Academic Psychiatry

, Volume 38, Issue 4, pp 464–469 | Cite as

Personalized Normative Feedback for Depression Symptoms: a Qualitative Pilot Study of Female Undergraduates

  • Melanie HomEmail author
  • Catherine Heaney
  • Cheryl Koopman
Empirical Report



This pilot study explored students’ responses to feedback about their own and their peers’ depression symptoms. The study also examined how experiences with the normative feedback might vary according to academic exposure to depression-related topics.


For 9 weeks, female undergraduates (N = 73) completed a weekly web-based version of the 8-item Patient Health Questionnaire, which gauges depression symptom levels. Next, they participated in semi-structured face-to-face interviews where they responded to the personalized normative feedback. The interviews were transcribed, coded, and analyzed.


Students responded favorably to the feedback and without notable distress. The feedback increased students’ awareness of their own depression symptoms and those of their peers. Those with higher academic exposure to depression-related topics were more likely to have accurate perceptions of their peers’ depression symptoms and were less likely to be surprised by information in the feedback than students with less exposure.


Personalized normative feedback for depression symptoms has potential as an effective tool for promoting more accurate views of personal and peer depression symptoms and reducing barriers to help-seeking. Students with less academic exposure to depression-related topics may benefit from increased knowledge of how to gauge their own depression symptoms and increased awareness of their peers’ symptoms. Further research is needed to more fully evaluate the effects of this feedback and to directly assess the effects of this feedback on help-seeking behaviors.


Emotional problems/support Curriculum development 



This research was funded by Stanford University Undergraduate Advising and Research. We appreciate our participants and interviewers who helped make this study possible.


The authors have no conflicts of interest to disclose.


  1. 1.
    American College Health Association. American College Health Association–National College Health Assessment II: Reference Group Executive Summary Fall 2012. Hanover: American College Health Association; 2013.Google Scholar
  2. 2.
    Zivin K, Eisenberg D, Gollust SE, et al. Persistence of mental health problems and needs in a college student population. Journal of Affective Disorders. 2009;117:180–5.PubMedCrossRefGoogle Scholar
  3. 3.
    Gulliver A, Griffiths KM, Christensen H. Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review. BioMed Central Psychiatry. 2010;113:1–9.Google Scholar
  4. 4.
    Eisenberg D, Hunt J, Speer N, et al. Mental health service utilization among college students in the United States. Journal of Nervous and Mental Disease. 2011;199:301–8.PubMedCrossRefGoogle Scholar
  5. 5.
    Eisenberg D, Speer N, Hunt J. Attitudes and beliefs about treatment among college students with untreated mental health problems. Psychiatric Services. 2012;63:711–3.PubMedCrossRefGoogle Scholar
  6. 6.
    Eisenberg D, Downs MF, Golberstein E, et al. Stigma and help seeking for mental health among college students. Medical Care Research and Review. 2009;66:522–41.PubMedCrossRefGoogle Scholar
  7. 7.
    Eisenberg D, Hunt J, Speer N. Help seeking for mental health on college campuses: review of evidence and next steps for research and practice. Harvard Review of Psychiatry. 2012;20:222–32.PubMedCrossRefGoogle Scholar
  8. 8.
    Downs MF, Eisenberg D. Help seeking and treatment use among suicidal college students. Journal of American College Health. 2012;60:104–14.PubMedCrossRefGoogle Scholar
  9. 9.
    Hunt J, Eisenberg D. Mental health problems and help-seeking behavior among college students. Journal of Adolescent Health. 2010;46:3–10.PubMedCrossRefGoogle Scholar
  10. 10.
    Kauer SD, Reid SC, Crooke AH, et al. Self-monitoring using mobile phones in the early stages of adolescent depression: randomized controlled trial. J Med Internet Res. 2012;25:e67.CrossRefGoogle Scholar
  11. 11.
    Donker T, Griffiths KM, Cuijpers P, et al. Psychoeducation for depression, anxiety, and psychological distress: a meta-analysis. BMC Medicine. 2009;7:1741–7015.CrossRefGoogle Scholar
  12. 12.
    Geisner IM, Neighbors C, Larimer ME. A randomized clinical trial of a brief, mailed intervention for symptoms of depression. J Consult Clin Psychol. 2006;74:393–9.PubMedCrossRefGoogle Scholar
  13. 13.
    Carey KB, Borsari B, Carey MP, et al. Patterns and importance of self-other differences in college drinking norms. Psychology of Addictive Behaviors. 2006;20:385–93.PubMedCentralPubMedCrossRefGoogle Scholar
  14. 14.
    LaBrie JW, Hummer JF, Grant S, et al. Immediate reductions in misperceived social norms among high-risk college student groups. Addictive Behaviors. 2010;35:1094–101.PubMedCrossRefGoogle Scholar
  15. 15.
    Berkowitz A. An overview of the social norms approach. In: Lederman L, Steward L, Goodhart F, Laitman L, editors. Changing the culture of college drinking: a socially situated health communication campaign. Hampton: Hampton; 2005. p. 193–214.Google Scholar
  16. 16.
    Lewis MH, Neighbors C, Geisner IM, et al. Examining the associations among severity of injunctive drinking norms, alcohol consumption, and alcohol-related negative consequences: the moderating roles of alcohol consumption and identity. Psychology of Addictive Behaviors. 2010;24:177–89.PubMedCentralPubMedCrossRefGoogle Scholar
  17. 17.
    Walters ST, Neighbors C. Feedback interventions for college alcohol misuse: what, why and for whom? Addictive Behaviors. 2005;30:1168–82.PubMedCentralPubMedCrossRefGoogle Scholar
  18. 18.
    Eisenberg D, Hunt J, Speer N. Mental health in American colleges and universities: variation across student subgroups and across campuses. The Journal of Nervous and Mental Disease. 2013;20:60–7.CrossRefGoogle Scholar
  19. 19.
    Blanco C, Okuda M, Wright C, et al. Mental health of college students and their non-college-attending peers: results from the National Epidemiologic Study on Alcohol and Related Conditions. Archives of General Psychiatry. 2008;65:1429–73.PubMedCentralPubMedCrossRefGoogle Scholar
  20. 20.
    Lichtenstein G, McCormick AC, Sheppard SD, et al. Comparing the undergraduate experience of engineers to all other majors: significant differences are programmatic. Journal of Engineering Education. 2010;99:305–17.CrossRefGoogle Scholar
  21. 21.
    Kroenke K, Strine TW, Spitzer RL, et al. The PHQ-8 as a measure of current depression in the general population. Journal of Affective Disorders. 2009;114:163–73.PubMedCrossRefGoogle Scholar
  22. 22.
    Kroenke K, Spitzer RL, Williams JBW, et al. The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptoms Scales: a systematic review. General Hospital Psychiatry. 2010;32:345–59.PubMedCrossRefGoogle Scholar
  23. 23.
    Dedoose. Website: Accessed 15 Dec 2012.
  24. 24.
    Miles MB, Huberman AM, Saldana J. Qualitative data analysis: a methods sourcebook. Thousand Oaks: Sage Publications, Inc.; 2013.Google Scholar
  25. 25.
    Dewey ME. Coefficients of agreement. British Journal of Psychiatry. 1983;143:487–9.PubMedCrossRefGoogle Scholar

Copyright information

© Academic Psychiatry 2014

Authors and Affiliations

  1. 1.Stanford University School of MedicineStanfordUSA

Personalised recommendations