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Perceived alliance with mental health support content on social media predicts self-reported relief and behavior change in university students
ABSTRACT
Background:
Social media platforms are increasingly used as informal sources of mental health support, especially among young people. However, the relational mechanisms underlying their perceived benefits remain poorly understood.
Objective:
This study examined whether perceived working alliance with mental health–related social media content predicts self-reported psychological relief and behavior change among university students, and whether these effects are influenced by baseline psychological distress.
Methods:
A cross-sectional online survey was conducted among 443 Czech university students (mean age 21.6; 72% female). Participants completed measures of psychological distress (Kessler-6), perceived working alliance with social media content (WAI-TECH-SF), and reported outcomes including perceived relief from distress and self-reported real-life behavior change. Relationships were tested using latent variable path analysis with bootstrap estimates.
Results:
Path analysis revealed that perceived alliance predicted perceived benefit (β = 0.59, p < .001), encompassing both psychological relief and behavior change. Psychological distress did not significantly predict alliance or benefit after bootstrap adjustment, suggesting that perceived connection to content operates independently of initial distress levels. Notably, initial psychological distress did not predict alliance or benefit after bootstrap adjustment, suggesting that perceived connection to digital content operates independently of baseline distress. However, a one-way ANOVA showed significant group differences in distress (F(2, 415) = 5.07, p < .01): students who intentionally followed mental health content on social media reported the highest distress levels, followed by those with incidental exposure, and finally those with no engagement, implying that students experiencing greater distress may actively seek such content as a self-support strategy. Notably, 76.5% of students expressed support for institutions such as schools or hospitals to recommend evidence-based and professionally reviewed content—highlighting a demand for trusted guidance in navigating digital mental health resources.
Conclusions:
Our findings suggest that it is possible for users to experience a relational bond or alliance with mental health content on social media, and that this perceived connection may shape how much and what kind of support they take from it. These results highlight the importance of not only content design and empathy but also the role of trust, professional recommendation, and credibility of content creators. Clinical Trial: Not registered
Citation
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.