Associations of COVID-19 online information sources and information overload with psychological distress symptoms: a population-based study

Using information communication technologies as information sources of COVID-19 was associated with psychological problems, but mechanisms remain uncertain. We examined associations of COVID-19 information sources and information overload with psychological distress symptoms and explored the mediating effect of information overload in Hong Kong. A random sample of Chinese adults (N= 1501; 52.6% females; 55.0% aged 30-59) from dual landline and online surveys in April 2020 reported frequency of using traditional media, Internet websites, social networking sites, instant messaging, and online discussion forums as COVID-19 information sources. Psychological distress symptoms were measured using the Patient Health Questionnaire 4-item ([PHQ-4]; 0-12). Information overload defined as a perception of being overwhelmed was measured (1-6). Linear regressions were performed to analyze the associations, and the mediating effect of information overload was examined. Greater PHQ-4 score was observed for frequent use of Internet websites (adjusted b = 0.58, 95% CI 0.29, 0.87, adjusted beta = 0.12) and online discussion forums (adjusted b = 0.39, 95% CI 0.08, 0.70, adjusted beta= 0.08) and information overload (adjusted b = 0.54, 95% CI 0.44, 0.63, adjusted 13 = 0.28). Information overload mediated 44.9% and 36.9% of associations of frequent use of Internet websites and online discussion forums with PHQ-4 score, respectively. Frequent use of social networking sites was associated with lower PHQ-4 score (adjusted b = -0.37, 95% CI -0.69, -0.04, adjusted beta = -0.07) partially through lower information overload (37.5%). Psychological distress symptoms were associated with frequent use of Internet websites and online discussion forums as COVID-19 information sources, which were mediated through information overload.