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    Cyberchondria and Anxiety Sensitivity in Patients with Panic Disorder: A Case-Control Study
    (Mdpi, 2026) Orman, Kubra; Sun, Tunahan; Ugur, Kerim; Kizilkaya, Fatma
    Background and Objectives: Cyberchondria (CYB) has been associated with health anxiety and anxiety sensitivity (AS); however, its role in panic disorder (PD) remains unclear. This study aimed to compare CYB and AS levels between patients with PD and healthy controls and to examine their associations with PD severity. Materials and Methods: This cross-sectional case-control study included 71 patients with PD and 69 age- and sex-matched healthy controls. Participants completed the Cyberchondria Severity Scale (CSS), Anxiety Sensitivity Index-3 (ASI-3), and Beck Anxiety Inventory (BAI). PD severity was assessed using the Panic Disorder Severity Scale (PDSS). Group comparisons were additionally conducted using analysis of covariance (ANCOVA), controlling for relevant sociodemographic and clinical variables. Pearson correlation and hierarchical multiple regression analyses were performed. Results: Patients with PD had significantly higher CSS (80.70 +/- 22.71 vs. 60.62 +/- 17.22) and ASI-3 total scores (35.66 +/- 17.87 vs. 12.25 +/- 10.18) than healthy controls. In the PD group, CYB was positively correlated with AS (r = 0.38, p < 0.01), whereas no significant association was found between CYB and PD severity (r = 0.09, p > 0.05). AS showed a moderate positive correlation with PD severity (r = 0.46, p < 0.01). In hierarchical regression analyses, CYB did not predict PD severity. Adding AS significantly increased the explained variance; however, in the final model, only general anxiety severity (BAI) remained a significant predictor of PD severity. Conclusions: Patients with PD exhibit elevated levels of CYB and AS, which are positively associated with each other. Nevertheless, PD severity appears to be primarily driven by general anxiety symptoms rather than CYB. These findings suggest that CYB may represent a parallel maladaptive coping behavior rather than a direct determinant of symptom severity, with potential implications for assessment and intervention. Longitudinal studies are warranted to clarify causal relationships.
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    Treatment-related modulation of visuo-vestibular integration in post-earthquake dizziness syndrome: a longitudinal virtual reality-based study
    (Springer Heidelberg, 2026) Korkmaz, Hanifi; Karaer, Isil Cakmak; Orman, Kubra; Talu, Burcu; Inceoglu, Feyza
    BackgroundPost-earthquake dizziness syndrome (PEDS) is increasingly recognized as a condition marked by persistent dizziness and imbalance after major earthquakes, often without clear peripheral vestibular pathology. Despite proposed roles of visuo-vestibular dysfunction and sensory conflict, longitudinal objective evidence remains limited.ObjectiveTo examine the longitudinal effects of virtual reality-based vestibular rehabilitation (VR), cognitive behavioral therapy (CBT), and their integration (VR + CBT) on objective visuo-vestibular processing and symptom burden in adults with PEDS.MethodsIn a four-arm longitudinal study, 48 earthquake-exposed adults with PEDS were evaluated at baseline, post-intervention, and 3-month follow-up following an 8-week intervention. Objective visuo-vestibular outcomes were assessed using an immersive virtual reality-based system, including static and dynamic subjective visual vertical (SVV/DSVV), rod-and-frame test (RFT), and visual motion sensitivity (VMS) tests. Subjective outcomes included dizziness-related handicap (DHI) and post-traumatic stress symptoms (PCL-5).ResultsDizziness-related disability and trauma-related symptoms improved over time across groups, indicating clinical modifiability of PEDS. Objective measures demonstrated a domain-specific response profile: SVV and DSVV remained largely stable, whereas RFT showed improvement in active treatment arms, suggesting reduced visual frame dependence. VMS outcomes exhibited differential trajectories, with the integrated VR + CBT group showing the most consistent and durable modulation under visually provocative conditions.ConclusionsRecovery in PEDS appears to involve selective modulation of context-dependent visuo-vestibular processing rather than uniform changes across all spatial orientation measures. Integrated VR + CBT yields the most coherent and durable benefits in visually demanding domains, supporting multidisciplinary models that jointly address sensory conflict and cognitive-emotional mechanisms after major earthquakes.