◆ Charee M Thompson, University of Illinois at Urbana-Champaign
◆ Manuel D. Pulido, University of Illinois at Urbana-Champaign
◆ Sarah Caban, University of Illinois at Urbana-Champaign
Individuals with mental illnesses often narrate how others are unsupportive of their experiences living with and managing their illnesses. However, we lack robust theoretical explanations for the provision of inadequate social support. Drawing from appraisal theories of uncertainty, we developed a model hypothesizing that individuals’ uncertainty about others’ mental illnesses is associated with fear/anxiety appraisals that decrease social support efficacy, in turn leading to less and poorer quality social support. Put differently, we predicted that fear/anxiety and social support efficacy mediate the association between mental illness uncertainty and support quantity and quality.
We recruited 300 individuals living in the US (Mage = 34.07, SD = 9.49; 50% female, 50% male) through TurkPrime who received US$3.50 for completing an online survey. Participants reported on friends (38.1%), family members (35.1%), and romantic partners (23.1%) who have had mental illnesses on average 10.20 years (SD = 9.01). Participants reported being aware of the mental illness(es) on average 6.05 years (SD = 6.59). We included measures of mental illness uncertainty (hereafter “uncertainty”), fear/anxiety, social support efficacy (hereafter “efficacy”), social support quantity (e.g., emotional, esteem, tangible, informational, network), and overall support quality. Using PROCESS, we tested six multiple mediation models: Models 1-5 for support quantity and Model 6 for overall support quality.
We found similar results for Models 1 and 2. Fear/anxiety and efficacy mediated the association between uncertainty and emotional and esteem support (total effect emotional, b = -.13, 95% CIs [-.19, -.06]; esteem, b = -.12, 95% CIs [-.19, -.05]). There was a negative indirect effect of uncertainty on emotional (b = -.20, 95% CIs [-.28, -.13]) and esteem (b = -.16, 95% CIs [-.24, -.08]) support through efficacy. There was a positive indirect effect of uncertainty on emotional (b = .18, 95% CIs [.12, .25]) and esteem (b = .13, 95% CIs [.07, .20]) support through fear/anxiety.
We found similar results for Models 3-5. Only fear/anxiety mediated the association between uncertainty and network (b = .16, 95% CIs [.10, .23]), informational (b = .19, 95% CIs [.08, .31]), and tangible (b = .15, 95% CIs [.09, .22]) support. Uncertainty had a negative direct effect on network (b = -.20, 95% CIs [ -.32, -.08]), informational (b = -.14, 95% CIs [ -.24, -.04]), and tangible (b = -.19, 95% CIs [ -.30, -.07]) support.
For Model 6, fear/anxiety and efficacy mediated the association between uncertainty and overall support quality (total effect, b = -.36, 95% CIs [-.44, -.27]). There was a negative indirect effect of uncertainty on overall support quality through efficacy (b = -.30, 95% CIs [-.39, -.21]).
As hypothesized, uncertainty had a negative direct or indirect effect on all support types and overall support quality, partly through decreases in efficacy. Counter to predictions, fear/anxiety predicted support quantity for all types. Findings point to a difficult situation for support providers: although uncertainty motivates support provision by activating fear/anxiety, this effect may be undermined for forms of support that require complex communication skills (e.g., emotional, esteem, overall quality) through corresponding decreases in efficacy.