep disturbance, and psychomotor retardation.
The scale measures the frequency of symptoms of depression among healthy, nondepressed populations as well as among those with real earnings on the Internet 7 091 disorders.
Although the scale can reliably distinguish clinically depressed individuals from those who are not depressed as diagnosed by interview measures like the structured clinical interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition DSM-IV [ 57 ], it is more frequently used to assess the degree of depression in the general population.
We used the CES-D as a continuous measure of degree of depression rather than using a cut-off to classify participants as clinically depressed for two reasons.
First, prior research indicates that those with higher levels of depression face worse health outcomes even if they are not clinically depressed [ 5859 ]. Second, a continuous measure of depression is more sensitive than a dichotomous one, thereby reducing the type II error of failing to identify relationships that actually exist.
Because of an error, this item was omitted from the second survey and measured only on the first and third ones. Internet Uses Respondents described how often they had used the Internet for 27 different purposes in the previous six months. They made these estimates on a 7-point, logarithmic-like scale, in which a unit increase represented an approximate doubling of Internet use. The six scales were: communicating with friends and family, communicating in online groups and to meet people, retrieving and using non-health information, retrieving and using health information, seeking entertainment or escape, and shopping [ 37 ].
We conducted a confirmatory factor analysis in the current sample to test whether the six-factor model better explained the data than a single-factor model. The single-factor model represented the hypothesis that Internet use is best measured by a single index.
Listed below are the Internet-use scales examined in this research and the Chronbach alpha measure of internal reliability of the items that make up each scale. Since the health outcome was assessed only on the first questionnaire at time 1 and on the third questionnaire at time 3there is only a single lagged dependent variable and thus a single observation per respondent; changes in general heath, therefore, were analyzed using ordinary least-squares regression.
However, depression was assessed on all three questionnaires at times 1, 2, and 3. Therefore, there are two lagged dependent variables measuring depression real earnings on the Internet 7 091 at time 2 controlling for depression at time 1 and depression at time 3 controlling for depression at time 2. This resulted in two observations per respondent.
To adjust both the coefficients and standard errors for the nonindependence of observations within respondents, we analyzed changes in depression using random effects regression, with the respondent as the random effect.
Because prior levels of the outcome variables ie, health and depression are included in the analyses, both the dependent variables and the other predictor variables have been adjusted for the initial levels of health or depression. Lagged dependent variable regression is appropriate for testing dynamic theories of change, in which states or events at one time influence states or events at a later time [ 63 ]. Preliminary tests indicated that these conditions were met, making lagged dependent variable regression appropriate for the research reported here.
The sample includes all respondents who had change scores on the depression and health outcomes: respondents who completed the CES-D depression index at least twice and who described their general health twice. We included in the analyses participants who had never used the Internet. Our analyses did not change when we eliminated respondents who had never used the Internet.