4 - (SYM 94) Framing Depression as a “signal” Enhances Self-efficacy and Expectations for Therapy

The past 50 years have seen a marked increase in presenting depression as a “biomedical illness” akin to cancer and diabetes. While these framings often have benevolent motivations to reduce stigma and blame, accumulating research indicates there are some costs to these framings, including poorer expectations for recovery, especially for psychotherapy. It is possible a different framing of depression can help mitigate these costs.

The current research, which was inspired by social cognition and evolutionary psychiatry, presents an alternative framing for depression: that it serves a functional purpose. Specifically, in two studies (Study 1, correlational, N = 723; Study 2, experimental, N = 844), we evaluated a novel belief and message about depression that it is a signal that something in life needs more attention.

Participants in Study 1 were undergraduates from three universities in the United States (total N = 746) who completed an online survey for course credit. They completed validated measures of depression symptom severity, stigmatizing attitudes, causal beliefs about depression, attitudes about psychotherapy and medication, and a novel 10-item measure assessing the functional aspects of depression (e.g., “Depression serves a purpose”). The novel measure displayed a normal distribution and adequate internal reliability (α = .75). Moderation analyses suggested that functional beliefs predicted positive attitudes about therapy for those with higher levels of depression (b = 1.44, p = .04) but not among those with lower depression (b = -0.95, p = .34). Moreover, compared to biomedical beliefs about depression, functional beliefs were related to more optimistic attitudes about recovery.

Study 2 was an online, pre-registered randomized controlled trial in which participants with depression experience watched videos of a psychologist talking about depression either as a disease like cancer or a functional signal that serves a purpose. Participants exposed to the Signal condition displayed greater offset efficacy (d = 0.15, p = .022) and fewer stigmatizing attitudes (d = 0.15, p = .026). Results were stronger among females, who also showed a higher growth mindset about depression – the belief that depression can change (d = 0.22, p = .011).

Overall, results indicate that framing depression as a functional signal may have promising effects on stigma and attitudes about recovery.