State Psychological Reactance to Depression Public Service Announcements Among People With Varying Levels of Depressive Symptomatology

The Impact of Video-Based Microinterventions on Attitudes Toward Mental Health and Help Seeking in Youth: Web-Based Randomized Controlled Trial

BACKGROUND

Mental health (MH) problems in youth are prevalent, burdening, and frequently persistent. Despite the existence of effective treatment, the uptake of professional help is low, particularly due to attitudinal barriers.

OBJECTIVE

This study evaluated the effectiveness and acceptability of 2 video-based microinterventions aimed at reducing barriers to MH treatment and increasing the likelihood of seeking professional help in young people.

METHODS

This study was entirely web based and open access. The interventions addressed 5 MH problems: generalized anxiety disorder, depression, bulimia, nonsuicidal self-injury, and problematic alcohol use. Intervention 1 aimed to destigmatize and improve MH literacy, whereas intervention 2 aimed to induce positive outcome expectancies regarding professional help seeking. Of the 2435 participants who commenced the study, a final sample of 1394 (57.25%) participants aged 14 to 29 years with complete data and sufficient durations of stay on the video pages were randomized in a fully automated manner to 1 of the 5 MH problems and 1 of 3 conditions (control, intervention 1, and intervention 2) in a permuted block design. After the presentation of a video vignette, no further videos were shown to the control group, whereas a second, short intervention video was presented to the intervention 1 and 2 groups. Intervention effects on self-reported potential professional help seeking (primary outcome), stigma, and attitudes toward help seeking were examined using analyses of covariance across and within the 5 MH problems. Furthermore, we assessed video acceptability.

RESULTS

No significant group effects on potential professional help seeking were found in the total sample (F2,1385=0.99; P=.37). However, the groups differed significantly with regard to stigma outcomes and the likelihood of seeking informal help (F2,1385=3.75; P=.02). Furthermore, separate analyses indicated substantial differences in intervention effects among the 5 MH problems.

CONCLUSIONS

Interventions to promote help seeking for MH problems may require disorder-specific approaches. The study results can inform future research and public health campaigns addressing adolescents and young adults.

TRIAL REGISTRATION

German Clinical Trials Register DRKS00023110; https://drks.de/search/de/trial/DRKS00023110.

Effort and effort discounting as predictors of seeking psychotherapy among individuals with depression

OBJECTIVES

Many individuals who experience depression do not seek psychotherapy, and past research has had limited success in predicting help-seeking in this population. Accounting for behavioral characteristics of depression that affect help-seeking decisions, such as effort discounting (devaluation of rewards as a function of effort), may address this gap.

METHODS

Individuals with moderate-severe depression symptoms who were not in psychotherapy (N = 253) reported their depression symptom severity and the amount of effort they anticipated seeking psychotherapy would require; they also completed a behavioral measure of effort discounting. At a 3-month follow-up, they reported whether they initiated psychotherapy during the follow-up period.

RESULTS

Depression symptom severity was associated with perceptions that seeking psychotherapy would be more effortful. In turn, perceptions that seeking psychotherapy would be more effortful prospectively predicted a lower likelihood of initiating psychotherapy. Effort discounting was unrelated to psychotherapy use.

CONCLUSIONS

These results suggest that differences in the anticipated effort required to seek psychotherapy can increase depressed individuals' risk of going untreated. Future research may test whether reducing the effort of seeking psychotherapy increases psychotherapy use among those with depression. For instance, streamlining insurance enrollment procedures, implementing patient decision aids, or offering telehealth treatment options may be beneficial.

