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A Randomized Controlled Trial of Direct-to-Consumer Advertising of Cognitive-Behavior Therapy for Depression
Title
A Randomized Controlled Trial of Direct-to-Consumer Advertising of Cognitive-Behavior Therapy for Depression
Creator
Antler, Caroline
Date
2020
Description
Almost half of individuals in the US struggling with depression never seek treatment and, of those that do, over half receive inadequate care....
Show moreAlmost half of individuals in the US struggling with depression never seek treatment and, of those that do, over half receive inadequate care. Although the efficacy of CBT for MDD is well established, the rate of individuals receiving psychotherapy has declined. With copious evidence supporting the effectiveness of direct-to-consumer advertising (DTCA) of pharmaceuticals, the current study evaluated the potential utility of DTCA of CBT for MDD.One hundred seventy-eight adults with (a) prior exposure to DTCA for antidepressants and (b) no mental health diagnoses or treatment were randomly assigned to view one of three video conditions: CBT for depression (CBT, n = 60), CBT plus information on antidepressants (CBT+MED, n = 58), or Control (arthritis and diabetes Public Service Announcements (PSAs); n = 60). After viewing the video participants completed measures of attitudes about, and willingness to engage in, CBT and antidepressant medication. The study was conducted online with participants being recruited through Prolific and the survey created via Qualtrics.Compared to controls, participants viewing CBT DTCA videos (with or without information on antidepressants) were more willing to engage in CBT, had less public and self-stigma associated with CBT, and believed CBT has less potential for harm. Compared to the CBT group, the CBT+MED group reported greater concern about the risks of disclosing personal information in a therapy setting.These results extend previous findings by applying the DTCA marketing style to a specific diagnosis and type of therapy. Findings indicate that DTCA-style ads for CBT for MDD can be effective in reducing stigma and increasing treatment willingness. They further suggest that DTCA-style marketing of evidence-based psychotherapies can be efficacious when created for specific treatments and disorders. The findings have substantial implications for public health and the dissemination of evidence-based practice.
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The effect of information overload on knowledge recall and related cognitions for an educational program based on the Mental Health First Aid Model
Title
The effect of information overload on knowledge recall and related cognitions for an educational program based on the Mental Health First Aid Model
Creator
Bink, Andrea B.
Date
2020
Description
Early-intervention public health education programs have been effective at teaching a skillset to help others. However, some of these programs...
Show moreEarly-intervention public health education programs have been effective at teaching a skillset to help others. However, some of these programs have also been criticized for delivering more information than is necessary to learn the skill. Receiving too much information could cause information overload and interfere with program goals. The current study investigated the differential effect on outcomes of two trainings: (i) a standard training with lecture material about depression and anxiety (illness-information), and a skillset to guide interpersonal support for someone with depression and anxiety (skill-information); and (ii) a targeted training that omitted the lecture material and only presented the skillset. Predicted outcomes were that the combination of illness-information and skill-information in the standard training would result in information overload and would interfere with skill-information recall and attitude change. The current study also investigated two variables that could influence outcomes: general information overload about mental health (MHIO) and interest in the topic of mental health. Results were that participants in the standard training endorsed significantly more information overload and performed significantly better on recall measures than participants in the targeted training. Both trainings were effective at attitude change. Finally, preexisting MHIO was associated with training information overload, care seeking, and skill-information recall. Preexisting topic interest was associated with skill-information recall. Results suggest that some background lecture material might be necessary to learn how to support someone with depression and anxiety. Also, programs that promote interpersonal support are effective at attitude change no matter how much information they provide.
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The Association Between Executive Functioning, Verbal Memory, and Internalized Stigma in Predicting Psychotropic Medication Adherence Behaviors Among People with Serious Mental Illness
Title
The Association Between Executive Functioning, Verbal Memory, and Internalized Stigma in Predicting Psychotropic Medication Adherence Behaviors Among People with Serious Mental Illness
Creator
Powell, Karina
Date
2020
Description
Long-term symptom management is an important consideration for many individuals with serious mental illness to maintain recovery over time,...
