Prevention Science

, Volume 7, Issue 2, pp 167–177 | Cite as

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
Original Paper


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 



This research was supported by National Health and Medical Research Council grant #YS047.


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Copyright information

© Society for Prevention Research 2006

Authors and Affiliations

  • Ronald M. Rapee
    • 1
  • Ann Wignall
    • 2
  • Jeanie Sheffield
    • 3
  • Nick Kowalenko
    • 4
  • Anna Davis
    • 3
  • Jordana McLoone
    • 1
  • Susan H. Spence
    • 1
  1. 1.Department of PsychologyMacquarie UniversitySydneyAustralia
  2. 2.Northern Sydney Area HealthSydneyAustralia
  3. 3.University of QueenslandSydneyAustralia
  4. 4.Royal North Shore HospitalSydneyAustralia

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