Reducing Self-stigma and Increasing Treatment Seeking Intentions Among Youth With Depressive Symptoms: A Mixed-methods Study
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Enrollment
- 1,520
- Locations
- 1
- Primary Endpoint
- Attitude Towards Seeking Professional Psychological Help
Study Overview
Brief Summary
Young people with depression, especially those of underserved minority groups, avoid treatment due to stigma and discrimination. Social contact is a form of interpersonal contact with members of the stigmatized group and the most effective type of intervention for improvement in stigma-related knowledge and attitudes.
In a prior study, the investigators developed short video interventions to reduce stigma and increase treatment seeking among people with depression. The videos vary by protagonist race/ethnicity (Latinx, non-Latinx Black, non-Latinx White) who share their experiences with depression, challenges, and recovery process. The investigators would like to test the efficacy of these videos using Prolific (a crowdsourcing platform). Specifically, the investigators are interested in conducting a randomized controlled trial (RCT) to test the efficacy of these videos as compared to a vignette control condition on reducing self-stigma and increasing help-seeking intentions and behavior at baseline, post, and 30 day follow-up among youth with depressive symptom scores on the PHQ-9≥ 5.
Detailed Description
In a randomized control trial (RCT) with pre-, post-intervention, and 30-day follow-up assessments, we aim to 1) test the efficacy of brief social video interventions, varying protagonist race/ethnicity, as compared to vignette control in reducing self-stigma and increasing treatment-seeking intentions and behavior among 1600 Prolific users ages 18-25 with depressive symptoms (PHQ-9≥ 5), and 2) explore whether matching to protagonist race/ethnicity increases intervention efficacy. We hypothesize that 1) Brief social contact-based video interventions will reduce self-stigma towards depression and increase treatment-seeking intentions and behavior compared to vignette control, and 2) The participants whose race/ethnicity match the protagonist will have greater changes in self-stigma and treatment-seeking than participants with unmatched protagonists, i.e., matching moderates the intervention's effects.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Single (Participant)
Eligibility Criteria
- Ages
- 18 Years to 25 Years (Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Endorsing mild to severe depressive symptoms (Patient Health Questionnaire (PHQ-9) score of 5 or greater)
- •Ages 18-25
- •US Residents
- •English speaking
Exclusion Criteria
- •Not endorsing mild to severe depressive symptoms
- •Age less than 18 or greater than 25
Arms & Interventions
Brief video intervention (Black Woman)
A brief social contact-based video with a Black woman protagonist
Intervention: Brief video intervention (Black Woman) (Behavioral)
Brief video intervention (Latinx Woman)
A brief social contact-based video with a Latinx woman protagonist
Intervention: Brief video intervention (Latinx Woman) (Behavioral)
Brief video intervention (White Woman)
A brief social contact-based video with a White woman protagonist
Intervention: Brief video intervention (White Woman) (Behavioral)
Vignette Control
A brief vignette control condition
Intervention: Vignette Control (Behavioral)
Outcomes
Primary Outcomes
Attitude Towards Seeking Professional Psychological Help
Time Frame: 30 day follow-up
Treatment seeking intentions will be measured using three items from the Attitudes Towards Seeking Professional Psychological Help Scale (ATSPPHS) Scale (Elhai et al., 2008). Items include: 'I might want to have psychological counselling in the future', 'I would want to get psychological help if I were worried or upset for a long period of time' and 'A person with an emotional problem is not likely to solve it alone; he or she is more likely to solve it with professional help'. Responses range from 1 (disagree) to 4 (agree). Total scores range from 3 to 12 with higher scores indicating higher treatment seeking intentions.
Treatment related stigma
Time Frame: 30 day follow-up
Treatment-related stigma will be measured with the Self-Stigma of Seeking Help scale (SSOSH-3) (Brenner et al., 2021). Items include "I would feel inadequate if I went to a therapist for psychological help," "It would make me feel inferior to ask a therapist for help," and "If I went to a therapist, I would be less satisfied with myself." Response range from 1 (strongly disagree) to 5 (strongly agree). Total scores range from 3 to 15, with higher scores indicating greater stigma.
