Digital stigma coping strategies: A meta-analytic review of the association between health-related stigma dimensions and social support messages shared online

Abstract Although stigma is widely accepted to be a multidimensional construct, the implications of its dimensions for social support warrant greater consideration. We conducted a meta-analysis of 31 content analyses to investigate the association between specific dimensions of stigma and the types of social support messages shared in health-related contexts online. Among health conditions where character stigma was greater, information, network, and tangible support were more prevalent. Physical stigma was associated with a higher prevalence of esteem support. Information, emotional, network, and tangible support were more prevalent among health conditions where concealable stigma was greater. Among health conditions where visible stigma was greater, information, and esteem support were more prevalent. Our study contributes to stigma and social support research by providing evidence that health-related stigma has multiple dimensions each with distinct implications for social support. More broadly, this project offers a framework that can be used to examine the ways in which social meanings of health conditions may be translated into digital behavior.

[1]  Bert N. Uchino,et al.  Understanding the Links Between Social Support and Physical Health: A Life-Span Perspective With Emphasis on the Separability of Perceived and Received Support , 2009, Perspectives on psychological science : a journal of the Association for Psychological Science.

[2]  Brea L. Perry,et al.  Functional specificity in discussion networks: The influence of general and problem-specific networks on health outcomes , 2010, Soc. Networks.

[3]  Bruce G. Link,et al.  A modified labeling theory approach to mental disorders : an empirical assessment , 1989 .

[4]  Sayaka Sugimoto,et al.  Support Exchange on the Internet: A Content Analysis of an Online Support Group for People Living with Depression , 2013 .

[5]  Wim H. van Brakel,et al.  Measuring health-related stigma--a literature review. , 2006 .

[6]  Christopher C. Yang,et al.  Informational support exchanges using different computer‐mediated communication formats in a social media alcoholism community , 2014, J. Assoc. Inf. Sci. Technol..

[7]  A. Winzelberg.  The analysis of an electronic support group for individuals with eating disorders , 1997 .

[8]  P. Thoits.  Resisting the Stigma of Mental Illness , 2011 .

[9]  B. Weiner,et al.  An attributional analysis of reactions to stigmas. , 1988, Journal of personality and social psychology.

[10]  C. Cutrona,et al.  Stress and Social Support—in Search of Optimal Matching , 1990 .

[11]  Vincent R. Waldron,et al.  Communication of social support in computer-mediated groups for people with disabilities. , 1999, Health communication.

[12]  J. Finn,et al.  An exploration of helping processes in an online self-help group focusing on issues of disability. , 1999, Health & social work.

[13]  Carol S. Aneshensel,et al.  Handbook of the sociology of mental health , 1999 .

[14]  L. Donelle,et al.  Social support and online postpartum depression discussion groups: a content analysis. , 2012, Patient education and counseling.

[15]  Stephanie Tom Tong,et al.  The Use of Pro-Ana Blogs for Online Social Support , 2013, Eating disorders.

[16]  David E. Biegel,et al.  Families of Persons With Substance Use and Mental Disorders: A Literature Review and Conceptual Framework* , 2006 .

[17]  Liang Chen,et al.  Social support on Weibo for people living with HIV/AIDS in China: a quantitative content analysis , 2014 .

[18]  M G Gelder,et al.  Stigmatisation of people with mental illnesses. , 2000, The British journal of psychiatry : the journal of mental science.

[19]  Stephenie R. Chaudoir,et al.  “Discredited” Versus “Discreditable”: Understanding How Shared and Unique Stigma Mechanisms Affect Psychological and Physical Health Disparities , 2013, Basic and applied social psychology.

[20]  Stephen A. Rains,et al.  Social Support and Computer-Mediated Communication: A State-of-the-Art Review and Agenda for Future Research , 2016 .

[21]  Nicole Martins,et al.  Communicating Stigma: The Pro-Ana Paradox , 2013, Health communication.

[22]  David C. DeAndrea,et al.  Testing the Proclaimed Affordances of Online Support Groups in a Nationally Representative Sample of Adults Seeking Mental Health Assistance , 2015, Journal of health communication.

[23]  Charles D. Hughes,et al.  Considering Disability Culture for Culturally Competent Interactions With Individuals Who Stutter , 2016 .

[24]  F. Oprescu,et al.  Explorations of uncertainty management: internet based behaviors of caregivers in the context of clubfoot , 2009 .

