Adverse Effects
Although the effectiveness of online support has been proven through research, there are many adverse effects that may come from the use of online interaction and support for both psychological and somatic issues. One of the negative outcomes of the use of online intervention is the emergence of support groups that do not promote the treatment of a disorder, but actually support the negative actions and symptoms of the disorder. These websites are called online negative enabling support groups (ONESG). Examples of these are pro-anorexia (pro-ana) websites. The pro-ana websites were created with the intent to support the potentially harmful actions of those who suffer from the eating disorder, anorexia like fasting which can lead to serious somatic issues. Researchers estimate that there are about 200 to 400 websites that are dedicated to supporting negative behaviors of anorexia (Brotsky & Giles,2007). This range is so large because a lot of ONESGs do not associate themselves with the pro-ana movement due to the negative media surrounding the sites, but the still promote the negative behaviors. In such websites, you can find instructions and tips for maintaining and even trying to develop an anorexic behaviors which include rapid weight loss diets and motivational images (Haas, Irr, Jennings, & Wagner, 2010). Pro-ana websites increase and normalize negative expressions and do not attempt to re-frame negative thoughts like traditional support groups would. Instead these websites allow individuals to share advice on fasting, dieting, and motivational quotes and images that support negative behaviors involved in anorexia. The motivational images in the postings are typically referred to as thinspiration (Brotsky & Giles, 2007). Thinspiration involves pictures of thin celebrities, models, and other members of the ONESG and inspirational quotes motivating others to be thinner. Due to this promotion of thinness and the support of others, those who suffer from anorexia get enabling support that maintains and may even increase the physically harmful behaviors associated with the disorder.
The attraction of such websites is similar to those of regular support groups. Those with an eating disorder find the anonymity of internet facilitated support comforting. It allows them to seek the support of their disorder without being recognized and without a stigma. Haas and his colleagues (2010) note that many individuals that suffer from anorexia hide this side of themselves away from their friends and family to avoid the negative stigma that is stuck with such a label. This anonymity also allows for more extreme views to be expressed and exchanged between individuals because individuals feel as though they are able to hide behind the computer. This ability to share extreme views with less consequence such as judgment is one of the main reasons ONESGs form (Haas et al., 2010). In a covert study of the pro-ana online community, it was found that the support from individual to individual within the community was overwhelmingly strong (Brotsky & Giles, 2007). It is difficult for people to get into these sights without proving themselves to be truly anorexic because administrators of the sites did not want outsiders posting negative, judgmental comments. However, once the researcher in the covert study got into a few of these sites she was welcomed with an incredible amount of support. This support is another reason why individuals join ONESGs.
Online support groups that are promote the treatment of psychological and somatic heath issues have some adverse effects that should be considered as well. In a study of breast cancer support groups, it was found that patients may actually lose emotional support because it is often in an anonymous environment (citation). This anonymity may make the person feel less connected to the therapist or other patients because they do not receive nonverbal emotional cues as they would in traditional therapy sessions. However, this does not mean that individuals who suffer from breast cancer and other diseases are unable to find emotional support online. Finding emotional support online may be difficult for some people and for those that feel a lack of emotional connection through anonymous support groups may find it easier to participate in nonymous groups. Nonymous groups differ from anonymous groups because they make the person identifiable in some way.
The attraction of such websites is similar to those of regular support groups. Those with an eating disorder find the anonymity of internet facilitated support comforting. It allows them to seek the support of their disorder without being recognized and without a stigma. Haas and his colleagues (2010) note that many individuals that suffer from anorexia hide this side of themselves away from their friends and family to avoid the negative stigma that is stuck with such a label. This anonymity also allows for more extreme views to be expressed and exchanged between individuals because individuals feel as though they are able to hide behind the computer. This ability to share extreme views with less consequence such as judgment is one of the main reasons ONESGs form (Haas et al., 2010). In a covert study of the pro-ana online community, it was found that the support from individual to individual within the community was overwhelmingly strong (Brotsky & Giles, 2007). It is difficult for people to get into these sights without proving themselves to be truly anorexic because administrators of the sites did not want outsiders posting negative, judgmental comments. However, once the researcher in the covert study got into a few of these sites she was welcomed with an incredible amount of support. This support is another reason why individuals join ONESGs.
