(PS1-88) Cultural Differences in Self-other Effectiveness Ratings of Depression Treatments

Abstract Text:

Background: Depression is a common and debilitating mental illness (Hasin et al., 2018). Perceived effectiveness of treatment is an important factor when individuals consider pursuing mental health care, and many underestimate the effectiveness of treatment (Roth et al., 2024). Indeed, many clinicians have encountered patients who may intellectually understand benefits of a particular treatment but doubt its utility for themselves. Previous studies found cultural differences in perceived helpfulness of depression treatment (Harris et al., 2020); however differences for specific types of treatment were not thoroughly investigated. Therefore, this study aims to understand differences in the perceived effectiveness of various depression treatments for self and for others and whether culture moderates these relationships.

Methods: Individuals were recruited from an international Internet-based depression screening study (Leykin et al., 2012); participants were invited to the present study if they understood English or Spanish and screened positive for current major depression. Following Goodmann et al. (2021), participants included in this analysis were either English speakers from traditionally English-speaking Western countries (n = 126) or Spanish-speakers from Latin America (n = 173). Participants answered questions related to their past treatment history and regarding perceived effectiveness of treatment options for themselves and others. Repeated measures ANCOVAs were used to understand factors that may explain differences in self-other effectiveness ratings.

Results: Regarding talk therapy, self-other discrepancy was not observed in the Latin American group, whereas Western English speakers rated therapy as less effective for themselves (p = .043). Regarding antidepressant medication, the self-other discrepancy was greater for Western English speakers than for the Latin American group, though both groups tended to rate medications as more effective for others (p = .036). Regarding internet-based treatment, cultural differences were not observed; however, those with higher depression scores or with no history of internet treatment considered it less effective for self (p = .006 and p = .013, respectively), and older individuals – less effective for others (p = .011). Regarding ECT, though both cultures rated it as more effective for others than for self, Western English speakers rated it particularly effective for others (p = .026). Regarding alternative therapies, Western English speakers with higher depression considered them more effective for others (p = .019). Finally, regarding self-help books, cultural differences were not present, but more depressed individuals and those with no past history of self-help book use considered books to be less effective for themselves (p < .001 and p = .009, respectively), and those with more education – less effective for others (p = .026).

Conclusion: Psychoeducation campaigns are needed to improve the public’s perception of the effectiveness of mental health treatments. However, these efforts must ensure that individuals see the relevance of these treatments for their own situations; they also must take into account cultural and individual differences.