Frontiers in Psychology 01 frontiersin.org Combatting negative bias: a mental contrasting and implementation intentions online intervention to increase help-seeking among individuals with elevated depressive symptomatology Amanda R. Keeler 1,2,3 *, Liesl A. Nydegger 4,5 and William D. Crano 6 1 Penn State Primary Care Research Laboratory, Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA, United States, 2 Depression and Persuasion Research Laboratory, School of Social Science, Policy and Evaluation, Claremont Graduate University, Claremont, CA, United States, 3 Mood Disorder Research Lab, Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, PA, United States, 4 Department of Health, Behavior and Society, Johns Hopkins University, Baltimore, MD, United States, 5 Department of Kinesiology & Health Education, The University of Texas at Austin, Austin, TX, United States, 6 Institute of Health Psychology and Prevention Science, School of Social Science, Policy and Evaluation, Claremont Graduate University, Claremont, CA, United States Background: There are many reasons why individuals with depression may not seek help. Among those with elevated depressive symptomatology, some previous interventions aimed at increasing help-seeking have unintentionally decreased help-seeking intentions. Beck’s cognitive theory of depression posits that individuals with elevated depressive symptomatology process information differently from those without depression (i.e., increased cognitive errors, negative bias); potentially explaining the iatrogenic results of previous interventions. Mental contrasting and implementation intentions (MCII; a self-regulatory strategy) interventions have successfully influenced physical and mental health behaviors. However, MCII has not been used specifically for initiating help-seeking for depression. The goal of this research was to ascertain whether an online MCII intervention could increase actual help-seeking or the intention to seek help for depression. Method: Two online randomized pre-post experiments were conducted to measure the primary outcome measures 2 weeks post-intervention (Study 1 collected Summer 2019: information-only control [“C”], help-seeking MCII intervention [“HS”], and comparison MCII intervention [“E”]; Study 2 collected Winter 2020: “C” and “HS”). At Time 1, adults recruited from MTurk had a minimum Beck Depression Inventory (BDI-II) score of 14 (mild depressive symptoms) and were not seeking professional help. Results: Study 1 (N= 74) indicated that the intervention was feasible, provided preliminary support, and clarified intervention components for Study 2. Study 2 (N= 224) indicated that the HS group reported greater intentions to seek help and actual help-seeking than the C group. Proportionally, actual help-seeking was more likely among individuals who received the HS intervention and either did not perceive themselves as depressed at Time 2 or had BDI-II scores indicating that their depressive symptomatology decreased from Time 1. Limitations: Participation was limited to US residents who self-reported data. OPEN ACCESS EDITED BY Rashmi Gupta, Indian Institute of Technology Bombay, India REVIEWED BY Frank Wieber, Zurich University of Applied Sciences, Switzerland Calandra Lindstadt, Colorado State University, United States *CORRESPONDENCE Amanda R. Keeler mandakeeler@me.com RECEIVED 16 January 2023 ACCEPTED 16 May 2023 PUBLISHED 15 June 2023 CITATION Keeler AR, Nydegger LA and Crano WD (2023) Combatting negative bias: a mental contrasting and implementation intentions online intervention to increase help-seeking among individuals with elevated depressive symptomatology. Front. Psychol. 14:1145969. doi: 10.3389/fpsyg.2023.1145969 COPYRIGHT © 2023 Keeler, Nydegger and Crano. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. TYPE Original Research PUBLISHED 15 June 2023 DOI 10.3389/fpsyg.2023.1145969