Labelling effects and adolescent responses to peers with depression: an experimental investigation

BACKGROUND

The impact of illness labels on the stigma experiences of individuals with mental health problems is a matter of ongoing debate. Some argue that labels have a negative influence on judgments and should be avoided in favour of information emphasising the existence of a continuum of mental health/illness. Others believe that behavioral symptoms are more powerful influencers of stigma than labels. The phenomenon has received little attention in adolescent research, despite the critical importance of the peer group at this developmental stage. This study employs a novel experimental design to examine the impact of the depression label and continuum information on adolescents' responses to peers with depression.

METHODS

Participants were 156 adolescents, 76 male, 80 female (M = 16.25 years; SD = .361), assigned to one of three conditions (Control, Label, Continuum). Participants respond to four audio-visual vignette characters (two clinically depressed) on three occasions. Outcome measures included judgment of the mental health of the vignette characters and emotional responses to them.

RESULTS

Neither the provision of a depression label or continuum information influenced perceptions of the mental health of the characters in the audio-visual vignettes or participants' emotional responses to them.

CONCLUSION

The findings have implications for the design of interventions to combat depression stigma with adolescents. Interventions should not necessarily target perceptions of psychiatric labels, but rather perceptions of symptomatic behaviour.

Views and experience of communication when receiving a serious mental health diagnosis: satisfaction levels, communication preferences, and acceptability of the SPIKES protocol

BACKGROUND

There is limited research investigating how information about a mental health diagnosis is discussed and received.

AIMS

To measure community-based service users' satisfaction and preferences toward receiving news of a serious mental health diagnosis and to assess the acceptability of a diagnostic communication protocol (SPIKES: Setting; Perception; Invitation; Knowledge; Empathy; Summarizing).

METHOD

A survey was conducted with 101 participants.

RESULTS

Participants rated the methods clinicians use to facilitate diagnostic discussions are highly important; however, they were not wholly satisfied with their experience. Higher satisfaction was reported if participants were provided with information in a face-to-face meeting (p < 0.001), and if they received supplementary support at the time of diagnosis from additional health professionals rather than only a sole practitioner (p < 0.001). The SPIKES protocol was rated as highly acceptable, with Empathy being rated as the most important feature.

CONCLUSIONS

This research indicates there were specific areas of communication practices which can be improved within mental health service provision, as a gap existed between participants' desire for support and their experience. Strategies outlined in the SPIKES protocol, and others such as addressing stigma concerns, may prove useful in development of clinician training and service improvement.

Categorical versus dimensional models of mental disorder: the taxometric evidence

OBJECTIVE

To review studies of the categorical versus dimensional status of mental disorders that employ taxometric methodology.

METHOD

A comprehensive qualitative review of all published taxometric studies of psychopathology.

RESULTS

Categorical and dimensional models each receive well-replicated support for some groups of mental disorders. Studies favour categorical models for melancholia, eating disorders, pathological dissociation, and schizotypal and antisocial personality disorders. Dimensional models tend to be favoured for the broad neurotic spectrum--general depression, generalized anxiety, posttraumatic stress disorder--and for borderline personality disorder.

CONCLUSIONS

Taxometric research clarifies the latent structure of psychopathology in ways that have implications for the classification, assessment, explanation and conceptualization of mental disorder.