Show moreLong-term symptom management is an important consideration for many individuals with serious mental illness to maintain recovery over time, prevent relapse and rehospitalization, and decrease symptom severity. Psychotropic medications can be an important aspect of treatment planning; however, many barriers exist that can impact medication adherence and treatment efficacy. Research suggests that internalized stigma and neurocognition may impact medication adherence, but research has yet to investigate the relationship between these three constructs in tandem. In this study, medication adherence was measured via medication possession ratio calculated from pharmacy records (objective) and self-reported medication use (subjective). Selection of neurocognitive domains and assessment measures was informed by MATRICS and ISBD-BANC consensus batteries. The primary expectations were that verbal memory and executive functioning would be related to medication adherence behaviors and that these domains would moderate the relationship between internalized stigma and medication adherence. A consistent association was seen between measures of self-reported medication use over time, suggesting participants were generally consistent in their reported use. While analyses testing the primary hypotheses were nonsignificant, in the context of limitations of statistical power, trends emerged that may be worthy of further investigation. Future research should continue to explore the potentially multifaceted relationships between factors contributing to adherence. A more comprehensive understanding these relationships has implications for clinicians and consumers in addressing treatment barriers and disengagement by developing more nuanced and targeted interventions.
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EXAMINING THE ROLES OF PUBLIC STIGMA AND ACCULTURATION ON CARE-SEEKING IN PAKISTANIS
Title
EXAMINING THE ROLES OF PUBLIC STIGMA AND ACCULTURATION ON CARE-SEEKING IN PAKISTANIS
Creator
Laique, Aamir
Date
2021
Description
Pakistani Americans face bi-directional cultural influences related to their heritage culture and the mainstream culture of the host. The...
Show morePakistani Americans face bi-directional cultural influences related to their heritage culture and the mainstream culture of the host. The present study examined the impact of culture on the relationship between public stigma and care-seeking attitudes. A sample of 158 Pakistani Americans was collected using MTurk. Hierarchical regression was conducted to examine the moderating effect of heritage acculturation and mainstream acculturation on the relationship between public stigma and care-seeking. Multiple regression analysis predicting care-seeking from public stigma, heritage acculturation, and mainstream acculturation did not yield a statistically significant model. Hierarchical regression analyses examining the moderating effect of heritage acculturation and mainstream acculturation were non-significant. Acculturation had no notable impact on stigma and care-seeking. This study was unable to demonstrate significant results. Future considerations should include inter-generational differences, other forms of stigma that may play a crucial role, and inclusion of different measures to determine if there are other scales better suited for the target population.
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Self-Stigma & Vicarious Stigma Experienced by Parents of Children with Mental Health Challenges
Title
Self-Stigma & Vicarious Stigma Experienced by Parents of Children with Mental Health Challenges
Creator
Serchuk, Marisa Dyan
Date
2019
Description
Research has been limited regarding the stigma experienced by parents of children with mental health challenges. It is commonly understood...
Show moreResearch has been limited regarding the stigma experienced by parents of children with mental health challenges. It is commonly understood that stigma effects people with lived-experience (e.g., a child with mental health challenges), however, stigma has been noted to have a wide scope, which extends to family members as well. Parents of children with mental health challenges have been found to endorse aspects of self-stigma, specifically regarding public stereotypes of blame and feelings of incompetence. Vicarious stigma is a fairly new area of research, which describes the sad and/or angry response a parent may experience when witnessing their child being stigmatized. The purpose of this study is to examine emotional and behavioral outcomes related to specific types of stigma experienced by parents of children with mental health challenges. Archival data from a larger study of adult participants (N=50), who identified as having a child (age 3-10 years old) with mental health challenges, completed measures examining self-stigma, vicarious stigma, stress, depression, quality of life, disclosure, secrecy coping, and help-seeking. A novel measurement for vicarious stigma was introduced and examined in this study. Results found higher levels of self-stigma and dimensions of vicarious stigma were associated with higher levels of depression as well as diminished quality of life. Higher levels of self-stigma were also associated with lower perceived benefits of disclosing and greater levels of secrecy coping. These findings highlight the importance of further examining the role of stigma for parents of children with mental health challenges.
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Mental Health Stigma and Care-Seeking in First Generation Indian Immigrants
Title
Mental Health Stigma and Care-Seeking in First Generation Indian Immigrants
Creator
Shah, Binoy
Date
2019
Description
Objective: Immigrants from India face unique obstacles, including migration related factors and cultural pressures, that may contribute to...