A Reasoned Action Approach to Depression Help-Seeking Messaging for College Students: Implications of Cognitive Biases in Depression

In this study we integrated insights from research on cognitive biases in depression with the reasoned action approach to predicting and changing behavior (RAA) with the goal of identifying implications for help-seeking messaging for college students with varying levels of depression. Findings from a sample of 374 U.S. college students support the ability of RAA to explain help-seeking intentions for non-depressed, mildly depressed students, and moderate to severely depressed students. More severe depression was associated with less favorable attitudes, perceived norms, perceived capacity, and intention; changes in the relative strength of attitudes, perceived norms, and perceived capacity in explaining help-seeking intentions; stronger expectations of negative outcomes of help-seeking and weaker expectations of positive outcomes; and to some extent, stronger expectations of negative outcomes for oneself than for others. These findings underscore that depressed students construe help-seeking differently than non-depressed students, and that depressed and non-depressed students need different help-seeking messages.

The Influence of Pop Songs Referencing Anxiety, Depression, and Suicidal Ideation on College Students' Mental Health Empathy, Stigma, and Behavioral Intentions

U.S. college students' general mental health is rapidly declining, and scholars have observed significant increases in references to depression, suicide, and mental health metaphors in popular music. Given that college students are spending more time than ever before listening to popular music, this survey aimed to assess some of the potential implications. College students (N = 253) completed an online survey about their exposure to contemporary pop songs that reference mental health difficulties such as anxiety, depression, and suicidal ideation. Both college students' increased perceived personal connection (PPC) with the songs referencing mental health difficulties and parasocial relationships (PSR) with their performing artists were associated with increased mental health empathy. This increased mental health empathy mediated outcomes including reduced mental health stigma, increased support for public mental health resources, and increased willingness to support others struggling with their mental health. Neither PPC with the song nor PSR with the song's artist was associated with personal willingness to seek mental health help. However, post hoc analyses revealed that college students who reported stronger PPC to these songs also reported that they use music to "deal with their own mental health issues." This study's findings suggest that pop music artists who open up about mental health difficulties may have potential as novel message sources in communication campaigns designed to improve mental health outcomes among college students.

Involving Crowdworkers with Lived Experience in Content-Development for Push-Based Digital Mental Health Tools: Lessons Learned from Crowdsourcing Mental Health Messages

Digital tools can support individuals managing mental health concerns, but delivering sufficiently engaging content is challenging. This paper seeks to clarify how individuals with mental health concerns can contribute content to improve push-based mental health messaging tools. We recruited crowdworkers with mental health symptoms to evaluate and revise expert-composed content for an automated messaging tool, and to generate new topics and messages. A second wave of crowdworkers evaluated expert and crowdsourced content. Crowdworkers generated topics for messages that had not been prioritized by experts, including self-care, positive thinking, inspiration, relaxation, and reassurance. Peer evaluators rated messages written by experts and peers similarly. Our findings also suggest the importance of personalization, particularly when content adaptation occurs over time as users interact with example messages. These findings demonstrate the potential of crowdsourcing for generating diverse and engaging content for push-based tools, and suggest the need to support users in meaningful content customization.

Online Public Rumor Engagement Model and Intervention Strategy in Major Public Health Emergencies: From the Perspective of Social Psychological Stress

During major public health emergencies, a series of coupling problems of rumors getting out of control and public psychological imbalance always emerge in social media, which bring great interference for crisis disposal. From the perspective of social psychological stress, it is important to depict the interactive infection law among distinct types of rumor engagers (i.e., advocates, supporters, and amplifiers) under different social psychological stress states, and explore the effectiveness of rumor intervention strategies (i.e., hindering and persuasion) from multiple dimensions, to scientifically predict the situation of public opinion field and guide the public to restore psychological stability. Therefore, this paper constructs an interactive infection model of multiple rumor engagers under different intervention situations based on a unique user-aggregated dataset collected from a Chinese leading online microblogging platform (“Sina Weibo”) during the COVID-19 in 2020. The simulation result shows that (1) in the period of social psychological alarm reaction, the strong level of hindering intervention on the rumor engagers leads to more serious negative consequences; (2) in the period of social psychological resistance, the persuasion and hindering strategies can both produce good outcomes, which can effectively reduce the overall scale of rumor supporters and amplifiers and shorten their survival time in social media; (3) in the period of social psychological exhaustion, rumor intervention strategies are not able to have a significant impact; (4) the greater the intensity of intervention, the more obvious the outcome. Experimental findings provide a solid research basis for enhancing social psychological stress outcomes and offer decision-making references to formulate the rumor combating scheme.

