From Intolerance of Uncertainty to Cyberchondria through Information Overload: The Italian Validation of the Cyberchondria Severity Scale 12 (CSS-12) and a Mediation Model

The present two-study research aimed to validate the Italian version of the Cyberchondria Severity Scale-12 (CSS-12), assess its psychometric properties, and explore the relationships among intolerance of uncertainty (IU), cyberchondria, online information overload (OIO), and online information trust (OIT). Confirmatory factor analysis was used in Study 1 and a path analysis mediation model was tested in Study 2. Online self-report questionnaires were administered to samples from the Italian general population. Study 1 confirmed the robust factorial structure of the CSS-12, supporting both a hierarchical second-order model and four first-order dimensions (excessiveness, compulsivity, reassurance, distress), with strong internal consistency, convergent-divergent validity, and test-retest reliability. Study 2 demonstrated that IU is directly associated with cyberchondria and that this relationship is partially mediated by OIO, but not by OIT. Psychological distress also emerged as a significant variable associated with cyberchondria. The findings highlight OIO as a critical mechanism linking IU to maladaptive health-related online behaviors, while the role of OIT appears more nuanced and context-dependent. Results underscore the value of the CSS-12 as a brief, reliable tool for research and clinical use in Italy and suggest that interventions targeting IU and information overload may be effective in mitigating cyberchondria.