How the Need for Certainty Shapes Health Decisions
Why the urge to know for sure can quietly shape how we search, worry, and decide
đ§INTRO
Welcome to Beyond the Buzz â where curiosity meets clarity.
Iâm Dr. Tara Moroz, scientist and communicator with decades of experience translating complex human research into clear, evidence-informed insight.
Today weâre talking about something that shapes so many of our health decisions without us even noticing: the psychological need for certainty.
That urge to know right now â to understand a symptom, make sense of a story you heard online, or rule out something scary.
But our bodies are complex, and uncertainty is built into biology.
So today, weâre looking at how big this behaviour really is, what the evidence shows about uncertainty and online searching, and what research suggests may actually help reduce some of the distress around it.
đTHE BUZZ
Letâs start with the scale of this behaviour.
People are using the internet more than ever to find clarity about their health (H1).
During JulyâDecember 2022, 59% of U.S. adults reported going online in the past year to look for health or medical information (H2).
Thatâs more than half of surveyed adults â in just a 12-month window.
This isnât a niche behaviour; itâs widespread (H1, H2).
Now letâs look at the economic side.
The global symptom checker chatbots market â tools designed to offer quick, personalized interpretations of symptoms â is projected to grow from $1.2 billion in 2024 to $3.6 billion by 2029 (H3).
When an industry triples in size in five years, it tells us the desire for quick certainty is not only common â itâs financially valuable (H3).
đ§žRECEIPT CHECK
Letâs check the evidence â our kind of receipt check on what uncertainty does to our online behaviour.
This is the moment to pause and ask the questions that matter â whatâs the evidence, whatâs the source, and how do we know?
đŹWHAT THE EVIDENCE SHOWS
Hereâs what the evidence shows.
Systematic reviews and meta-analyses in this area have found consistent associations between health anxiety, online health information seeking, and cyberchondria â distress that increases, not decreases, with more searching (E1âE11).
People with higher health anxiety tend to search more, and the searching itself can contribute to greater emotional discomfort (E1âE11).
Another systematic review examined online health research and anxiety (E2).
It found that while searching can offer brief reassurance, conflicting or alarming content can quickly restart the urge to check again, especially in people already feeling anxious (E2).
More recent meta-analytic work has confirmed a reliable positive association between online health information seeking and health anxiety across multiple samples (E3).
The relationship goes both ways: anxiety increases searching, and repeated searching can heighten anxiety (E1âE11).
Then thereâs intolerance of uncertainty â that âI canât stand not knowingâ feeling.
Experimental research in this area shows that people with higher intolerance of uncertainty engage in more information-seeking when a threat feels relevant (E4, E6, E8, E9, E10, E11).
This is one of the internal engines of the search loop (E6, E8, E9, E10, E11).
Longitudinal work suggests that approaches aligned with cognitiveâbehavioural therapy may help reduce both catastrophic thinking and excessive information seeking (E5, E8).
This gives us evidence-supported ways people might interrupt the cycle (E5, E8).
Across the wider body of research, a consistent pattern emerges: uncertainty often triggers searching, searching can expose people to mixed or alarming information, and that exposure can fuel the very anxiety they were trying to calm (E1âE11).
A helpful shift is moving from seeking certainty to seeking clarity.
Certainty implies 100% confidence.
Biology rarely allows that.
Clarity is about having enough information to make a reasonable, informed next step.
The evidence suggests that distress comes not from the initial search, but from repeated reassurance-seeking under conditions of anxiety (E1âE11) and intolerance of uncertainty (E4, E6âE11).
And research shows that approaches aligned with cognitiveâbehavioural techniques can reduce catastrophic thinking and information-seeking loops (E5, E8).
Clarity is achievable.
Certainty often isnât.
đ§ WHY THIS TREND RESONATES
So why does this trend â turning to the internet as a first response to health uncertainty â resonate?
At a human level, uncertainty is uncomfortable (E1âE11).
And when something feels uncertain and important â like your health â the impulse to reduce ambiguity gets stronger (E1âE11).
At the same time, weâre surrounded by tools promising fast clarity.
If a search bar or chatbot seems to offer instant answers, the brain starts to expect â even demand â certainty (E1âE11).
And because much online information is fragmented or sensational, many people end up seeing contradictory or extreme examples, which intensifies the urge to âkeep checking until something makes senseâ (E8âE11).
đ§THE TAKEAWAY
So whatâs the takeaway?
Here are three evidence-aligned ideas you can experiment with:
Set an âenough pointâ before you start searching.
Research shows that itâs not the initial search, but the reassurance-seeking cycle, that links to distress (E1âE11).
Look for patterns, not single posts.
