Nonsupport Versus Varying Levels of Person-Centered Emotional Support: a Study of Women with Breast Cancer

Abstract

Social support studies often focus on psychological outcomes for the support recipient and also presume potential support providers who will attempt to provide support in the first place. Therefore, the negative relational outcomes associated with not receiving emotional support when support is expected (nonsupport) are an understudied topic. Instances of nonsupport were compared to various emotional support messages on relational and psychological outcomes to understand how nonsupport compares against support messages of varying quality. Two hundred twenty-four women with breast cancer were asked to think of a person expected to provide emotional support if they disclosed their diagnosis on social media. Participants were given either a hypothetical support message from this person or told the person provided no message even though a message was expected. Dunnett's t tests were used to analyze the nonsupport condition against low, moderate, and highly person-centered support messages. Providing no emotional support message (nonsupport) creates low levels of emotional improvement and high levels of negative relational ramifications similar to low person-centered messages. Moreover, only participants receiving the low person-centered message agreed on average they would rather have received no message at all instead. Because low person-centered messages and saying nothing whatsoever both create negative relational ramifications, support providers should strive to communicate emotional support messages with at least a moderate amount of person-centeredness. These findings further suggest those who are expected to provide emotional support cannot dodge this obligation since nonsupport is shown to have negative relational outcomes to low person-centered support messages.

Mixed Messages: I. The Consequences of Communicating Negative Statements Within Emotional Support Messages to Cancer Patients

“…This study suggests that the presence of a single negative statement within a support message has significant effects on the perceived effectiveness of the entire message and the supporter’s competence. These findings reinforce the idea that communicating social support—which is typically conceived of as a positive, pro-social behavior—can go awry and lead to negative outcomes for cancer patients ( 4 , 11 ), their supporters ( 5 ), and the patient-supporter relationship ( 3 ).…”

“…Additionally, all of the negative statements coded in these emotional support messages were about the supporter learning of the diagnosis indirectly (ie, from someone other than the patient). Prior research notes other negative statements besides issues with indirect disclosures occur within supportive messages to cancer patients, including minimizing the cancer patient’s experiences ( 19 ), criticizing the patient’s response to the diagnosis ( 4 ), or being overly imposing in suggesting how the cancer patient ought to act or feel ( 3 ). Although it is easy to speculate that these other negative topics would yield similar results if they occurred within longer supportive messages, empirical evidence is needed to test this claim.…”

“…Notably, researchers conducting emotional support studies often ask participants to evaluate contrived support messages that are created systematically to reflect different levels of message quality. That is, the emotional support messages used in some studies are purposefully created to be consistent in quality throughout the entire message (3,6,7). Whereas high-quality support message conditions typically consist of exclusively positive statements of caring and concern, low-quality message conditions typically contain only negative statements.…”

“…Unlike some forms of support that focus on resolving specific problems faced by cancer patients, emotional support messages focus on reducing feelings of distress associated with a cancer diagnosis (1). When cancer patients receive effective emotional support messages, they typically experience an improvement in their emotional state (2,3). On the other hand, ineffective emotional support messages typically fail to improve the patient’s emotional state (3,4).…”

“…When cancer patients receive effective emotional support messages, they typically experience an improvement in their emotional state (2,3). On the other hand, ineffective emotional support messages typically fail to improve the patient’s emotional state (3,4). In some cases, supporters communicate emotional support messages that are so ineffective that the cancer patient views the supporter as incompetent (5).…”