The Membership Life Cycle in Online Support Groups (3-3)

This study was supported by a grant from NARSAD, The Mental Health Research Association and was written by Galit Nimrodi. This study explores the membership life cycle in online support groups for people with depression by examining 558 people with various membership durations in 16 online support groups.

Support for this argument may be found in survey studies that investigated subjective variables such as the perceived benefits or the reason for participating in online support groups for people with depression. Houston and colleagues (2002), for example, reported that emotional support was the main reason for participation and that the majority of members agreed that participation alleviated their symptoms. Powell, McCarthy, and Eysenbach (2003) found that most repeat visitors reported gaining knowledge of depression, and about half of them indicated that they were “able to discuss subjects that they felt unable to discuss elsewhere” and that they “felt less isolated.” Other studies yielded similar findings and reported that members’ feedback was that the online support group provided them with help and understanding, an outlet for expression, and a place to turn to when alone and that participation was a process that led to a sense of relief and a change in their lives. There is almost no evidence for perceived disadvantages of online depression support groups (Griffiths et al., 2009b). While these studies provide substantial support for the impact of online depression support groups on outcomes other than the level of depression, they lack differentiation among members. Hence, no study so far has examined whether the nonclinical benefits gained from participation vary among different segments of community members, including members with different membership duration.

The Present Study
 
The study presented in this article provides some of the missing information in the current body of knowledge. The main goal of this study was to explore the membership life cycle in online support groups. For that purpose, online peer-to-peer support groups for people with depression were examined. Online depression support groups may be regarded as a good representative of online support groups because health-related online support groups are the most prominent online support groups (Johnson & Ambrose, 2006), because people with stigmatized illnesses use the Internet for health information and social support significantly more than those with nonstigmatized conditions, and because, among those with stigmatized conditions, people with depression use the Internet the most.
This study was designed to explore the associations between duration of membership in online support groups, participation patterns (i.e., behavior) and psychological measures. The latter included participants’ interests, perceived benefits, and level of depression. Hence, the study not only combined behavioral and psychological measures, it also combined clinical (i.e., objective) and nonclinical (i.e., subjective) measures of members’ well-being. This combination provided some general suggestions regarding individuals’ experience of membership in online support groups.
 
Method

Although longitudinal research is probably the best method to explore the membership life cycle, it could not be applied in the current investigation because of the need to ensure participants’ anonymity. A basic condition for conducting a longitudinal investigation is asking interviewees to provide their contact information for further questioning. Given that the participants here struggled with a stigmatized mental illness, they probably would not have agreed to participate in the study if it was not anonymous. Under this limitation, the study was cross-sectional and simply examined group members with various membership durations.

Data Collection and Sample

The study was based on an online survey of 558 members of 16 online support groups for people with depression. To recruit participants, the principal investigator (PI) contacted the administrators of 30 active online support groups and asked for their permission to post a call for volunteers on their websites. All of the groups were English-based and explicitly targeted people with depression (according to their names, home pages, and welcome posts). Eleven administrators approved and even posted the call on the PI’s behalf, two said that they would examine the request but never answered, and one refused. Others did not respond even after three requests. In these cases, the PI independently posted messages in the online support groups. Of the 16 unauthorized messages posted, only five survived. Others were deleted by group administrators after a short period (between several hours and a couple of days), and the PI was banned from the sites. The remaining 16 (11 approved and 5 non-approved) online support groups surveyed are listed in Table 1. Yet, it is assumed that some respondents were recruited by the short-lived non-approved posts in the other 11 online groups.