Online support groups that are promote the treatment of psychological and somatic heath issues have some adverse effects that should be considered as well. In a study of breast cancer support groups, it was found that patients may actually lose emotional support because it is often in an anonymous environment (citation). This anonymity may make the person feel less connected to the therapist or other patients because they do not receive nonverbal emotional cues as they would in traditional therapy sessions. However, this does not mean that individuals who suffer from breast cancer and other diseases are unable to find emotional support online. Finding emotional support online may be difficult for some people and for those that feel a lack of emotional connection through anonymous support groups may find it easier to participate in nonymous groups. Nonymous groups differ from anonymous groups because they make the person identifiable in some way.
People looking for support groups for somatic and psychological issues often worry that it will not be effective for them and that there will be issues such as their issues being ignored. Research has shown that although there are flaws in online support groups there may be less to fear than you think. In a study by Uden-Kraan et al. (2008) researchers looked at if the prevalence of commonly feared disadvantages actually occuring in online support groups. This study was made up primarily of females and looked at three breast cancer sites, three fibromyalgia sites, and two arthritis sites. The disadvantages of online support that were being examined were asynchronous communication, quality of medical information, the use and evaluation of health care services, and negative postings. The issues surrounding asynchronous communication involved things such as people being ignored when they asked a question or other issues would quickly take over the posting and it become off topic. The fear with the quality of medical information is that the average user would pass on information as legitimate medical advice when in actuality the information is just coming from them and could actually be potentially harmful. The feared problems with the evaluation of health care services was that users would use the different sites to present medical practitioners and practices in a negative way. This could cause people to turn away from getting the care that they needed because of these bad reviews. The final fear was negative postings. With this issue, they were worried that users would start a trend of very negative depressing posts that would bring other user's emotions down. These diseases can be detrimental to the way in which someone lives and if they vent just their negative feelings online they may bring down the spirits of others who were previously doing fine (Uden-Kraan et al., 2008).
The study found that these feared disadvantages were not very prevalent in these websites (Uden-Kraan et al., 2008). Asynchronous communications was not seen much in the sites studied. Some post were not answered or overlooked but generally questions were answered within twenty four hours. This is obviously too long for any type of urgent care, but that is not the purpose of web based care. The study found that most posts were about medication, treatment, and symptoms. The most common type of information shared were personal experiences. These experiences and anecdotes were not being passed off as medically sound advice, but simply what happened to them and how they felt about it. The study also found that the fear of putting off doctor visits was not a big issue. In the 1,500 posts examined only four showed signs that someone was using online support too much when they should have gone to a doctor. These cases were fairly mild and not life threatening. One of the biggest and most widely spread fears is that there is dangerous information being passed off as medical fact on online help cites and this was found to not be an issue. The study found that no postings contained potentially dangerous information (Uden-Kraan et al., 2008). The issue of flaming, extreme unwarranted hostility in posts, was not present in any large amount on any of the websites examined.
In the end, online support was found to not have the disadvantages that some believed it did. The ideas that people are giving advice as though they were professionals and others following it and getting hurt was found to be false. Online support was just that, support. It is effective as a means to share feelings and get information about their disease and other real life issues. It is not a substitute for care though. So long as people receive the proper medical attention online support will help to alleviate some of the loneliness and uncertainty that many of these diseases can cause, making it healthy and safe.
The study found that these feared disadvantages were not very prevalent in these websites (Uden-Kraan et al., 2008). Asynchronous communications was not seen much in the sites studied. Some post were not answered or overlooked but generally questions were answered within twenty four hours. This is obviously too long for any type of urgent care, but that is not the purpose of web based care. The study found that most posts were about medication, treatment, and symptoms. The most common type of information shared were personal experiences. These experiences and anecdotes were not being passed off as medically sound advice, but simply what happened to them and how they felt about it. The study also found that the fear of putting off doctor visits was not a big issue. In the 1,500 posts examined only four showed signs that someone was using online support too much when they should have gone to a doctor. These cases were fairly mild and not life threatening. One of the biggest and most widely spread fears is that there is dangerous information being passed off as medical fact on online help cites and this was found to not be an issue. The study found that no postings contained potentially dangerous information (Uden-Kraan et al., 2008). The issue of flaming, extreme unwarranted hostility in posts, was not present in any large amount on any of the websites examined.
In the end, online support was found to not have the disadvantages that some believed it did. The ideas that people are giving advice as though they were professionals and others following it and getting hurt was found to be false. Online support was just that, support. It is effective as a means to share feelings and get information about their disease and other real life issues. It is not a substitute for care though. So long as people receive the proper medical attention online support will help to alleviate some of the loneliness and uncertainty that many of these diseases can cause, making it healthy and safe.