Date of Award

5-31-2017

Document Type

Open Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Clinical Psychology

First Advisor

Heidi M. Levitt

Second Advisor

Ester Shapiro

Third Advisor

Takuya Minami

Abstract

Multiple campaigns geared towards reducing public and self-stigma associated with depression, and increasing help-seeking behaviors have been launched in the past two decades. There has been an increase in promoting psychoeducation on the biological bases of mental illness. Recent international studies have documented that this increase in public knowledge has not reduced stigma. Indeed, growing evidence suggests that biological models, in comparison to other causal models of mental illness, decrease people’s sense of self-efficacy and self-control, and decrease positive expectancies of treatments and prognosis–among those with and without mental illness. Individuals who have come in contact with health services, however, hold more positive and realistic expectancies of treatments than those who have not. Therefore, adequate education about mental illness and its treatment by providers is key at improving treatment expectancies and engagement. Results documented that biological explanations increased biological causes and reduced endorsement of social and psychological causes, led to decreases in endorsement of non-professional help, and increased endorsement of positive outcome expectancies for attending psychotherapy. Second, psychosocial explanations increased endorsement of social causes, increased likelihood in engaging in psychotherapy, and increased endorsement of positive outcome expectancies for attending psychotherapy and taking psychiatric medications. Third, biopsychosocial conditions produced increases in endorsement of taking psychiatric medications and increased endorsement of positive outcome expectancies for attending psychotherapy. Fourth, control condition increased endorsement of taking psychiatric medications and increased endorsement of positive outcome expectancies for attending psychotherapy. There was no interaction effect of self-stigma for attending psychotherapy or taking psychiatric medications; however, main effects of time suggest that self-stigma for attending psychotherapy and taking psychiatric medication reduced across time. Moreover, after treatment education there were no interactions between time and condition. However, main effects of time showed increased likelihood taking psychiatric medications and decreased likelihood seeking non-professional help, increases positive outcome expectancies of treatment, and decrease in self-stigma for seeking treatment. The findings of the current study suggest that biologically based psychoeducation of depression may hinder patients. It is most optimal to include and highlight the effect of psychosocial factors of depression through psychoeducation campaigns.

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