1 Texas A&M University, College Station, TX, USA.
Health Educ Behav. 2019 Jun;46(3):463-470. doi: 10.1177/1090198118811898. Epub 2018 Nov 8.
Despite a growing mental health crisis in the United States, empirical indicators of what could make a depression help-seeking message effective and why are currently not available. Even worse, some depression help-seeking messages can activate negative beliefs among depressed individuals that may make help-seeking even less likely than before. The current study is based on the premise that normative theoretical frameworks used for health promotion purposes might not work in populations affected by depression. Addressing a primary driver for health behavior change in gain-and-loss framing, the present research examines the nature of risk perceptions regarding help-seeking among those with depressive symptomatology who have not yet sought help ( N = 738) to inform more effective suicide prevention efforts. Previously, quantitative analyses revealed that the effectiveness of gain-and-loss framing, particularly on attitudes toward help-seeking, depends on the severity of depressive symptomatology. Whereas a persuasive gain-frame advantage was found for those with mild and severe depression symptoms, both framing strategies appeared to backfire and worsen attitudes among those with moderately severe depression symptoms. The present study enriches those results by conducting an in-depth analysis of risk perceptions regarding help-seeking to inform more effective depression help-seeking messages. Risk perceptions were primarily indicative of stigma and the related resistance to seeking help. Judgment and mistreatment were expected not only from the general public but also from the mental health professionals from whom help should be sought. Theoretical and practical implications are discussed.
尽管美国的心理健康危机日益严重,但目前还没有关于哪些因素可以使治疗抑郁症的求助信息有效以及为什么有效的实证指标。更糟糕的是,一些治疗抑郁症的求助信息可能会激活抑郁症患者的负面信念,使他们更不愿意寻求帮助。本研究基于这样一个前提,即用于促进健康目的的规范理论框架可能不适用于受抑郁症影响的人群。本研究以增益-损失框架在促进健康行为改变方面的主要驱动因素为基础,考察了尚未寻求帮助的具有抑郁症状人群(N=738)对求助风险认知的性质,以期为更有效的自杀预防工作提供信息。先前的定量分析表明,增益-损失框架的有效性,特别是对求助态度的影响,取决于抑郁症状的严重程度。对于轻度和重度抑郁症状的人来说,增益框架的优势具有说服力,而对于中度抑郁症状的人来说,两种框架策略似乎都适得其反,使他们对求助的态度恶化。本研究通过对求助风险认知进行深入分析,为更有效的治疗抑郁症的求助信息提供信息,进一步丰富了这些结果。风险认知主要表明了耻辱感和相关的求助抵制。不仅预期来自公众,也预期来自本应寻求帮助的心理健康专业人员的判断和虐待。讨论了理论和实践意义。