Self-disclosure in online support groups: The patterns of disclosure and their potential health benefits for women with breast cancer

This dissertation research examines how women with breast cancer benefit from self-disclosure in online support groups. What are the patterns of their disclosure in online support groups? What individual characteristics predict these disclosure patterns? In what ways does written disclosure in online groups lead to potential health benefits? By answering these questions, this research provides a theoretical framework for the patterns, predictors, and influences of written disclosure in online support groups. This research involved a secondary analysis of data which were collected originally as a part of Digital Divide Pilot Project (Gustafson et al., 2005a, 2005b). Low-income women with breast cancer were recruited and given access to bulletin-board-type online groups. Three sets of data were analyzed: baseline and four-month follow-up surveys assessing participants\u27 (N = 231) background characteristics and health outcomes, a set of messages posted in the online groups during the four-month period, and log data that saved the occurrences of message posting and reading. Findings showed large individual variances in the behavior of posting disclosive messages in terms of both the quantity and the content of posts. The patterns of disclosure were predicted primarily by ethnicity and age. Data supported the positive associations between disclosure in online groups and health benefits at follow-up, mainly in a subset of active posters who wrote two or more disclosive messages. Insightful disclosure led to greater improvements in health self-efficacy, emotional well-being, and functional well-being, mediated by lowered breast cancer concerns. Negative emotional disclosure weakened the negative relations between concerns and functional well-being. Supportive disclosure also produced favorable benefits, such that providing support to other women at least in a part of disclosive messages was related to greater improvements in functional well-being and concerns; expressing gratitude for received support in disclosure was associated with greater improvements in health self-efficacy and concerns. However, the hypothesis about the lagged reciprocity of disclosure (i.e., the extent to which individuals reciprocate by posting after they read insightful or emotional expressions in other women\u27s disclosures) was not supported. Overall the findings suggest a theoretical framework to study self-disclosure in online support groups considering both the intrapersonal and interpersonal aspects of written disclosure