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Qiu L, Wangzhou K, Liu Y, Ding J, Li H, Ma J. Status of professional mental health help-seeking intention associated factors among medical students: a cross-sectional study in China. Front Psychiatry 2024; 15:1376170. [PMID: 38895034 PMCID: PMC11184052 DOI: 10.3389/fpsyt.2024.1376170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 04/22/2024] [Indexed: 06/21/2024] Open
Abstract
Aim Low professional help-seeking intention (PHSI) hinders effective treatment of mental illness. PHSI among Chinese students is still understudied and under-recognized. This study aimed to evaluate the status of PHSI and its associated risk factors among Chinese medical students. Methods A cross-sectional survey was conducted in Hainan province, South China, between January 1, 2021, and May 31, 2021. A total of 2182 medical students were recruited and surveyed via an anonymous structured questionnaire. Logistic regression analyses were performed to identify the factors associated with PHSI. Results Among the 2182 medical students (mean age 21.0 years (SD = 3.70), 61.5% females), those with and without PHSI were 72.0% and 28.0%, and 16.4% with moderate to severe depression. Male students, those with a high level of depression stigma, serious family dysfunction, and heavy dependence on mobile phones were significantly less likely to seek professional mental health help, with odds ratios (ORs) of 1.5, 2.0, 2.1, and 1.7, respectively. Conclusion A significant proportion of Chinese medical students demonstrate low PHSI, influenced by factors such as gender, depression stigma, family dysfunction, and mobile phone dependence. Future interventions aimed at increasing medical students' PHSI should prioritize reducing depression stigma, mitigating reliance on mobile phone use, and enhancing family function to address these key barriers to seeking professional mental health support.
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Affiliation(s)
- Lei Qiu
- International School of Public Health, Hainan Medical University, Hainan, China
| | - Kaixin Wangzhou
- School of Management, Hainan Medical University, Hainan, China
| | - Yudan Liu
- School of Public Health, North Sichuan Medical College, Sichuan, China
| | - Jindong Ding
- International School of Public Health, Hainan Medical University, Hainan, China
- Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Hui Li
- School of Health Services Management, Anhui Medical University, Hefei, China
| | - Jinhui Ma
- School of Management, Hainan Medical University, Hainan, China
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Calear AL, Morse AR, Christensen H, McCallum S, Werner-Seidler A, Alexander R, Batterham PJ. Evaluating suicide attitudes and suicide literacy in adolescents. J Ment Health 2024; 33:312-319. [PMID: 37605447 DOI: 10.1080/09638237.2023.2245883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 04/05/2023] [Accepted: 07/08/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND Two of the most common modifiable barriers to help-seeking for mental health problems during adolescence are stigma and poor mental health literacy. However, relatively little is known about stigma as it relates to suicide, and knowledge about suicidality in this age group. AIMS To assess levels of suicide literacy and suicide attitudes in an adolescent sample, and to identify correlates of these constructs. METHODS Data were drawn from the pre-intervention survey of the Sources of Strength Australia Project. A total of 1019 adolescents aged between 11 and 17 years participated. Suicide literacy and attitudes were measured alongside potential correlates including psychological distress, suicidal ideation, mastery, previous exposure to suicidal thinking and behaviour, and demographics. RESULTS Participants more strongly endorsed attitudes attributing suicide to isolation/depression, compared to attitudes glorifying or stigmatising suicide. Gaps in knowledge about suicide included the risk factors, signs and symptoms. Key correlates of suicide attitudes and literacy included age, gender and cultural background. CONCLUSION Findings highlight the need for further education activities in schools and public awareness campaigns that address the gaps in suicide knowledge and attitudes. Such activities would assist in the identification of suicide risk among young people and improve help-seeking in this population.