[25]  Stewart Christopher Alexander.  Leadership and Social Support on the Internet: A Longitudinal Analysis of Mental and Physical Illness Groups , 2002 .

[26]  Sumaira Malik,et al.  Coping with infertility online: an examination of self-help mechanisms in an online infertility support group. , 2010, Patient education and counseling.

[27]  Rachel A. Smith,et al.  A meta-analysis of disclosure of one's HIV-positive status, stigma and social support , 2008, AIDS care.

[28]  Kristen Campbell Eichhorn,et al.  Soliciting and Providing Social Support Over the Internet: An Investigation of Online Eating Disorder Support Groups , 2008, J. Comput. Mediat. Commun..

[29]  E. Wright,et al.  The dimensionality of stigma: a comparison of its impact on the self of persons with HIV/AIDS and cancer. , 2000, Journal of health and social behavior.

[30]  James D. Robinson,et al.  Expanding the Walls of the Health Care Encounter: Support and Outcomes for Patients Online , 2011, Health communication.

[31]  Stephen A. Rains,et al.  Weak-Tie Support Network Preference, Health-Related Stigma, and Health Outcomes in Computer-Mediated Support Groups , 2013 .

[32]  Kevin B. Wright,et al.  Communication in health-related online social support groups/communities: a review of research on predictors of participation, applications of social support theory, and health outcomes , 2016 .

[33]  Stephen A. Rains,et al.  Communicating Social Support in Computer-mediated Contexts: A Meta-analytic Review of Content Analyses Examining Support Messages Shared Online among Individuals Coping with Illness , 2015 .

[34]  Ming Liu,et al.  An analysis of social support exchanges in online HIV/AIDS self-help groups , 2009, Comput. Hum. Behav..

[35]  B. Pescosolido,et al.  The Stigma Complex. , 2015, Annual review of sociology.

[36]  Letitia Anne Peplau,et al.  Stigma Management and Well-Being: The Role of Perceived Social Support, Emotional Processing, and Suppression , 2009, Personality & social psychology bulletin.

[37]  M. Hatzenbuehler,et al.  How does sexual minority stigma "get under the skin"? A psychological mediation framework. , 2009, Psychological bulletin.

[38]  Elizabeth Andrea Swigar Imbesi.  Gender, social support and coping in online prostate, breast and lung cancer support forums , 2011 .

[39]  Rachel A. Smith,et al.  Language of the Lost: An Explication of Stigma Communication , 2007 .

[40]  sarah-rose marcus,et al.  Thinspiration vs. thicksperation: Comparing pro-anorexic and fat acceptance image posts on a photo-sharing site , 2016 .

[41]  David M. Keating.  Spirituality and Support: A Descriptive Analysis of Online Social Support for Depression , 2013, Journal of Religion and Health.

[42]  Peter Conrad,et al.  Social Behavior , 2018 .

[43]  Claude H. Miller,et al.  A Measure of Weak-Tie/Strong-Tie Support Network Preference , 2010 .

[44]  Snunith Shoham,et al.  Characteristics of a Virtual Community for Individuals Who Are d/Deaf and Hard of Hearing , 2012, American annals of the deaf.

[45]  Deborah F Tate,et al.  Weight loss social support in 140 characters or less: use of an online social network in a remotely delivered weight loss intervention , 2013, Translational behavioral medicine.

[46]  Christopher C. Yang,et al.  Using content and network analysis to understand the social support exchange patterns and user behaviors of an online smoking cessation intervention program , 2015, J. Assoc. Inf. Sci. Technol..

[47]  T. Ginossar.  Online Participation: A Content Analysis of Differences in Utilization of Two Online Cancer Communities by Men and Women, Patients and Family Members , 2008, Health communication.

[48]  J. Suhr,et al.  Controllability of Stressful Events and Satisfaction With Spouse Support Behaviors , 1992 .

[49]  Neil S. Coulson,et al.  Exploring the Communication of Social Support within Virtual Communities: A Content Analysis of Messages Posted to an Online HIV/AIDS Support Group , 2008, Cyberpsychology Behav. Soc. Netw..

[50]  Daphna Yeshua-Katz,et al.  Online Stigma Resistance in the Pro-Ana Community , 2015, Qualitative health research.

[51]  E L Struening,et al.  Stigma as a barrier to recovery: The consequences of stigma for the self-esteem of people with mental illnesses. , 2001, Psychiatric services.