Promoting Favorable Attitudes Toward Seeking Counseling Among People With Depressive Symptomatology: A Masspersonal Communication Approach

The Internet widely display interactions between various parties, calling for research to understand how message- and source-related factors in these easily observed interactions influence observers' attitudes in health contexts. From a masspersonal communication perspective, we investigated how reading a conversation about seeking counseling between two members of an online support group affects individuals' attitudes toward counseling-seeking behavior. In the conversation, one group member asked for advice about depressive symptoms, and in our online experiment with adults living in the United States (N = 250), we manipulated the responding source's expert status and framing of the message that recommended seeking counseling. Guided by an overarching theoretical framework-dual-process theory of supportive communication outcomes, we found a significant three-way interaction among severity of depressive symptomatology (low vs. high), message framing (gain vs. loss), and source expertise (peer vs. peer counselor vs. professional counselor). When a peer counselor provided the message, loss framing reduced self-stigma toward seeking counseling to a greater degree than gain framing and, in turn, induced more favorable attitudes toward the behavior among people with a high severity of depressive symptomatology. Those findings provide theoretical insights into the masspersonal communication approach to health promotion and inform promising communication strategies to promote counseling-seeking behavior among people with depressive symptomatology.

Using counterframing strategies to enhance anti-stigma campaigns related to mental illness

RATIONALE AND METHODS

Despite the prevalence of media-based anti-stigma campaigns, there is little empirical evidence of their effectiveness and little guidance regarding which communicative strategies can bolster their message. Using a Belgian sample (N = 737) recruited in March-April 2019, the current experimental study manipulated a campaign message using counterframing strategies. Hierarchical linear regression analyses were used to investigate the effectiveness of the resulting nine variants.

RESULTS

Campaign effectiveness was most increased by stating that people with a mental illness are "not free-riders or poseurs", or by redefining them as "go-getters" who are "certainly not abnormal or crazy". These variants decreased desired social distance, and significantly reduced stereotype endorsement for people with a high need for cognitive closure. Whereas several campaigns decreased attitudinal stigma for people with a high need for cognitive closure, they inadvertently increased it for people with a low need for cognitive closure.

CONCLUSION

This study indicates that small changes in the body copy can impact a campaign's destigmatizing potential. As such, empirical testing is essential to avoid ineffective or counter-productive anti-stigma interventions. Moreover, this study demonstrates that refuting stigmatizing statements can be a valid strategy in anti-stigma interventions, even though previous literature has argued against it.

Exploring perceived costs and benefits of first aid for youth with depression: a qualitative study of Japanese undergraduates

BACKGROUND

Early interventions for depression among youth are greatly needed. Although Youth Mental Health First Aid (YMHFA) program has been developed to teach the public how to help young people with mental disorders, including depression, it has assumed human altruism and overlooked the possibility that participants would experience conflict between the costs and benefits of helping behaviors. The present qualitative study, therefore, initially explored content of the costs and benefits perceived by youth in terms of helping their peers with depression.

METHODS

A total of 56 Japanese undergraduates (32 female, 24 male; M age  = 20.20, SD = 1.09) participated in the face-to-face survey. They were provided with basic knowledge about helping behaviors and were presented with a vignette describing an undergraduate with depression. Then, they left free descriptive comments on their views of the costs/benefits of helping/not helping the person in the vignette. As supplemental quantitative analyses, we statistically compared numbers of labels (n = 624), which were obtained from participants' comments, across two (costs/benefits) × two (helping/not helping) domains. Finally, we conducted a qualitative content analysis that combined inductive and deductive methods to categorize these labels.

