Adolescents' reactions to universal and indicated prevention programs for depression

Perceived stigma and consumer satisfaction

Ronald M. Rapee*, Ann Wignall, Jeanie Sheffield, Nick Kowalenko, Anna Davis, Jordana McLoone, Susan H. Spence

*Corresponding author for this work

    Research output: Contribution to journalArticle

    54 Citations (Scopus)


    There is a common view that one of the major considerations in selecting between universal and indicated interventions is the marked stigma produced by the latter. However, to date there has been no empirical examination of this assumption. The current study examined reported stigma and program satisfaction following two school-based interventions aimed at preventing depression in 532 middle adolescents. The interventions were conducted either across entire classes by classroom teachers (universal delivery) or in small high risk groups by mental health professionals (indicated delivery). The indicated delivery was associated with significantly greater levels of perceived stigma, but effect sizes were small and neither program was associated with marked stigma in absolute terms. Perceived stigma was more strongly associated with aspects of the individual including being male and showing greater externalizing symptomatology. In contrast, the indicated program was evaluated more positively by both participants and program leaders and effect sizes for these measures of satisfaction were moderate to large. The results point to the need for further empirical evaluation of both perceived stigma and program satisfaction in providing balanced considerations of the value of indicated and universal programs.

    Original languageEnglish
    Pages (from-to)167-177
    Number of pages11
    JournalPrevention Science
    Issue number2
    Publication statusPublished - Jun 2006

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