Neural response to evaluating depression predicts perceivers’ mental health treatment recommendations

Abstract

Nonstigmatized perceivers’ initial evaluations of stigmatized individuals have profound consequences for the well-being of those stigmatized individuals. However, the mechanism by which this occurs remains underexplored. Specifically, what beliefs about the stigmatized condition (stigma-related beliefs) shape how nonstigmatized perceivers evaluate and behave toward stigmatized individuals? We examined these questions with respect to depression-related stigmatization because depression is highly stigmatized and nondepressed individuals’ behavior (e.g., willingness to recommend treatment) directly relates to removing stigma and increasing well-being. In Study 1, we identified common stigma-related beliefs associated with depression (e.g., not a serious illness, controllable, threatening), and found that only perceptions that depression is a serious condition predicted nondepressed perceivers’ willingness to recommend mental health treatment. Moreover, perceivers’ beliefs that depression is a distressing condition mediated the relationship between perceived seriousness and treatment recommendations (Study 1). In Study 2, we used fMRI to disentangle the potential processes connecting distress to nondepressed perceivers’ self-reported treatment intentions. Heightened activity in the dorsomedial prefrontal cortex (dmPFC)—a region widely implicated in evaluating others—and the ventrolateral prefrontal cortex (vlPFC)—a region widely implicated in regulating negative emotions—emerged when nondepressed perceivers evaluated individuals who were ostensibly depressed. Beliefs that depression is a distressing condition mediated the relationship between dmPFC (but not vlPFC) activity and nondepressed individuals’ self-reported treatment recommendations.