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Affiliation(s)
- Alison L Calear
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Alyssa R Morse
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Helen Christensen
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Sonia McCallum
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
| | | | - Rebecca Alexander
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
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Shi J, Chen Y, Jiang Y, Li Y, Wang W, Zhao H, Guo L, Liao Y, Zhang H, Gao C, McIntyre RS, Zhang WH, Han X, Lu C. Stigma and its associations with medication adherence in major depressive disorder. Psychiatry Res 2024; 331:115664. [PMID: 38070363 DOI: 10.1016/j.psychres.2023.115664] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 12/03/2023] [Accepted: 12/04/2023] [Indexed: 01/02/2024]
Abstract
This study sought to evaluate internalized stigma (IS) and perceived stigma (PS), in persons (n = 522) living with major depressive disorder (MDD), with a view to analyzing the association of IS and PS with medication adherence in a cohort of participants with MDD in China. Perceived stigma is the awareness of societal negative views and attitudes towards depression, and IS is applying others' attitudes to oneself, both measured by the Depression Stigma Scale (DSS). Medication adherence was assessed using the Medication Adherence Rating Scale (MARS). We observed that 76.0 % of participants reported IS and 84.5 % reported PS. Factors associated with increased IS included older age, marital status, disease history, and a higher baseline Patient Health Questionnaire-9 (PHQ-9). Higher education level, family income, and scores on the Connor-Davidson Resilience Scale (CD-RISC) were associated with lower levels of IS. Higher education levels, Childhood Trauma Questionnaire (CTQ) scores, and living with others were also associated with higher PS, while engagement in exercise and higher number of prior episodes were associated with lower PS. IS had a negative association with medication adherence, whereas PS did not significantly associate with adherence. In conclusion, a testable hypothesis is derived from our data that strategies targeting IS amongst persons with MDD may improve overall rates of adherence to antidepressant treatment, a necessary prelude to improving recovery.
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Affiliation(s)
- Jingman Shi
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, PR China; Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, 510080, PR China
| | - Yan Chen
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, No.7, Huaming Road, Shenzhen 518054, PR China
| | - Yingchen Jiang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, PR China; Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, 510080, PR China
| | - Yanzhi Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, PR China; Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, 510080, PR China
| | - Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, PR China; Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, 510080, PR China
| | - Hao Zhao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, PR China; Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, 510080, PR China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, PR China; Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, 510080, PR China
| | - Yuhua Liao
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, No.7, Huaming Road, Shenzhen 518054, PR China
| | - Huimin Zhang
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, No.7, Huaming Road, Shenzhen 518054, PR China
| | - Caihong Gao
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, No.7, Huaming Road, Shenzhen 518054, PR China
| | - Roger S McIntyre
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Department of Pharmacology, University of Toronto, Toronto, ON, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Wei-Hong Zhang
- International Centre for Reproductive Health (ICRH), Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; School of Public Health, Université libre de Bruxelles (ULB), Bruxelles, Belgium
| | - Xue Han
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, No.7, Huaming Road, Shenzhen 518054, PR China.
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, PR China; Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, 510080, PR China.
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Zheng S, Wang R, Zhang S, Ou Y, Sheng X, Yang M, Ge M, Xia L, Li J, Zhou X. Depression severity mediates stigma and quality of life in clinically stable people with schizophrenia in rural China. BMC Psychiatry 2023; 23:826. [PMID: 37951892 PMCID: PMC10640747 DOI: 10.1186/s12888-023-05355-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 11/07/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Depressive symptoms associated with schizophrenia are closely related to stigma and quality of life(QOL). There is, however, no thorough research on the connection between the three. This study sought to investigate the possible factors influencing depressive symptoms in people with schizophrenia (PWS) in rural Chaohu, China, and to further explore the role of depression severity in stigma and lifestyle quality. METHODS Eight hundred twenty-one schizophrenia patients accomplished the entire scale, including the 9-item Patient Health Questionnaire (PHQ-9), the Social Impact Scale (SIS), and the World Health Organization on Quality of Life Brief Scale(WHOQOL-BREF). A straightforward mediation model was employed to determine if the intensity of the depression could act as a mediator between stigma and QOL. RESULTS Two hundred seventy-nine schizophrenia patients (34%) had depressive symptoms (PHQ ≥ 10), and 542 patients (66%) did not (PHQ < 10). Logistic regression showed that marital status, job status, physical exercise, standard of living, and stigma contributed to the depressed symptoms of schizophrenia. Depression severity partially mediated the effect between stigma and QOL, with a mediating effect of 48.3%. CONCLUSIONS This study discovered a significant incidence of depressed symptoms associated with schizophrenia, with depression severity serving as a mediator variable connecting stigma and QOL and partially moderating the association.
