Dean, JH; (2014) Online Support Groups for Depression and Anxiety: Outcome and Process. Doctoral thesis , UCL (University College London).

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Abstract

The studies described in this thesis aimed to investigate the potential benefits of an online support group (OSG) for participants experiencing depression and anxiety. After a review of the literature (Chapter 1), the first experiment (Chapter 2) analyses the validity of a commonly used text analysis software called Linguistic Inquiry and Word Count (LIWC), which is used later in the RCT to examine the correlates of the outcome measures. In order to prepare for the RCT, two pilot studies were carried out (Chapter 3), one to test the OSG arm and another to test the placebo control condition, an expressive writing task. The main RCT (Chapter 4) adopted a six-month randomised control trial design, with participants randomised to either (1) an OSG or (2) an expressive writing placebo control condition. The hypothesis was that participants randomised to the OSG would show greater improvement on the main outcome measures (reduced depression and anxiety, increased satisfaction with life and social support) than those in the expressive writing comparison group. The results for all four primary outcomes--depression, anxiety, satisfaction with life and social support --showed an improvement with time over the six months of the study. But participants responded similarly to the expressive writing and the OSG, so no evidence was found for the experimental hypothesis. However, the OSG had much higher drop-out rates than the expressive writing condition, suggesting that acceptability was lower. Finally, participants' feedback on the OSG and expressive writing was investigated qualitatively (Chapter 5). The main problems participants perceived with the OSG were a lack of comfort and connection with others, negative social comparisons and the potential for receiving bad advice. In comparison, participants were broadly positive about the expressive writing task. The conclusion is that little positive evidence was found for the benefits of using an OSG for depression and anxiety. Recommendations for clinicians and policy-makers are discussed (Chapter 6).

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