Framing depression as a functional signal, not a disease: Rationale and initial randomized controlled trial

This research paper – published in Social Science & Medicine – comes from Hans S. Schroder, Andrew Devendorf, and Brian J. Zikmund-Fisher.


  • Depression is often discussed as a medical disorder.
  • This framework has some benefits but also has some drawbacks.
  • We compared the disease framework to a novel framing of depression as a signal.
  • Framing depression as a signal led to less stigma and more hope about recovery.
  • Framing depression as a signal had no impact on treatment attitudes.

The abstract says:

“Depression is often framed as a disease or dysfunctional syndrome, yet this framing has unintended negative consequences including increased stigma. Here, we consider an alternative messaging framework – that depression serves an adaptive function. We describe the historical development of popular messages about depression and draw from the fields of evolutionary psychiatry and social cognition to describe the alternative framework that depression is a ‘signal’ that serves a purpose. We then present data from a pre-registered, online randomized-controlled study in which participants with self-reported depression histories viewed a series of videos that explained depression as a ‘disease like any other’ with known biopsychosocial risk factors (BPS condition), or as a signal that serves an adaptive function (Signal condition). In the entire sample (N = 877), three of the six hypotheses were supported: The Signal condition led to less self-stigma, greater offset efficacy, and more adaptive beliefs about depression. Exploratory analyses revealed these Signal effects were stronger among females (N = 553), who also showed a greater growth mindset of depression after the Signal explanation. Results suggest that framing depression as an adaptive signal can benefit patients and avoid harmful consequences of popular etiological presentations. We conclude that alternative framings of depression are worthy of further study …”

You can read the whole paper from here.

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