Actual help-seeking
Time Frame: 30 day follow-up
One item will be utilized to measure actual help-seeking: Over the past 30 days, did you contact the mental health referrals we have provided or have sought out mental health treatment elsewhere?
Depression Stigma
Time Frame: 30 day follow-up
The Depression Stigma Scale (DSS) is a self-report scale comprised of two 9-item subscales measuring participants' personal beliefs about depression and participants' beliefs about others' attitudes (Griffiths et al., 2004). The current study will only utilize the personal beliefs subscale. Each item is rated on a 5-point Likert scale ranging from strongly disagree (1) to strongly agree (5). Scores range from 9 to 45. Higher scores indicate more stigma.
Depression Stigma
Time Frame: Baseline
The Depression Stigma Scale (DSS) is a self-report scale comprised of two 9-item subscales measuring participants' personal beliefs about depression and participants' beliefs about others' attitudes (Griffiths et al., 2004). The current study will only utilize the personal beliefs subscale. Each item is rated on a 5-point Likert scale ranging from strongly disagree (1) to strongly agree (5). Scores range from 9 to 45. Higher scores indicate more stigma.
Depression Stigma
Time Frame: Post (immediately after the video or vignette control is shown)
The Depression Stigma Scale (DSS) is a self-report scale comprised of two 9-item subscales measuring participants' personal beliefs about depression and participants' beliefs about others' attitudes (Griffiths et al., 2004). The current study will only utilize the personal beliefs subscale. Each item is rated on a 5-point Likert scale ranging from strongly disagree (1) to strongly agree (5). Scores range from 9 to 45. Higher scores indicate more stigma.
Attitude Towards Seeking Professional Psychological Help
Time Frame: Baseline
Treatment seeking intentions will be measured using three items from the Attitudes Towards Seeking Professional Psychological Help Scale (ATSPPHS) Scale (Elhai et al., 2008). Items include: 'I might want to have psychological counselling in the future', 'I would want to get psychological help if I were worried or upset for a long period of time' and 'A person with an emotional problem is not likely to solve it alone; he or she is more likely to solve it with professional help'. Responses range from 1 (disagree) to 4 (agree). Total scores range from 3 to 12 with higher scores indicating higher treatment seeking intentions.
Attitude Towards Seeking Professional Psychological Help
Time Frame: Post (immediately after the video or vignette control is shown)
Treatment seeking intentions will be measured using three items from the Attitudes Towards Seeking Professional Psychological Help Scale (ATSPPHS) Scale (Elhai et al., 2008). Items include: 'I might want to have psychological counselling in the future', 'I would want to get psychological help if I were worried or upset for a long period of time' and 'A person with an emotional problem is not likely to solve it alone; he or she is more likely to solve it with professional help'. Responses range from 1 (disagree) to 4 (agree). Total scores range from 3 to 12 with higher scores indicating higher treatment seeking intentions.
Treatment related stigma
Time Frame: Baseline
Treatment-related stigma will be measured with the Self-Stigma of Seeking Help scale (SSOSH-3) (Brenner et al., 2021). Items include "I would feel inadequate if I went to a therapist for psychological help," "It would make me feel inferior to ask a therapist for help," and "If I went to a therapist, I would be less satisfied with myself." Response range from 1 (strongly disagree) to 5 (strongly agree). Total scores range from 3 to 15, with higher scores indicating greater stigma.
Treatment related stigma
Time Frame: Post (immediately after the video or vignette control is shown)
Treatment-related stigma will be measured with the Self-Stigma of Seeking Help scale (SSOSH-3) (Brenner et al., 2021). Items include "I would feel inadequate if I went to a therapist for psychological help," "It would make me feel inferior to ask a therapist for help," and "If I went to a therapist, I would be less satisfied with myself." Response range from 1 (strongly disagree) to 5 (strongly agree). Total scores range from 3 to 15, with higher scores indicating greater stigma.
Secondary Outcomes
- Emotional engagement(Post (immediately after the video or vignette control is shown))
Investigators
Doron Amsalem
Assistant Professor of Clinical Psychiatry
New York State Psychiatric Institute