Year of Award

2017

Document Type

Dissertation - Campus Access Only

Degree Type

Doctor of Philosophy (PhD)

Degree Name

Clinical Psychology

Department or School/College

Department of Psychology

Committee Chair

Duncan G. Campbell

Commitee Members

David Schuldberg, Jennifer S. Robohm, Keith Anderson, Loretta Bolyard

Abstract

As many as 70% of individuals who visit primary care providers (PCPs) (e.g., family practice physicians and internists) experience depressive symptoms (Robinson, Geske, Prest, & Barnacle, 2005). Additionally, Olfson et al. (2002) found greater involvement of physicians in depression treatment from 1987-1997, and greater use of psychotropic medications to treat depression over the same time frame. In spite of increases in depression treatment, many individuals still do not seek depression treatment or do not adhere fully to prescribed treatments. In fact, it is estimated that only 30% of adults with a current mood disorder receive treatment (Ohayon, Shapiro & Kennedy, 2000). While previous research demonstrates that stigma influences depression treatment seeking (Henshaw, 2014), label avoidance, or the fear of being labeled as “depressed,” is an important and understudied facet of stigma (Corrigan, 2002). Because many people who are high in label avoidance do not present for depression treatment, little is known about how they conceptualize their depressive symptoms, or how different explanations for depression might influence their willingness to engage in care. Additionally, those who avoid depression treatment may experience elevated risk of severe depression symptomatology and self-harm behaviors. Consequently, research should focus on understanding how label avoiders think about their depression, and how researchers and providers might use this information to communicate better with these individuals about their depression. This project utilized a college undergraduate sample (n=208) and tested whether label avoidance and explanations about depression etiology demonstrated effects on treatment willingness among undergraduates with mild-moderate depressive symptoms. Contrary to hypothesized results, there was no significant main effect for depression explanation on treatment willingness, nor was there an interaction effect between depression explanation and label avoidance on treatment willingness. However, results revealed a statistically significant effect for label avoidance, indicating that higher stigma was associated with lower willingness to seek help for depression from a non-prescribing mental health provider, a primary care provider, and a psychiatrist. Label avoidance was also associated with an increased willingness to manage depression on one’s own. Consistent with hypothesized results, those with high stigma, as measured by label avoidance, evidenced greater agreement with a biological explanation of depression compared to those who reported low stigma. The implications of this work are that psychoeducation through public anti-stigma initiatives and PCP appointments may help decrease depression stigma and increase willingness to seek treatment.

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© Copyright 2017 William Jonathan Meyer