RESULTS

The supplemental quantitative analyses (i.e., ANOVA and post hoc analyses) on the numbers of labels highlighted that the participants perceived suppressors (i.e., costs of helping, benefits of not helping) as well as motivators (i.e., costs of not helping) in making decision to help peers with depression. The qualitative content analysis mainly showed that: (i) the categories in each domain covered multiple facets of costs and benefits, including negative/positive effects on the participants themselves, the person in the vignette, and interpersonal relationships; and that (ii) the participants perceived the conflicts of costs and benefits regardless of whether they help their peers with depression.

CONCLUSIONS

These results provide evidence for how young people experience the conflicts between the costs and benefits of helping behaviors toward their peers with depression and reveal specific content of these costs and benefits. These findings could serve as a basis for extending YMHFA programs and designing educational content to promote public helping behaviors in realistic situations.

Understanding Information Seeking about the Health of Others: Applying the Comprehensive Model of Information Seeking to Proxy Online Health Information Seeking

A significant proportion of online health information seeking is related to the health of others, such as the one of family members and friends, instead of an individual's own health. Understanding these behaviors of proxy seekers, i.e., individuals who seek information about the health of others, can improve the transmission of health information to and social support for others. The comprehensive model of information seeking (CMIS) is an established model that predicts information seeking for the individual seeker. The model was modified and extended with concepts of social network ties to predict proxy information seeking intentions and the resulting social support intentions. Hypothetical scenarios of persons from the social network suffering from depression were varied in severity of disease and the relationship closeness to test their influence on model variables. Structural equation modeling (N = 607) served to evaluate the associations between the health-related factors and proxy health information seeking intentions, as well as support intentions. The results confirmed the direct effects of beliefs on information-carrier utility. Contrary to expectations, demographics, experience, and salience had direct effects on proxy information seeking intentions. The results indicate that a modified CMIS helps to better meet surrogate seekers' needs for supporting patients.

Can Mental Health Anti-stigma Messages Have Untoward Effects on Some People with Depression?: An Exploratory Study

Scholars have warned that mental health anti-stigma campaigns targeting the general public can possibly be detrimental to some who are stigmatized. Scholars also have noted that people with depression respond to some public service announcements (PSAs) differently than those without. Accordingly, the current study explored whether anti-stigma PSAs targeting the general public could cause problematic outcomes for people with depression. Participants with (n = 55) and without (n = 133) heightened depressive symptomatology viewed two mental health anti-stigma PSAs. Participants provided thoughts about the PSAs through a single, open-ended question. To allow for an assessment of convergence, participants rated overall favorability toward each PSA through a close-ended item. Results indicated that most qualitative responses were favorable; however, 23.6% of respondents with heightened depressive symptomatology, compared to 1.5% without, provided responses coded as indicating that at least one PSA caused unintended negative affect, χ²(1) = 25.96, [Formula: see text] p < .001. Evidence of untoward effects primarily came from the Friend PSA and the qualitative responses indicate how this occurred. Moreover, complementing the qualitative coding, the Friend PSA was rated less favorably by participants with heightened depressive symptomatology (M = 5.00, SD = 1.67), than those without (M = 5.64, SD = 1.44), F(1, 186) = 6.99, p = .009, η_p² = .036. There were no significant differences in quantitative favorability ratings regarding the Labeling PSA. Indicating that further investigation is warranted, results suggest it is possible for an anti-stigma PSA targeting the general public to cause unintended negative affect among some people with depression.

A Mixed Methods Approach to Creating Depression Public Service Announcements by Collaborating with People with Depressive Symptomatology

Depression is a treatable condition; unfortunately, many do not seek help. Depression public service announcements (D-PSAs) are one means of increasing help-seeking behavior. However, as Beck's cognitive theory of depression indicates, it can be challenging to persuade people with depression. Although there have been successful D-PSAs, some have been ineffective or led to boomerang effects. With the goal of providing guidance for future messages, we use a mixed-methods approach to assess how people with heightened depressive symptomatology perceive motivations and barriers regarding help-seeking. Study 1 participants (N = 186), with and without depressive symptomatology, provided motivations and barriers to seeking help for depression. Study 1's qualitative analysis determined 112 motivations and 124 barriers to help-seeking. Study 2 participants (N= 214), all with heightened depressive symptomatology, rated the motivations and barriers from Study 1 on their attitude function, importance, awareness, and argument strength. This insight guided successful D-PSA creation in a follow-up study, reported elsewhere. The methodological approach utilized, and the specific motivations and barriers revealed, will ideally assist scholars and practitioners seeking to develop future D-PSAs.

