Resistance, reactance, and misinterpretation: Highlighting the challenge of persuading people with depression to seek help

Abstract

Interventions that increase help‐seeking among people with depression have the potential to save lives. Several efforts have been impressively successful; however, research has also chronicled inconsistent results, with some endeavors indicating boomerang effects. The goal of the current analysis is to synthesize select findings from cognitive theorizing on depression with persuasion scholarship to explain how and why the combination of unfavorable attitudes toward help‐seeking, attitudes that are increasingly resistant to influence, psychological reactance, and cognitive errors can result in challenging responses to messages encouraging help‐seeking among people with depression. In addition, we highlight the importance of utilizing theory‐based approaches to circumvent resistance to persuasion and provide an explanation as to why the provision of immediate help‐seeking mechanisms could be a key aspect of successful intervention efforts. We also stress the importance of formative research and pilot testing, and warn against the potentially harmful error of assessing messages targeting people with depression on those without heightened levels of depressive symptomatology. Ideally, this effort will draw attention to the challenge of persuading people with depression to seek help and also motivate social psychologists to consider the ways they can use their craft to positively influence the health and well‐being of people with depression.

Positive Emotion Infusions: Can Savoring Increase Help‐Seeking Intentions among People with Depression?

“…It is possible that the success of PEIs could be amplified through the use of different discrete positive emotions. Alternatively, given that iatrogenic effects can occur when individuals with elevated depressive symptomatology represent the target audience (Siegel et al, 2017), it is unlikely that gratitude represents the only positive emotion where iatrogenic effects may be possible (Siegel & Thomson, 2016). Thus, every attempt to persuade this population must be extensively assessed prior to widespread implementation.…”

“…For example, if savoring were to be used in a web-based intervention, a link to virtual or chat-based online therapy or help with scheduling an appointment at a local clinic could be displayed immediately following a savoring exercise. Special consideration would also have to be given to the wording of help-seeking information to circumvent potential iatrogenic effects due to misinterpretation and promote positive help-seeking behaviors for those with elevated depressive symptomatology (see Siegel et al, 2017, for a review of the literature and intervention recommendations).…”

“…Although success is certainly possible, recent reviews help underscore the challenges facing those attempting to increase help-seeking among people with elevated depressive symptomatology (Siegel, Lienemann, & Rosenberg, 2017). For example, Gulliver, Griffiths, and Christensen (2010) conducted a systematic review on barriers to mental health help-seeking and found that among adolescents, factors inhibiting help-seeking included, though are not limited to, perceived stigma, low mental health literacy, and embarrassment.…”

“…Siegel et al, 2017). Siegel, Lienemann, and Tan (2015) used a variation of the overheard communication technique (i.e.…”

Storm, Stress, Silence: A Focus Group Examination of Mental Health Culture and Challenges Among Graduate Students Currently or Previously Experiencing Depression

“…An additional future direction would be taking steps to understand the most effective means of intervention. Prior studies have noted the potential challenge of influencing people with depression, particularly regarding help-seeking (e.g., Siegel et al, 2017), but success is indeed possible. Additional future directions are described in the next section.…”