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Affiliation(s)
- Siyuan Zheng
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei City, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei City, China
- Anhui Psychiatric Center, Hefei City, China
| | - Ruoqi Wang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei City, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei City, China
- Anhui Psychiatric Center, Hefei City, China
| | - Shaofei Zhang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei City, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei City, China
- Anhui Psychiatric Center, Hefei City, China
| | - Yangxu Ou
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei City, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei City, China
- Anhui Psychiatric Center, Hefei City, China
| | - Xuanlian Sheng
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei City, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei City, China
- Anhui Psychiatric Center, Hefei City, China
| | - Meng Yang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei City, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei City, China
- Anhui Psychiatric Center, Hefei City, China
| | - Menglin Ge
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei City, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei City, China
- Anhui Psychiatric Center, Hefei City, China
| | - Lei Xia
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei City, China
- Anhui Psychiatric Center, Hefei City, China
| | - Jun Li
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei City, China
- Anhui Psychiatric Center, Hefei City, China
| | - Xiaoqin Zhou
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei City, China.
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei City, China.
- Anhui Psychiatric Center, Hefei City, China.
- Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei City, China.
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Hao Y, Wu Q, Wang X, Ma Y, Wang Y, Peng P, Wang X, Yang Q, Liu Y, Li M, He L, Wang Q, Zhou Y, Liu T, Chen S. Stigmatizing attitudes toward mental illness among caregivers of patients with mental disorders in China. Front Public Health 2023; 11:1071954. [PMID: 37427283 PMCID: PMC10325790 DOI: 10.3389/fpubh.2023.1071954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 03/22/2023] [Indexed: 07/11/2023] Open
Abstract
Objective This study aimed to investigate stigmatizing attitudes toward depression, schizophrenia, and general anxiety disorder (GAD) among caregivers of patients with mental disorders in China. Methods A cross-sectional study was conducted among 607 caregivers in China, using vignettes that described three mental illnesses. Data on the caregivers' attitudes and other people's attitudes toward individuals with mental disorders and their willingness to come in contact with people with mental disorders were collected. Results In the three vignettes, caregivers agreed that positive outcomes outnumbered negative outcomes. The top two statements endorsing the stigma were "the person could snap out of the problem" and "people with this problem are dangerous." In the section for perceived stigma, caregivers in the GAD vignette agreed that most people believed this problem is not a real medical illness, compared to schizophrenia. The rates of the statement endorsing unpredictability were significantly different in the schizophrenia (57.2%) and depression (45.5%) vignette, in comparison to the GAD (45.6%) vignette. For personal stigma, the caregivers tended to avoid people described in the depression vignette more often than in the GAD vignette. The caregivers were most unwilling to let the person described in the vignettes marry into their family, especially in the schizophrenia vignette. Conclusion Despite the stigma and desire for social distance associated with schizophrenia, depression, and GAD, caregivers often expect positive outcomes. Actions should be taken to improve caregivers' knowledge about mental health and reduce the stigma.
