‘I Know How You Feel’: Effects of Cognitive and Emotional Sharing of Negative Experiences in Online Support Groups

Online forum participation Whereas ‘back in the old days’ individuals depended on experts and close relatives for health information, nowadays individuals are turning to the Internet to look for information about health-related issues (Rice, 2006). A rapidly increasing number of healthrelated support groups provide users with ample opportunities to share their personal stories online. Online support groups differ from professional health websites in their interactive, experience-based nature. Several studies examined the messages participants post online, suggesting the following motives for participating in online health forums: (1) exchanging information, (2) encountering emotional support, (3) finding recognition and understanding, (4) sharing experiences and helping others, and (5) amusement and creative expression (e.g., Fernsler & Manchester, 1997; Klemm, Reppert, & Visich, 1998; Sharf, 1997; Setoyama, Nakayama, & Yamazaki, 2009; Uden-Kraan, Drossaert, Taal, Seydel, & Laar, 2009). Studies also showed a positive relationship between forum use and users’ selfreported psychological wellbeing (e.g., decreased depression, loneliness, stress, stronger positive emotions) (Fernsler & Manchester, 1997; Gustafson et al., 1994; Klemm et al., 2003; McTavish, Gustafson, Owens, Wise, & Taylor, 1994; Uden-Kraan et al., 2009). Most studies are correlational. Only a few preposttest studies revealed that forum use had a positive effect on wellbeing compared to participants’ wellbeing before using the online forum (Lieberman et al., 2003; Winzelberg et al., 2003). Although the essence of forum use lies in the exchange of health-related narratives online, no study to date has examined how the content of such online narratives relate to user motives and health outcomes. One exception comes from a survey study existing of three waves examined how insightful disclosure (e.g., writing about ones thoughts and feelings) within an online support group for women with breast cancer affected wellbeing. Using a word counting program this study showed that written insightful disclosure improved emotional wellbeing and reduced negative mood (Shaw, Hawkins, McTavish, Pingree, & Gustafson, 2006). So, it seems forum users’ wellbeing is related to their writing-style. Unfortunately, little is known about these underlying writing processes in online support groups. Moreover, no study focused on the influence of responses on these narratives from online peers. Thus, as most studies focused on origins and possible consequences of forum use, little is known about the processes that bring about such positive changes, i.e., mediating factors. The present study tests the effects of two key elements in online forum use: (1) expressive writing and (2) responses from peers.