Adolescents’ Reactions to Universal and Indicated Prevention Programs for Depression: Perceived Stigma and Consumer Satisfaction
Abstract
There is a common view that one of the major considerations in selecting between universal and indicated interventions is the marked stigma produced by the latter. However, to date there has been no empirical examination of this assumption. The current study examined reported stigma and program satisfaction following two school-based interventions aimed at preventing depression in 532 middle adolescents. The interventions were conducted either across entire classes by classroom teachers (universal delivery) or in small high risk groups by mental health professionals (indicated delivery). The indicated delivery was associated with significantly greater levels of perceived stigma, but effect sizes were small and neither program was associated with marked stigma in absolute terms. Perceived stigma was more strongly associated with aspects of the individual including being male and showing greater externalizing symptomatology. In contrast, the indicated program was evaluated more positively by both participants and program leaders and effect sizes for these measures of satisfaction were moderate to large. The results point to the need for further empirical evaluation of both perceived stigma and program satisfaction in providing balanced considerations of the value of indicated and universal programs.
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Help-seeking is known to be associated with a self-selection bias.
“As help-seeking is known to be associated with a self-selection bias, there is an urgent need to offer help at very early stages even before individuals actively seek help while keeping the advantages of targeted prevention [26, 32].”
From Efficacy of a transdiagnostic Internet prevention approach in adolescents (EMPATIA study): study protocol of a randomized controlled trial (2024) · cites this paper as [32]
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“…have shown the potential to reduce subclinical symptoms or even prevent the onset of a mental disorder in help-seeking and community samples [28–31] with a relatively good benefit–cost ratio and with high participant satisfaction by allocating resources to those reporting a need for it [26, 32].”
Background
- Authors
- Rapee, R. M., Wignall, A., Sheffield, J., Kowalenko, N., Davis, A., McLoone, J., & Spence, S. H.
- Affiliations
- Macquarie University (AU)
- Northern Sydney Local Health District (AU)
- The University of Queensland (AU)
- Royal North Shore Hospital (AU)
- Corresponding author
- Rapee, Ronald M.
- Venue
- Prevention Science
- Published
- 2006-05-17
- Volume
- 7
- Issue
- 2
- Pages
- 167-177
- ISSN
- 1389-4986 (ISSN-L)
- 1573-6695
- OpenAlex
- W1970120483
- Cited by
- 87
- References
- 42
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 8 · 2023: 2 · 2022: 7 · 2021: 3 · 2020: 4 · 2019: 3 · 2018: 5 · 2017: 5 · 2016: 9 · 2015: 4 · 2014: 6 · 2013: 7 · 2012: 5
- FWCI
- 0.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Prevention Science (publishedVersion)
- PubMed (publishedVersion)
- Griffith Research Online (submittedVersion)
- Funders
- National Health and Medical Research Council
- National Medical Research Council
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
- Keywords
- adolescent depression, depression prevention, universal prevention programs, perceived stigma, program satisfaction, school-based intervention, middle adolescence, externalizing problems, gender differences
- MeSH terms
- Adolescent, Adolescent Behavior, Consumer Behavior, Depression, Humans, Mental Health Services, Preventive Health Services, Stereotyping
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