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Affiliation(s)
- Yuzhu Hao
- National Clinical Research Center on Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Qiuxia Wu
- National Clinical Research Center on Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xuyi Wang
- National Clinical Research Center on Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yuejiao Ma
- National Clinical Research Center on Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yunfei Wang
- National Clinical Research Center on Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Pu Peng
- National Clinical Research Center on Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xin Wang
- National Clinical Research Center on Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Qian Yang
- National Clinical Research Center on Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yueheng Liu
- National Clinical Research Center on Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Manyun Li
- National Clinical Research Center on Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Li He
- National Clinical Research Center on Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Qianjin Wang
- National Clinical Research Center on Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yanan Zhou
- National Clinical Research Center on Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
- Department of Psychiatry, Hunan Brain Hospital (Hunan Second People’s Hospital), Changsha, China
| | - Tieqiao Liu
- National Clinical Research Center on Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Shubao Chen
- National Clinical Research Center on Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
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Scholze K, Reich H, Passow P, Sander C, Czaplicki A, Hegerl U. Lifestyle causal beliefs are associated with higher personal and perceived stigma regarding depressive disorders: results from a representative population survey. BMC Psychiatry 2023; 23:414. [PMID: 37291498 PMCID: PMC10249268 DOI: 10.1186/s12888-023-04907-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 05/27/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND Depression is a prevalent and severe disorder associated with considerable stigma. This stigma contributes to the suffering and impedes help seeking behaviour of those affected. Stigma can be influenced by causal beliefs about depression and personal contact with people suffering from depression. The aim of this study was to investigate (1) the associations between beliefs about the aetiology of depression and personal / perceived stigma, as well as (2) a possible moderating effect of personal contact with people with depression on these associations. METHODS Stigma, causal beliefs, and contact with depression were assessed in a representative online survey among German adults (N = 5,000). Multiple regression analyses were performed with contact levels (unaffected vs. personally affected (diagnosed) vs. personally affected (undiagnosed) vs. affected by relatives with depression vs. persons who treat depression) and causal beliefs (biogenetic vs. psychosocial vs. lifestyle) as predictor variables for personal and perceived stigma as dependent variables. RESULTS Higher personal stigma was associated with lifestyle causal beliefs (p < .001, f² = 0.07), lower personal stigma with biogenetic (p = .006, f² = 0.01) and psychosocial (p < .001, f² = 0.02) causal beliefs. A positive interaction between psychosocial beliefs and the contact group "relatives" (p = .039) further suggests that this contact group does not benefit so strongly from psychosocial causal beliefs regarding personal stigma. Higher perceived stigma was associated with psychosocial (p < .001, f² = 0.01) and lifestyle (p < .011, f² = 0.01) causal beliefs. Regarding contact levels, the "unaffected" had significantly higher personal stigma scores than each of the other contact groups (p < .001). The contact group "affected (diagnosed)" had significantly higher perceived stigma scores than "unaffected". CONCLUSIONS The available data show that anti-stigma campaigns should clearly communicate, that depression is not caused by an unfavorable lifestyle. In general, psychosocial or biological explanatory models should be explained. Especially for the target group "relatives of depressive patients", who can be an important support for patients, education about biogenetic explanatory models should be provided. However, it is important to note that causal beliefs are only one of many factors that impact on stigma.
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Affiliation(s)
- Katharina Scholze
- Depression Research Centre, German Depression Foundation, Leipzig, Germany
| | - Hanna Reich
- Depression Research Centre of the German Depression Foundation, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Phyllis Passow
- Depression Research Centre, German Depression Foundation, Leipzig, Germany
| | - Christian Sander
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Andreas Czaplicki
- Depression Research Centre of the German Depression Foundation, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Ulrich Hegerl
- Johann Christian Senckenberg Distinguished Professorship, Goethe-University, Frankfurt am Main, Germany
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Curran T, Ito-Jaeger S, Perez Vallejos E, Crawford P. What's up with everyone?': The effectiveness of a digital media mental health literacy campaign for young people. J Ment Health 2023; 32:612-618. [PMID: 36876659 DOI: 10.1080/09638237.2023.2182412] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
BACKGROUND In 2021, the Arts and Humanities Research Council commissioned a mass-media mental health campaign called "What's up With Everyone?" Here, innovative co-created messages were professionally storied and animated by an internationally recognized production company and focused on improving mental health literacy in five core areas: competition, social media, perfectionism, loneliness and isolation, and independence. AIMS This study examines the impact of the "What's up With Everyone?" campaign on young people's mental health awareness. METHODS Seventy-one (19 males, 51 females, M age = 19.20 years, SD = 1.66, range = 17-22) young people completed a one-sample, pre-post experiment to measure changes in knowledge, attitudes, confidence, and stigma of mental health struggles, as well as help-seeking for mental ill-health before and following exposure to animations. RESULTS Paired and one-sample t-tests revealed that knowledge, attitudes, confidence, and willingness to seek support improved at post-test. There were also significant reductions in the stigma towards depression following the animations. CONCLUSIONS Continued long-term investment in campaigns such as "What's up With Everyone?" seems warranted given the impact on mental health awareness, help-seeking, and stigma.
