Construal Level Theory and Text Messaging Support for Antidepressant Medication Therapy

Laura A Downey, Purdue University

Abstract

This research is based on Construal Level Theory (CLT) and explores the impact of inducing high-level vs low-level construals through various message content on health behavior intentions in the context of medication taking in depression and anxiety. In addition to the direct effects on intentions, the research also explored the mediating roles of perceived psychological distance and risk perception on these intentions and the moderating effects of age and mental health stigma. Previous work in CLT suggests that concrete low-level construals, or mental representations, are likely to dominate thinking near decision times, but those who remain focused on more abstract high-level construals are more likely to follow through with good intentions and that a person can be induced to focus on these abstract benefits and goals through messaging. However, evidence that a person’s construal level mindset can be maintained over time to support ongoing intended behavior in the face of daily cognitive demands is lacking.Messages were sent via secure text service to a mobile device twice weekly for 4-weeks. Results of within and between-subjects analysis showed that low-level construal messages have the greatest direct effect on behavioral intentions (BI) (Wilks’ λ F=11.591, p<.001, η 2=.056) and actual medication taking behavior (Wilks’ λ F=2.979, p=.051, η 2=.271) as compared to controls. Significant changes were also seen in perceived social distance to a future risk (SD) (Wilks’ λ F=61.654, p<.001, η 2=.240) and overall risk perception (RP) (Wilks’ λ F=3.393, p=.019, η 2=.058) over the 4-week study vs controls, but no mediation effect was detected between messaging, SD, or RP and BI. Finally, mental health stigma (MHS) was seen to moderate the direct effect of the messaging on BI (F=2.701, p=.048, R2chng=.043).Results suggest text messages delivered over time can positively impact treatment adherence intention, behavior, and health attitudes in patients with depression and anxiety. In addition, the construal level focus of the messages is likely to impact those outcomes differentially in various patient groups.

Degree

Ph.D.

Advisors

Ju, Purdue University.

Subject Area

Clinical psychology|Medicine|Mental health|Psychology

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