Systematic reviews work by synthesizing multiple sources (E1, E2, E3, E7) â mirroring that approach can reduce the impact of isolated extreme examples.
Use cognitive-behavioral therapy-aligned skills to interrupt catastrophic loops.
Evidence suggests that approaches consistent with cognitiveâbehavioural techniques can reduce catastrophic thinking and excessive checking (E5, E8).
đREFLECTION PROMPT
Something to reflect onâŚ
Where is the line â for you â between getting informed and chasing certainty?
You might notice situations where that line becomes blurry.
đŹOUTRO & CTA
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You can also explore the full sources and vote in this weekâs poll in The Evidence Edit.
This is Beyond the Buzz â cutting through the hype, because evidence is empowering.
đREFERENCES â Whatâs the Hype (H1âH#) / Whatâs the Evidence (E1âE#)
đ Open Access |đPaywalled
H1
Jia, X., Pang, Y., & Liu, L. S. (2021). Online health information seeking behavior: A systematic review. Healthcare, 9(12), 1740. https://doi.org/10.3390/healthcare9121740 đ
H2
Wang, X., & Cohen, R. A. (2023). Health information technology use among adults: United States, JulyâDecember 2022 (NCHS Data Brief No. 482). National Center for Health Statistics. https://stacks.cdc.gov/view/cdc/133700 đ
H3
Research and Markets. (2025). Symptom checker chatbots market report 2025. https://www.researchandmarkets.com/reports/6075345/symptom-checker-chatbots-market-report đ
E1
Singh, K., Fox, J. R., & Brown, R. J. (2016). Health anxiety and Internet use: A thematic analysis. Cyberpsychology: Journal of Psychosocial Research on Cyberspace, 10(2). https://cyberpsychology.eu/article/view/6177 đ
E2
Brown, R. J., Skelly, N., & Chew-Graham, C. A. (2020). Online health research and health anxiety: A systematic review and conceptual integration. Clinical Psychology: Science and Practice, 27(2), e12299. https://doi.org/10.1111/cpsp.12299 đ
E3
McMullan, R. D., Berle, D., ArnĂĄez, S., & Starcevic, V. (2019). The relationships between health anxiety, online health information seeking, and cyberchondria: Systematic review and meta-analysis. Journal of Affective Disorders, 245, 270â278. https://doi.org/10.1016/j.jad.2018.11.037 đ
E4
Wang, Z., Hu, Y., Huang, B., Zheng, G., Li, B., & Liu, Z. (2024). Is there a relationship between online health information seeking and health anxiety? A systematic review and meta-analysis. Health Communication. https://doi.org/10.1080/10410236.2023.2275921 đ
E5
Jagtap, S., Wasserman, E., Patel, K., PĂŠrez-LĂłpez, A. J., Fontenelle, L. F., & Fineberg, N. A. (2021). Information seeking and health anxiety during the COVID-19 pandemic: A longitudinal study. Journal of Psychiatric Research, 144, 296â302. https://doi.org/10.1002/cpp.2684 đ
E6
Te Poel, F., Baumgartner, M. S., & Hartmann, T. (2016). The curious case of cyberchondria: A longitudinal study on the reciprocal relationship between health anxiety and online health information seeking. Journal of Anxiety Disorders, 43, 32â40. https://doi.org/10.1016/j.janxdis.2016.07.009 đ
E7
Schenkel, S. K., Jungmann, S. M., & Gropalis, M. (2021). Conceptualizations of cyberchondria and relations to anxiety-related pathology: A systematic review and meta-analysis. Journal of Medical Internet Research, 23(11), e27835. https://doi.org/10.2196/27835 đ
E8
Starcevic, V., & Berle, D. (2013). Cyberchondria: Towards a better understanding of excessive health-related Internet use. Expert Review of Neurotherapeutics, 13(2), 205â213. https://doi.org/10.1586/ern.12.162 đ
E9
Bahadir, O., & Dundar, C. (2024). The impact of online health information source preference on intolerance to uncertainty and cyberchondria in a youthful generation. Indian Journal of Psychiatry, 66(4), 360â366. https://doi.org/10.4103/indianjpsychiatry.indianjpsychiatry_715_23 đ
E10
Yang, X., Liu, M., Cao, Y., & Ma, C. (2025). Unpacking cyberchondria: The roles of online health information seeking via diverse sources. Technology in Society. Advance online publication. https://doi.org/10.1016/j.tele.2024.102225 đ
E11
Bartoszek, G., Ranney, R. M., Curanovic, I., Costello, S. J., & Behar, E. (2022). Intolerance of uncertainty and information-seeking behavior: Experimental manipulation of threat relevance. Behaviour Research and Therapy, 154, 104125. https://doi.org/10.1016/j.brat.2022.104125 đ
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