Show moreObjective: Immigrants from India face unique obstacles, including migration related factors and cultural pressures, that may contribute to underutilization of mental health treatment services. The present thesis examined paths between mental health stigma and care-seeking in a sample of first-generation Indian immigrants, with a specific emphasis on the influences of acculturation and parental autonomy support. Method: A sample of 201 first-generation immigrants from India was ascertained using MTurk. Path analysis was conducted to examine the relationships between public stigma of mental illness, disclosure, mental health care-seeking, parental autonomy support, and bi-directional acculturation. Results: Final model was supported by good fit indicators. Greater public stigma was associated with reduced care-seeking, but greater disclosure was associated with increased care-seeking. Interestingly, parental autonomy support, mainstream acculturation, and heritage acculturation facilitated disclosure but had no discernible impact on public stigma. Conclusions: In contrast to traditional anti-stigma strategies that focus on reducing public stigma, present results suggest that it may be more beneficial to facilitate care-seeking by targeting disclosure of status. In turn, disclosure may be promoted by facilitating autonomy supportive social networks and bi-directional acculturation.
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CULTURALLY SENSITIVE HELP-SEEKING AMONG ASIAN INTERNATIONAL AND ASIAN AMERICAN COLLEGE STUDENTS
Title
CULTURALLY SENSITIVE HELP-SEEKING AMONG ASIAN INTERNATIONAL AND ASIAN AMERICAN COLLEGE STUDENTS
Creator
Tsen, Jonathan Yee-jon
Date
2020
Description
Asian populations are rapidly rising, representing the fastest growing racial group of immigrants in the U.S. with many seeking higher...
Show moreAsian populations are rapidly rising, representing the fastest growing racial group of immigrants in the U.S. with many seeking higher education. While many face risk for poor mental health outcomes and high suicidal ideation, Asian college students report lower rates seeking mental health services than White Americans. The purpose of this study was to test a culturally sensitive help-seeking model for Asian international and Asian American college students, and to capture relevant psychological and cultural factors that influence help-seeking. This study used an observational design to build on the current research and evaluated the effects of acculturation, enculturation, public stigma of help-seeking, self-stigma of help-seeking, and attitudes on willingness to seek psychological services. Four hundred and fifty-eight students (Age M = 23.93, SD = 4.36) represented by 265 Asian International Students and 193 Asian American Students. Using a path analysis, results demonstrated a poorly fitted model, suggesting that acculturation, enculturation, public stigma, self-stigma, attitudes, and willingness do not relate significantly to each other when viewed altogether in a model. This remained true even when modifications to the model were made, and when observing the model within only Asian American student sample or Asian international student sample. However, significant direct effects were observed between enculturation and public stigma in the total sample, as well as separately in Asian American or Asian international samples. These findings highlight the importance of exploring with different methodological approaches to gain insight on other important psychological and cultural factors that impact help-seeking among Asian international and Asian American college students.
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Eating disorder support group utilization: Associations with psychological health and eating disorder psychopathology among support group attendees
Title
Eating disorder support group utilization: Associations with psychological health and eating disorder psychopathology among support group attendees
Creator
Murray, Matthew F.
Date
2023
Description
Individuals with eating disorders (EDs) report psychosocial impairments that may persist beyond ED symptom remission, suggesting a need to...
Show moreIndividuals with eating disorders (EDs) report psychosocial impairments that may persist beyond ED symptom remission, suggesting a need to examine ED treatment-adjunctive services that foster psychosocial health. One promising resource is support groups, as evidence across medical and psychiatric illnesses shows associations between group utilization and wellbeing. However, virtually no literature has examined ED-specific support groups and psychosocial health, and it is also unknown how use of supportive services relates to ED symptoms. The present study examined associations between past-month ED support group attendance and participation frequency, psychosocial health indices, and ED symptoms. A total of 215 participants who attended weekly virtual clinician-moderated ED support groups completed measures of psychosocial health, internalized stigma of mental illness, psychosocial impairment from an ED, specific types of social support elicited in group, and ED psychopathology. Adjusting for past-month ED treatment, Benjamini-Hochberg-corrected partial correlation analyses indicated that more frequent attendance was negatively related to body dissatisfaction, purging, excessive exercise, and negative attitudes toward obesity, and positively related to social support. More frequent verbal and chat participation were positively related to emotional and informational support and social companionship. Chat participation was additionally negatively related to excessive exercise and negative attitudes toward obesity. Results suggest that utilizing and participating in clinician-moderated ED support groups could provide an outlet for ED symptom management and solicitation of social support. Findings highlight areas for further consideration in the delivery of and future research on ED support groups.
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