Giving and receiving emotional support online: Communication competence as a moderator of psychosocial benefits for women with breast cancer

• Emotional communication competence moderates the benefits of emotional support.
• Expressing support improves mental well-being for patients with high competence.
• Expressing support decreases mental well-being for patients with low competence.
• Receiving support reduces cancer-related concern for patients with high competence.
• Receiving support increases cancer-related concern for patients with low competence.

This study examines the moderating role of emotional communication competence in the relationship between Computer-Mediated Social Support (CMSS) group participation, specifically giving and receiving emotional support, and psychological health outcomes. Data were collected as part of randomized clinical trials for women diagnosed with breast cancer within the last two months. Expression and reception of emotional support was assessed by tracking and coding the 18,064 messages that 236 patients posted and read in CMSS groups. The final data used in the analysis was created by merging (a) computer-aided content analysis of discussion posts, (b) action log data analysis of system usage, and (c) baseline and 6-month surveys collected to assess change. Results of this study demonstrate that emotional communication competence moderates the effects of expression and reception of emotional support on psychological quality of life and breast cancer-related concerns in both desired and undesired ways. Giving and receiving emotional support in CMSS groups has positive effects on emotional well-being for breast cancer patients with higher emotional communication, while the same exchanges have detrimental impacts on emotional well-being for those with lower emotional communication competence. The theoretical and practical implications for future research are discussed.