Should We Activate Risk Perceptions in the Context of Suicide Prevention? Examining Fear Appeals, Help-Seeking Determinants, and Help-Seeking Sources Among University Employees Who Suffer from Depression
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Health promotion strategies have largely focused on activating risk perceptions for health conditions in resistant at-risk populations in order to induce behavior change. Yet, doing so remains a questionable approach when promoting help-seeking behaviors among individuals who suffer from depression because clinical symptoms can negatively affect interpretations and responses to such efforts. This study sought to test the effects and effectiveness of risk-based health messaging utilizing fear appeals on help-seeking determinants, intentions, and sources. One hundred seventeen university employees affected by symptoms of depression were recruited to participate in a lab-based experimental setting. Participants were randomly assigned to one of three message conditions that differed in strength of fear appeal (low, moderate, high) when inducing suicide risk perceptions and promoting help-seeking. Consistent with previous research, participants indicated high stigma perceptions and low intentions to seek help. Risk-based messaging strategies such as fear appeals did not have an effect on help-seeking intentions in this sample. Intentions were largely determined by positive outcome expectations and social norms, whereas efficacy perceptions were positive and not a predictor of help-seeking intentions. Participants were most likely to seek help from intimate partners and friends and least likely to utilize a help-line. Health promotion messages should contain cues that activate, rather than change, the already positive outcome expectations of seeking help when targeting at-risk populations. Future research should explore possibilities for health promotion and education among support networks of those who suffer from depression and anxiety.
KeywordsSuicide prevention Depression Health communication Reasoned action theory Fear appeals
Compliance with Ethical Standards
Conflict of Interest
The author declares that there is no conflict of interest. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendment or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- Aiken, L. S., & West, S. G. (1991). Multiple regression. Testing and interpreting interactions. Newbury Park: Sage.Google Scholar
- Beck, A. T. (1976). Cognitive therapy and the emotional disorders. New York: Meridian.Google Scholar
- Brody, D. J., Pratt, L. A., & Hughes, J. (2018). Prevalence of depression among adults aged 20 and over: United States, 2013–2016. NCHS Data Brief, no 303. Hyattsville: National Center for Health Statistics.Google Scholar
- Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans-Lacko, S., Bezborodovs, N., et al. (2015). What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychological Medicine, 45(1), 11–27. https://doi.org/10.1017/S0033291714000129.CrossRefGoogle Scholar
- Cohen, J. (1977). Statistical power analysis for the behavioral sciences (rev. ed.). Hillsdale: Lawrence Erlbaum Associates, Inc.Google Scholar
- Covin, R., Dozois, D. J. A., Ogniewicz, A., & Seeds, P. M. (2011). Measuring cognitive errors: Initial development of the cognitive distortions scale (CDS). International Journal of Cognitive Therapy, 4(3), 297–322. https://doi.org/10.1521/ijct.2011.4.3.297.
- Erdfelder, E., Faul, F., & Buchner, A. (1996). GPOWER: A general power analysis program. Behavior Research Methods, Instruments, & Computers, 28(1), 1–11. https://doi.org/10.3758/BF03203630.
- Fishbein, M., & Ajzen, I. (2010). Predicting and changing behavior: The reasoned action approach. New York: Psychology Press.Google Scholar
- Klimes-Dougan, B., Klingbeil, D. A., & Meller, S. J. (2013). The impact of universal suicide-prevention programs on the help-seeking attitudes and behaviors of youths. Crisis, 34, 82–97. https://doi.org/10.1027/0227-5910/a000178.
- Klimes-Dougan, B., Yuan, C., Lee, S., & Houri, A. K. (2009). Suicide prevention with adolescents: Considering potential benefits and untoward effects of public service announcements. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 30(3), 128–135. https://doi.org/10.1027/0227-5910.30.3.128.CrossRefGoogle Scholar
- Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The Patient Health Questionnaire-2: Validity of a two-item depression screener. Medical Care, 41, 1284–1292.Google Scholar
- Lawson, C., MacLeod, C., & Hammond, G. (2002). Interpretation revealed in the blink of an eye: Depressive bias in the resolution of ambiguity. Journal of Abnormal Psychology. https://doi.org/10.1037/0021-843X.111.2.321.
- Lueck, J. A. (2017). Examining determinants of seeking help for depression: Implications for effective health promotion messages. Journal of Communication in Healthcare, 1–11. https://doi.org/10.1080/17538068.2017.1417957.
- Lueck, J. A. (2018). Respecting the “stages” of depression: Considering depression severity and readiness to seek help. Patient Education and Counseling. https://doi.org/10.1016/j.pec.2018.02.007.
- Lueck, J., & Yzer, M. (2017). Explaining intentions to seek help for depressive symptoms in the context of responsibility message framing. Health Communication, 1–8. https://doi.org/10.1080/10410236.2017.1322857.
- Mezulis, A. H., Abramson, L. Y., Hyde, J. S., & Hankin, B. L. (2004). Is there a universal positivity Bias in attributions? A meta-analytic review of individual, developmental, and cultural differences in the self-serving attributional bias. Psychological Bulletin, 130(5), 711–747. https://doi.org/10.1037/0033-2909.130.5.711.CrossRefGoogle Scholar
- Mongeau, P. A. (2013). Fear appeals. In J. P. Dillard, & L. Shen (Eds.), The Sage Handbook of Persuasion (2nd edn., pp. 184–199). New York: Routledge.Google Scholar
- Peters, G.-J. Y., Ruiter, R. A. C., & Kok, G. (2014). Threatening communication: A qualitative study of fear appeal effectiveness beliefs among intervention developers, policymakers, politicians, scientists, and advertising professionals. International Journal of Psychology, 49(2), 71–79. https://doi.org/10.1002/ijop.12000.CrossRefPubMedGoogle Scholar
- Pratt, L.A., & Brody, D. J. (2014). Depression in the U.S. household population, 2009-2012. NCHS Data Brief, 172, 1–8. PMID: 25470183.Google Scholar
- Siegel, J. T., & Thomson, A. L. (2017). Positive emotion infusions of elevation and gratitude: Increasing help-seeking intentions among people with heightened levels of depressive symptomatology. The Journal of Positive Psychology, 12(6), 509–524. https://doi.org/10.1080/17439760.2016.1221125.CrossRefGoogle Scholar
- Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097. Retrieved from https://doi.org/10.1001/archinte.166.10.1092.
- Stephenson, M., Southwell, B., & Yzer, M. (2011). Advancing health communication reearch: Issues and controversies in research design and analysis. In T. L. Thompson, R. Parrott, & J. F. Nussbaum (Eds.), The Routledge Handbook of Health Communication (2nd edn., pp. 560–577). New York: Routledge.Google Scholar
- Vogel, D. L., Wade, N. G., & Haake, S. (2006). Measuring the self-stigma associated with seeking psychological help. Journal of Counseling Psychology. https://doi.org/10.1037/0022-0184.108.40.2065.