Responses to persuasive messages encouraging professional help seeking for depression: comparison between individuals with and without psychological distress

BACKGROUND

The persuasive effect of health messages can depend on message features, audience characteristics, and target behaviors. The objective of this study was to compare the responses to persuasive messages encouraging professional help seeking for depression between individuals with and without psychological distress.

METHODS

A cross-sectional web-based survey was conducted on Japanese adults aged 35-45 years, who randomly received one of three persuasive messages that aimed to promote help-seeking intentions for depression. The primary message statements were as follows: (1) depression can happen to anyone, (2) depression needs treatment, and (3) depression improves with treatment. Participants rated the messages in terms of comprehensibility, persuasiveness, emotional response, and intended future use. Help-seeking intention for depression was measured using vignette methodology before and after exposure to the messages. Eligible participants who had not received medical treatment for their mental disorders were classified as either distressed (K6 score ≥ 5, N = 824) or non-distressed (K6 score < 5, N = 1133) and analyzed.

RESULTS

No significant differences in comprehensibility or persuasiveness scores were observed between the messages, but the distressed group had significantly lower scores than the non-distressed group. Negative emotional responses such as surprise, anger, fear, sadness, guilt, and anxiety were significantly stronger when reading message 2, while a positive emotional response such as happiness was significantly stronger when reading message 3. These emotional responses were more prominent in the distressed than in the non-distressed group. After reading messages 1, 2, and 3, the proportions of participants in the distressed group who reported having a positive help-seeking intention increased by 35.1%, 32.1%, and 27.7%, respectively, and by 6.4%, 17.3%, and 15.2%, respectively in the non-distressed group. Multiple logistic regression analysis among participants having no help-seeking intention before exposure to the messages showed that message 2 had a significantly greater effect of increasing help-seeking intentions in the non-distressed group.

CONCLUSION

The exposure to persuasive messages may promote help-seeking intentions for depression. It seems likely that loss framing will work better than neutral and gain framing. Meanwhile, the responses to persuasive messages may differ to some extent between distressed and non-distressed individuals, as individuals with psychological distress are likely to be more susceptible to persuasive messages than those without.

TRIAL REGISTRATION

Not applicable; this is not a report of intervention trial.

Should We Activate Risk Perceptions in the Context of Suicide Prevention? Examining Fear Appeals, Help-Seeking Determinants, and Help-Seeking Sources Among University Employees Who Suffer from Depression

Health promotion strategies have largely focused on activating risk perceptions for health conditions in resistant at-risk populations in order to induce behavior change. Yet, doing so remains a questionable approach when promoting help-seeking behaviors among individuals who suffer from depression because clinical symptoms can negatively affect interpretations and responses to such efforts. This study sought to test the effects and effectiveness of risk-based health messaging utilizing fear appeals on help-seeking determinants, intentions, and sources. One hundred seventeen university employees affected by symptoms of depression were recruited to participate in a lab-based experimental setting. Participants were randomly assigned to one of three message conditions that differed in strength of fear appeal (low, moderate, high) when inducing suicide risk perceptions and promoting help-seeking. Consistent with previous research, participants indicated high stigma perceptions and low intentions to seek help. Risk-based messaging strategies such as fear appeals did not have an effect on help-seeking intentions in this sample. Intentions were largely determined by positive outcome expectations and social norms, whereas efficacy perceptions were positive and not a predictor of help-seeking intentions. Participants were most likely to seek help from intimate partners and friends and least likely to utilize a help-line. Health promotion messages should contain cues that activate, rather than change, the already positive outcome expectations of seeking help when targeting at-risk populations. Future research should explore possibilities for health promotion and education among support networks of those who suffer from depression and anxiety.

