Original Paper

Prevention Science

, Volume 7, Issue 2, pp 167-177

First online:

Adolescents’ Reactions to Universal and Indicated Prevention Programs for Depression: Perceived Stigma and Consumer Satisfaction

  • Ronald M. RapeeAffiliated withDepartment of Psychology, Macquarie University Email author 
  • , Ann WignallAffiliated withNorthern Sydney Area Health
  • , Jeanie SheffieldAffiliated withUniversity of Queensland
  • , Nick KowalenkoAffiliated withRoyal North Shore Hospital
  • , Anna DavisAffiliated withUniversity of Queensland
  • , Jordana McLooneAffiliated withDepartment of Psychology, Macquarie University
  • , Susan H. SpenceAffiliated withDepartment of Psychology, Macquarie University

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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.


Depression Prevention Stigma Program satisfaction Adolescent