Vicki S. Helgeson

Internet Paradox Revisited

Kraut et al. (1998) reported negative effects of using the Internet on social involvement and psychological well-being among new Internet users in 1995–96. We called the effects a “paradox” because participants used the Internet heavily for communication, which generally has positive effects. A 3-year follow-up of 208 of these respondents found that negative effects dissipated. We also report findings from a longitudinal survey in 1998–99 of 406 new computer and television purchasers. This sample generally experienced positive effects of using the Internet on communication, social involvement, and well-being. However, consistent with a “rich get richer” model, using the Internet predicted better outcomes for extraverts and those with more social support but worse outcomes for introverts and those with less support.

A meta-analytic review of benefit finding and growth.

The authors conducted a meta-analysis to examine the relations of benefit finding to psychological and physical health as well as to a specific set of demographic, stressor, personality, and coping correlates. Results from 87 cross-sectional studies reported in 77 articles showed that benefit finding was related to less depression and more positive well-being but also more intrusive and avoidant thoughts about the stressor. Benefit finding was unrelated to anxiety, global distress, quality of life, and subjective reports of physical health. Moderator analyses showed that relations of benefit finding to outcomes were affected by the amount of time that had passed since stressor onset, the benefit finding measured used, and the racial composition of the sample.

Sex Differences in Coping Behavior: A Meta-Analytic Review and an Examination of Relative Coping

We used meta-analysis to examine recent studies of sex differences in coping. Women were more likely than men to engage in most coping strategies. The strongest effects showed that women were more likely to use strategies that involved verbal expressions to others or the self—to seek emotional support, ruminate about problems, and use positive self-talk. These sex differences were consistent across studies, supporting a dispositional level hypothesis. Other sex differences were dependent on the nature of the stressor, supporting role constraint theory. We also examined whether stressor appraisal (i.e., womens tendencies to appraise stressors as more severe) accountedfor sex differences in coping. We found some support for this idea. To circumvent this issue, we provide some data on relative coping. These data demonstrate that sex differences in relative coping are more in line with our intuitions about the differences in the ways men and women cope with distress.

Social Support and Adjustment to Cancer: Reconciling Descriptive, Correlational, and Intervention Research

Several research literatures are reviewed that address the associations of emotional, informational, and instrumental social support to psychological adjustment to cancer. Descriptive studies suggest that emotional support is most desired by patients, and correlational studies suggest that emotional support has the strongest associations with better adjustment. However, the evidence for the effectiveness of peer discussion groups aimed at providing emotional support is less than convincing. Moreover, educational groups aimed at providing informational support appear to be as effective as, if not more effective than, peer discussions. Reasons for inconsistencies between the correlational and intervention literatures are discussed, and future directions are outlined.

Psychological and physical adjustment to breast cancer over 4 years: Identifying distinct trajectories of change

The goal of this study was to identify distinct trajectories of adjustment to breast cancer over 4 years as well as to distinguish among the different trajectories. The mental and physical functioning of 287 women with breast cancer who remained alive and disease free through 4 years of follow-up were examined. The majority of women showed slight and steady improvement in functioning with time, but subgroups of women were identified who showed marked improvement and marked deteriorations over time. Age successfully distinguished different trajectories of physical functioning. Indices of personal resources (i.e., self-image, optimism, perceived control) and social resources (i.e., social support) successfully distinguished different courses of mental and physical functioning.

Is it beneficial to involve a family member? A meta-analysis of psychosocial interventions for chronic illness.

Links between chronic illness and family relationships have led to psychosocial interventions targeted at the patients closest family member or both patient and family member. The authors conducted a meta-analytic review of randomized studies comparing these interventions with usual medical care (k=70), focusing on patient outcomes (depression, anxiety, relationship satisfaction, disability, and mortality) and family member outcomes (depression, anxiety, relationship satisfaction, and caregiving burden). Among patients, interventions had positive effects on depression when the spouse was included and, in some cases, on mortality. Among family members, positive effects were found for caregiving burden, depression, and anxiety; these effects were strongest for nondementing illnesses and for interventions that targeted only the family member and that addressed relationship issues. Although statistically significant aggregate effects were found, they were generally small in magnitude. These findings provide guidance in developing future interventions in this area.

Group Support Interventions for Women With Breast Cancer: Who Benefits From What?

Research on the benefits of social support groups has been inconclusive. One reason is that individual differences in intervention responses have rarely been examined. The authors determined the extent to which individual difference variables moderated the effects of an information-based educational group and an emotion-focused peer discussion group on the mental and physical functioning of women with breast cancer (n = 230). The authors administered the SF-36 (S.E. Ware, K.K. Snow, M. Kosinski, & B. Gandek, 1993), a multidimensional quality of life instrument, pre- and postintervention. Educational groups showed greater benefits on the physical functioning of women who started the study with more difficulties compared with less difficulties (e.g., lacked support or fewer personal resources). Peer discussion groups were helpful for women who lacked support from their partners or physicians but harmful for women who had high levels of support. Implications of these results for clinical interventions are discussed.

Social support and quality of life.

Social support is a broad term, which includes the supportive ways that different people behave in the social environment. Structural measures of the environment deal with the mere existence of social relationships. Functional measures refer to the resources that people within an individuals social network provide. Structural support shows a linear relation to quality of life; the functional aspects of support demonstrate the stress-buffering hypothesis. One of the main focuses of this article is to help researchers determine what aspects of social relationships or what types of support need to be measured and to consider the mechanisms by which support might influence quality of life. Also addressed is how to translate the correlational research on social support and quality of life into the field of support interventions, taking into account individual and situational differences.

Improving Quality of Life in Men With Prostate Cancer: A Randomized Controlled Trial of Group Education Interventions

Men who were recently treated for prostate cancer (N=250) were randomly assigned to a control group, a group education intervention (GE), or a group education-plus-discussion intervention (GED). Both GE and GED increased prostate cancer knowledge. In the year postintervention, men in the GED condition were less bothered by sexual problems than men in the control condition, and they were more likely to remain steadily employed (93.0%) than men in the GE (75.6%) or control (72.5%) conditions. Among noncollege graduates, GED and GE resulted in better physical functioning than the control condition, and GED resulted in more positive health behaviors than the control or GE condition. Among college graduates, controls were comparable with the GE and GED groups in physical functioning and positive health behaviors.

Review and Meta-analysis of Couple-Oriented Interventions for Chronic Illness

BackgroundEvidence continues to build for the impact of the marital relationship on health as well as the negative impact of illness on the partner. Targeting both patient and partner may enhance the efficacy of psychosocial or behavioral interventions for chronic illness.PurposeThe purpose of this report is to present a cross-disease review of the characteristics and findings of studies evaluating couple-oriented interventions for chronic physical illness.MethodsWe conducted a qualitative review of 33 studies and meta-analyses for a subset of 25 studies.ResultsIdentified studies focused on cancer, arthritis, cardiovascular disease, chronic pain, HIV, and Type 2 diabetes. Couple interventions had significant effects on patient depressive symptoms (d = 0.18, p < 0.01, k = 20), marital functioning (d = 0.17, p < 0.01, k = 18), and pain (d = 0.19, p < 0.01, k = 14) and were more efficacious than either patient psychosocial intervention or usual care.ConclusionsCouple-oriented interventions have small effects that may be strengthened by targeting partners’ influence on patient health behaviors and focusing on couples with high illness-related conflict, low partner support, or low overall marital quality. Directions for future research include assessment of outcomes for both patient and partner, comparison of couple interventions to evidence-based patient interventions, and evaluation of mechanisms of change.