Emotional expression and empathy in an online peer support platform.

Online peer groups are a popular channel for mental health support, but the evidence for their effectiveness is mixed. The present study focused on empathy to better identify which supporters' comments regulated seekers' distress. We also explored how seekers' emotions may shape supporters' empathy. Posts (N = 7,646) published on an online peer support platform ("Emotional first aid [ERAN]") were sourced. Supporters' empathy (empathic concern, personal distress, exploration, and interpretation) and seekers' emotional expressions (soft negative, hard negative, and positive) were coded. We hypothesized that (1) empathic concern, exploration, and interpretation (but not personal distress) would predict better seekers' emotions (lower negative emotions and greater positive ones); (2) support seekers' soft negative and positive emotions would predict supporters' empathic concern and cognitive empathy (i.e., exploration and interpretation); but that (3) hard negative emotions would predict supporters' personal distress. A set of cumulative mixed models revealed that empathic concern predicted more seekers' positive emotions. However, cognitive empathy predicted more negative seekers' emotions. Seekers' soft negative emotions predicted greater expressions of supporters' empathy (of all types). Finally, seekers' positive emotions predicted more supporters' empathic concern and less personal distress, but also predicted less cognitive empathy (i.e., exploration). A secondary analysis found that this pattern of results differed to some extent as a function of the supporters' role as anonymous peers or the professional moderator. These findings suggest that empathy is a key component in online mental support platforms and that it may make online interactions more effective through emotional regulation. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Suicidality Calls to a National Helpline After a Terror Attack and War.

Importance: Changes in suicide rates after a nationwide trauma may be different from changes in psychiatric symptoms or general distress after such events. However, very few studies have examined short-term suicide-related reactions after such an event. Objective: To evaluate the short-term outcome of the events in Israel on October 7, 2023, a large-scale terror attack and unfolding war, on changes in suicidality as reflected in percentages of suicide-related calls in relation to all calls to a national mental health first aid helpline, the Israeli Association for Emotional First Aid (ERAN). Design, Setting and Participants: The data included all interactions via the various ERAN helpline services between January 1, 2022, and December 31, 2023. Exposures: The October 7, 2023, terror attack on Israel. Mean Outcomes and Measures: Changes in the numbers of overall calls and suicide-related calls to the ERAN helpline using an interrupted time-series analysis. Results: A total of 602 323 calls were received by the ERAN helpline. The number of calls reflecting psychological distress in the 3 months before October 7, 2023, was 67 555 compared with 89 445 calls in the 3 months after. Analysis indicated that overall calls increased significantly on October 7 (ß = 2089.16; 95% CI, 1918.97-2259.35). In addition, the daily trajectory of all calls changed significantly after October 7 (ß = -22.77; 95% CI, -33.37 to -12.16), such that there was a decrease in the number of calls per day (ß = -11.34; SE = 1.213; t = -9.35; P < .001). The number of suicide-related calls in the 3 months before October 7 was 1887, whereas 1663 suicide-related calls were registered in the 3 months after. Analysis showed that there were no changes in the daily number of suicide-related calls from before October 7 (ß = -0.001; 95% CI, -0.005 to 0.03) or on October 7 (ß = -0.22; 95% CI, -3.69 to 3.25). Therefore, the percentage of suicide-related calls decreased significantly on October 7 (ß = -1.42; 95% CI, -1.92 to -0.92) and gradually increased in the following period (ß = 0.016; 95% CI, 0.006-0.026). Conclusions and Relevance: The findings of this cohort study suggest that although short-term emotional distress increased after national trauma, the percentage of suicide-related calls decreased. These results support previous studies suggesting that suicidality is not one of the immediate reactions to such traumas.