Explaining Intentions to Seek Help for Depressive Symptoms in the Context of Responsibility Message Framing

U.S. college students are disproportionally affected by depression but typically do not seek help. To advance understanding of the role of health messages in shaping college students' help-seeking intentions, we used a reasoned action approach to experimentally investigate help-seeking intentions for depressive symptoms. Due to negative interpretation biases among those who suffer from depression, scholars have previously warned against attempts to decrease feelings of responsibility for one's depression in health messages. We tested the determinants of help-seeking intentions as a function of exposure to depression help-seeking messages that differed in responsibility cues. Findings revealed that in our sample low responsibility health message framing did not affect determinants of help-seeking intentions. We identified instrumental attitude (β = .53) and descriptive norms (β = .24) as determinants of intentions to seek help (R² = .42) across message conditions and across levels of depression. These findings indicate potentially important targets for messages that seek to increase help-seeking among depressed college students.

Increasing Help-Seeking Outcomes among People with Elevated Depressive Symptomatology with Public Service Announcements: An Examination of Functional Matching and Message Sidedness

The current experimental study assessed the utility, and potential harm, of depression public service announcements (D-PSAs) that were matched, moderately matched, or mismatched based on attitude function (i.e., social-adjustive or object-appraisal) and either one-sided or refutational two-sided. US adults (N = 567) with mild to severe depressive symptomatology were randomly assigned to view control messages or one set of D-PSAs. Results indicate that functionally matched D-PSAs, regardless of message sidedness, caused more favorable help-seeking outcome expectations, attitudes, and intentions compared to the control messages. Exposure to the mismatched D-PSAs, particularly refutational, led to less-favorable help-seeking outcome expectations, attitudes, and intentions compared with the control condition. Help-seeking outcomes among those exposed to the moderately matched messages were not significantly different from those exposed to the control messages, with the exception of those exposed to the one-sided moderately matched messages. The one-sided moderately matched messages resulted in lower help-seeking intentions than the control messages. Overall, results indicate that if messages can be tailored to match the recipients' attitude functions, help-seeking outcomes among people with heightened depressive symptomatology can be increased. However, the results also indicate that some D-PSAs can have negative effects.

Improving perceptions of cognitive-behavioral therapy with brief website exposure: Does neuroscientific allure impact attitudes?

BACKGROUND AND OBJECTIVES

The current study aimed to determine whether brief exposure to a webpage about cognitive-behavioral therapy (CBT) for the anxiety disorders improved knowledge and perceptions of this treatment. Further, this study tested whether participants were uniquely compelled by CBT if the mechanism of change cited neurological processes.

METHOD

Participants (N = 389) recruited online viewed a webpage screenshot that described CBT for anxiety. Participants were randomized to view a version of the webpage which either described the mechanism of change as: 1) psychological, 2) neurological, 3) combination of neurological and psychological, or 4) no mechanism described. Participants completed measures of knowledge and perception of CBT before and after viewing the webpage. Credibility ratings and symptoms were assessed after viewing the webpage.

RESULTS

Knowledge of CBT was limited and perceptions were largely neutral to somewhat positive at baseline. Both knowledge and perceptions of CBT meaningfully improved after viewing the webpage. Mechanism of change did not impact perceptions of CBT or its credibility, though in the neurological and combination conditions there was less improvement in knowledge than in the psychological or control conditions. Greater symptoms of anxiety were associated with slightly less improvement in knowledge and perceptions.

LIMITATIONS

The study did not include long-term follow up, so the durability of the effects is unknown. Further, sample homogeneity undermines broad generalizability.

CONCLUSIONS

There is significant room and capacity to improve lay-people's knowledge and perceptions of CBT. Neurological explanations did not appear to uniquely promote the perception of CBT or its credibility.

