New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA.
Child Study Center, Yale School of Medicine, New Haven, CT, USA.
J Child Psychol Psychiatry. 2022 Feb;63(2):210-217. doi: 10.1111/jcpp.13427. Epub 2021 Apr 6.
Confronting stigma early in life could enhance receptivity to seeking treatment. We evaluated the efficacy of social contact interventions to reduce stigma toward depression and to enhance treatment-seeking intentions among adolescents. We hypothesized that the brief video-based interventions would be more effective than their matched controls.
Using crowdsourcing, we recruited and randomly assigned 1,183 participants aged 14-18 to one of four video-based stimuli on a 4:4:1:1 ratio: (a) adolescent girl with depression; (b) adolescent boy with depression; (c) same girl, without depression; or (d) same boy, without depression. In each of the ~100-second-long videos, two simulated patients (SPs) depicted empowered presenters sharing their personal stories. In the depression conditions, SPs described how social support from family, friends, and professionals helped them overcome their symptoms and recover.
We found a significant effect for the Depression Stigma Scale (DSS) between active and control groups (F = 27.4, p < .001). We found a significant increase in treatment-seeking intentions, as measured by the General Help-Seeking Questionnaire (GHSQ; p < .001). Secondary analyses revealed that racial (but not gender) congruence between protagonists and participants resulted in greater stigma reduction and treatment seeking, as compared to racially incongruent pairings (t = 2.9, p = .004).
A brief video-based intervention effectively reduced stigma toward depression and increased treatment seeking among adolescents. Favorable changes were greater when race (but not gender) was congruent between protagonists and participants. Future studies should explore how to optimize brief contact-based interventions according to adolescents' race and ethnicity and how to scale such interventions to novel online platforms of dissemination.
在生命早期直面污名化问题可能有助于提高对治疗的接受度。我们评估了社会接触干预措施减少对抑郁症的污名化以及增强青少年寻求治疗意愿的效果。我们假设,简短的基于视频的干预措施将比对照组更有效。
我们使用众包方式招募了 1183 名年龄在 14 至 18 岁之间的参与者,并将他们随机分为四组,每组比例为 4:4:1:1,分别接受以下四种基于视频的刺激:(a)患有抑郁症的少女;(b)患有抑郁症的少年;(c)没有抑郁症的同一位少女;或(d)没有抑郁症的同一位少年。在每个约 100 秒长的视频中,两个模拟患者(SP)描绘了有能力的讲述者分享他们的个人故事。在抑郁症的条件下,SP 描述了家庭、朋友和专业人士的社会支持如何帮助他们克服症状并康复。
我们发现,主动组和对照组之间的抑郁污名量表(DSS)有显著差异(F=27.4,p<.001)。我们发现,一般求助问卷(GHSQ)的测量结果表明,寻求治疗的意愿显著增加(p<.001)。二次分析表明,与种族不一致的配对相比,主角和参与者之间的种族(但不是性别)一致性导致了更大的污名化减少和治疗寻求(t=2.9,p=.004)。
简短的基于视频的干预措施有效地减少了青少年对抑郁症的污名化,并增加了他们寻求治疗的意愿。当主角和参与者之间的种族(但不是性别)一致时,有利的变化更大。未来的研究应该探索如何根据青少年的种族和族裔优化简短的基于接触的干预措施,以及如何将这些干预措施扩展到新的在线传播平台。