Refining the prevalence inflation hypothesis: Disentangling overinterpretation from self-fulfilling prophecies

The prevalence inflation hypothesis suggests that mental health awareness efforts can lead to an increase in rates of mental illness, first because awareness efforts encourage individuals with subclinical levels of distress to see their problems as mental illnesses (“overinterpretation”), and second because these individuals may then think and act in ways that promote actual mental illness (“self-fulfilling prophecy”). In this discussion paper, I argue that these two components are best understood—and best studied—as two distinct hypotheses. I present each hypothesis, discuss early evidence regarding each one, and outline the benefits of studying them independently.