Matching Message Design and Depressed Cognition: An Exploration of Attention Patterns for Gain- and Loss-Framed Depression Help-Seeking Messages

Although disproportionally affected by depression, most depressed college students do not seek the help they need. Research has recently uncovered the potential negative effects of depression help-seeking messages if depressed cognition is not considered in the health message design process. It is unclear if depression determines whether and how individuals pay attention to gain- and loss-framed depression help-seeking messages-a mechanism that has significant implications for the strategic planning of health communication interventions. In order to enable the effective matching of message design and audience features, this study investigated attention patterns for gain (n = 75)- and loss (n = 78)-framed depression help-seeking messages using eye-tracking technology and self-report measures. The results confirmed that depression is a characteristic of risk avoidance and negative cognition. Depressed participants tended to pay more attention to disease information that was placed in a loss-framed rather than a gain-framed depression help-seeking message. Using negative message framing strategies for health messages seeking to educate about depression symptoms might therefore be a useful persuasive strategy-particularly when disseminated to vulnerable populations affected by depression. Furthermore, the present study emphasizes the effective use of eye-tracking technology in communication research.

Social mediation of persuasive media in adolescent substance prevention

Social commentary about prevention messages may affect their likelihood of acceptance. To investigate this possibility, student participants (N = 663) viewed 3 antimarijuana advertisements, each followed immediately by videotaped discussions involving 4 adults or 4 adolescents using either extreme or moderate language in their positive commentaries. The commentaries were expected to affect participants' perceptions of the extent to which the ads were designed to control their behavior (perceived control), which was hypothesized to inhibit persuasion. Two indirect effects analyses were conducted. Marijuana attitudes and usage intentions were the outcome variables. Both analyses revealed statistically significant source by language interactions on participants' perceived control (both p < .02). Further analyses revealed significant indirect effects of language extremity on attitudes and intentions through perceived control with adult, but not peer sources (both p < .05). These perceptions were associated with more negative marijuana attitudes and diminished usage intentions when adults used moderate (vs. extreme) language in their favorable ad commentaries (both p < .05). The findings may facilitate development of more effective prevention methods that emphasize the importance of the role of perceived control in persuasion, and the impact of interpersonal communication variations on acceptance of media-transmitted prevention messages. (PsycINFO Database Record

Depression, help-seeking perceptions, and perceived family functioning among Spanish-Dominant Hispanics and Non-Hispanic Whites

INTRODUCTION

Guided by Beck's (1967) cognitive theory of depression, we assessed whether perceived family functioning (PFF) mediated the relationship between depressive symptomatology and help-seeking inclinations.

METHODS

Study 1 included 130 Spanish-Dominant Hispanics and Study 2 included 124 Non-Hispanic Whites obtained using online crowd sourcing. Participants completed measures of depressive symptomatology, PFF, and several scales measuring aspects of help seeking inclinations and self-stigma. Study 2 also included an experiment. With an eye toward potential future interventions, we assessed the malleability of PFF. Specifically, participants were randomly assigned to recall positive or negative family experiences and then PFF was measures for a second time.

RESULTS

Both studies found PFF mediates the relationship between depressive symptomatology and the help seeking scales. Among non-depressed people, the positive manipulation improved PFF; however, among participants with elevated depressive symptomatology, writing about a positive family experience worsened PFF.

LIMITATION

With the exception of the experiment, most of the data were cross-sectional. For the experiment, it is possible that different manipulations or primes could have different effects.

CONCLUSION

Whether investigating responses from Spanish-Dominant Hispanics or Non-Hispanic Whites, PFF mediates the negative relationship between heightened depressive symptomatology and familial help-seeking beliefs, as well as self-stigma. However, even though the mediation analysis offers preliminary support that increasing PFF can potentially increase help-seeking behaviors of Hispanic and Non-Hispanic White people with depression, the results of the interaction analysis, specifically the negative impact of writing about positive family memories on people with elevated depression, illustrates the challenges of persuading people with depression.