%0 Journal Article
%@ 1438-8871
%I JMIR Publications
%V 25
%N 
%P e37289
%T Analyzing User-Generated Web-Based Posts of Adolescents’ Emotional, Behavioral, and Symptom Responses to Beliefs About Depression: Qualitative Thematic Analysis
%A Dysthe,Kim Kristoffer
%A Røssberg,Jan Ivar
%A Brandtzaeg,Petter Bae
%A Skjuve,Marita
%A Haavet,Ole Rikard
%A Følstad,Asbjørn
%A Klovning,Atle
%+ Department of General Practice/Family Medicine, University of Oslo, Kirkeveien 166, Oslo, 0450, Norway, 47 47 22 85 05 50, k.k.dysthe@medisin.uio.no
%K adolescent
%K depression
%K internet
%K education
%K preventive psychiatry
%K early medical intervention
%K health literacy
%K cognitive behavioral therapy
%D 2023
%7 24.1.2023
%9 Original Paper
%J J Med Internet Res
%G English
%X Background: Depression is common during adolescence. Early intervention can prevent it from developing into more progressive mental disorders. Combining information technology and clinical psychoeducation is a promising way to intervene at an earlier stage. However, data-driven research on the cognitive response to health information targeting adolescents with symptoms of depression is lacking. Objective: This study aimed to fill this knowledge gap through a new understanding of adolescents’ cognitive response to health information about depression. This knowledge can help to develop population-specific information technology, such as chatbots, in addition to clinical therapeutic tools for use in general practice. Methods: The data set consists of 1870 depression-related questions posted by adolescents on a public web-based information service. Most of the posts contain descriptions of events that lead to depression. On a sample of 100 posts, we conducted a qualitative thematic analysis based on cognitive behavioral theory investigating behavioral, emotional, and symptom responses to beliefs associated with depression. Results: Results were organized into four themes. (1) Hopelessness, appearing as a set of negative beliefs about the future, possibly results from erroneous beliefs about the causal link between risk factors and the course of depression. We found beliefs about establishing a sturdy therapy alliance as a responsibility resting on the patient. (2) Therapy hesitancy seemed to be associated with negative beliefs about therapy prognosis and doubts about confidentiality. (3) Social shame appeared as a consequence of impaired daily function when the cause is not acknowledged. (4) Failing to attain social interaction appeared to be associated with a negative symptom response. In contrast, actively obtaining social support reduces symptoms and suicidal thoughts. Conclusions: These results could be used to meet the clinical aims stated by earlier psychoeducation development, such as instilling hope through direct reattribution of beliefs about the future; challenging causal attributions, thereby lowering therapy hesitancy; reducing shame through the mechanisms of externalization by providing a tentative diagnosis despite the risk of stigmatizing; and providing initial symptom relief by giving advice on how to open up and reveal themselves to friends and family and balance the message of self-management to fit coping capabilities. An active counseling style advises the patient to approach the social environment, demonstrating an attitude toward self-action. 
%M 36692944
%R 10.2196/37289
%U https://www.jmir.org/2023/1/e37289
%U https://doi.org/10.2196/37289
%U http://www.ncbi.nlm.nih.gov/pubmed/36692944