Effect of web-based depression literacy and cognitive–behavioural therapy interventions on stigmatising attitudes to depression

Background Little is known about the efficacy of educational interventions for reducing the stigma associated with depression. Aims To investigate the effects on stigma of two internet depression sites. Method A sample of 525 individuals with elevated scores on a depression assessment scale were randomly allocated to a depression information website (BluePages), a cognitive–behavioural skills training website (MoodGYM) or an attention control condition. Personal stigma (personal stigmatising attitudes to depression) and perceived stigma (perception of what most other people believe) were assessed before and after the intervention. Results Relative to the control, the internet sites significantly reduced personal stigma, although the effects were small. BluePages had no effect on perceived stigma and MoodGYM was associated with an increase in perceived stigma relative to the control. Changes in stigma were not mediated by changes in depression, depression literacy or cognitive–behavioural therapy literacy. Conclusions The internet warrants further investigation as a means of delivering stigma reduction programmes for depression.

[1]  P. Corrigan,et al.  The Paradox of Self-Stigma and Mental Illness , 2006 .

[2]  S. Hollon,et al.  Cognitive self-statements in depression: Development of an automatic thoughts questionnaire , 1980, Cognitive Therapy and Research.

[3]  P W Corrigan,et al.  Prejudice, social distance, and familiarity with mental illness. , 2001, Schizophrenia bulletin.

[4]  L. Radloff The CES-D Scale , 1977 .

[5]  J. E. Wells,et al.  Perceived barriers to care in St. Louis (USA) and Christchurch (NZ): reasons for not seeking professional help for psychological distress , 1994, Social Psychiatry and Psychiatric Epidemiology.

[6]  Bruce G. Link,et al.  The impact of contact on stigmatizing attitudes toward people with mental illness , 2003 .

[7]  Bruce G. Link,et al.  Dispelling the stigma of schizophrenia: II. The impact of information on dangerousness. , 1999, Schizophrenia bulletin.

[8]  Graham Thornicroft,et al.  Reducing psychiatric stigma and discrimination: evaluation of educational interventions in UK secondary schools , 2003, British Journal of Psychiatry.

[9]  G. Andrews,et al.  Interpreting scores on the Kessler Psychological Distress Scale (K10) , 2001, Australian and New Zealand journal of public health.

[10]  Debbie R. Robinson,et al.  Stereotyping among Providers and Consumers of Public Mental Health Services , 2001, Behavior modification.

[11]  P W Corrigan,et al.  Changing attitudes about schizophrenia. , 1999, Schizophrenia bulletin.

[12]  P. Lachenbruch Statistical Power Analysis for the Behavioral Sciences (2nd ed.) , 1989 .

[13]  P. Hayward,et al.  Stigma and mental illness: A review and critique , 1997 .

[14]  P W Corrigan,et al.  Three strategies for changing attributions about severe mental illness. , 2001, Schizophrenia bulletin.

[15]  R Haghighat,et al.  A unitary theory of stigmatisation: Pursuit of self-interest and routes to destigmatisation , 2001, British Journal of Psychiatry.

[16]  Impact of a Humanistic Approach on Students' Attitudes, Attributions, and Ethical Conflicts , 1979 .

[17]  Jacob Cohen Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[18]  D. Penn,et al.  Interpersonal contact and the stigma of mental illness: A review of the literature , 2003 .

[19]  D P MacKinnon,et al.  Analysis of mediating variables in prevention and intervention research. , 1994, NIDA research monograph.

[20]  A. Gray Stigma in psychiatry. , 2002, Journal of the Royal Society of Medicine.

[21]  Bruce G. Link,et al.  On stigma and its consequences: evidence from a longitudinal study of men with dual diagnoses of mental illness and substance abuse. , 1997, Journal of health and social behavior.

[22]  D. Penn,et al.  Dispelling the stigma of schizophrenia. , 1997, Psychiatric services.

[23]  M. Angermeyer,et al.  The Relationship Between Public Causal Beliefs and Social Distance Toward Mentally Ill People , 2004, The Australian and New Zealand journal of psychiatry.

[24]  D. A. Kenny,et al.  The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. , 1986, Journal of personality and social psychology.

[25]  J. Read,et al.  The Differential Effectiveness of Psychosocial and Biogenetic Causal Explanations in Reducing Negative Attitudes toward “Mental Illness” , 2002, Psychiatry.

[26]  K. Griffiths,et al.  Providing information about the effectiveness of treatment options to depressed people in the community: a randomized controlled trial of effects on mental health literacy, help-seeking and symptoms , 2003, Psychological Medicine.

[27]  P. Corrigan,et al.  Stigmatizing attributions about mental illness , 2000 .

[28]  M. Sobel Asymptotic Confidence Intervals for Indirect Effects in Structural Equation Models , 1982 .

[29]  Peter Bailey,et al.  Measuring Search Engine Quality , 2001, Information Retrieval.

[30]  G Thornicroft,et al.  Reducing psychiatric stigma and discrimination--evaluating an educational intervention with the police force in England. , 2003, Social psychiatry and psychiatric epidemiology.

[31]  H. Christensen,et al.  Delivering interventions for depression by using the internet: randomised controlled trial , 2004, BMJ : British Medical Journal.