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Affiliation(s)
- Thomas Curran
- Department of Psychological and Behavioural Science, London School of Economics and Political Science, London, UK
| | - Sachiyo Ito-Jaeger
- Faculty of Medicine and Health Sciences, The University of Nottingham, Nottingham, UK
| | - Elvira Perez Vallejos
- Faculty of Medicine and Health Sciences, The University of Nottingham, Nottingham, UK
| | - Paul Crawford
- Faculty of Medicine and Health Sciences, The University of Nottingham, Nottingham, UK
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Alsabi RNS, Zaimi AF, Sivalingam T, Ishak NN, Alimuddin AS, Dasrilsyah RA, Basri NI, Jamil AAM. Improving knowledge, attitudes and beliefs: a cross-sectional study of postpartum depression awareness among social support networks during COVID-19 pandemic in Malaysia. BMC Womens Health 2022; 22:221. [PMID: 35690751 PMCID: PMC9187926 DOI: 10.1186/s12905-022-01795-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 05/23/2022] [Indexed: 11/24/2022] Open
Abstract
Background Postpartum depression (PPD) is the most prevalent mental health disorder after childbirth, notably during the COVID-19 pandemic. In addition, PPD is known to have a long-term influence on the mother and the newborn, and the role of social support network is crucial in early illness recognition. This study aims to evaluate the social support networks’ level of knowledge, attitudes and beliefs regarding PPD and examine their sociodemographic variables and exposure to the public information relating to PPD during the COVID-19 pandemic in Malaysia. Methods A cross-sectional study was conducted via an online Google Form disseminated to people in Klang Valley through WhatsApp, Email, Facebook, Instagram and other available social media among postpartum women’s social support networks aged 18 years and living in the Klang Valley area (N = 394). Data were collected from 1 March to 5 July 2021 and analysed using the Mann–Whitney U-test and generalised linear mixed models. Results During the COVID-19 epidemic in Klang Valley, most participants had good knowledge, negative attitudes and awareness of PPD. Marital status, gender and parity all had significant correlations with the amount of awareness regarding PPD. Ethnicity, gender, parity and educational level showed significant association with attitude towards PPD. No significant relationship was noted between sociodemographic variables and PPD beliefs. Public awareness of PPD was also associated with knowledge and attitude towards it. Conclusions A significant positive knowledge, negative attitude and negative awareness level of PPD exist among social support networks for postnatal women. However, no significant effect of belief on PPD awareness level was noted. Implications Insight campaigns and public education about PPD should be conducted to enhance postnatal mothers’ awareness and knowledge. Postnatal care, mental check-ups and counselling sessions for the new mothers are recommended. In future studies, a closer assessment of postpartum social support, variances and similarities across women from diverse racial/ethnic origins is critical.
Strengths and limitations This cross-sectional study is one of the early studies on the area of PPD in the Malaysian region during COVID-19. Numerous data have been collected using low-cost approaches using self-administered surveys through Google Forms in this research.
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Qiu L, Feng Y, Luo J, Zhang Y, Yang Q. Predictors of personal depression stigma in medical students in China: differences in male and female groups. MEDICAL EDUCATION ONLINE 2022; 27:2093427. [PMID: 35747998 PMCID: PMC9245981 DOI: 10.1080/10872981.2022.2093427] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/19/2022] [Accepted: 06/20/2022] [Indexed: 06/15/2023]
Abstract
Depression is common worldwide, and stigmatizing attitudes toward depression have proved to be one of the major barriers to seeking professional help. The purpose of this study was to evaluate the level of personal depression stigma and identify its predictive factors among medical students in Hainan, China, as well as explore the gender difference. A total of 2,186 medical students were recruited using stratified random cluster sampling and interviewed by structured anonymous questionnaires. Personal stigma was measured by the standardized Depression Stigma Scale (DSS). Multivariate linear regression models were used to identify predictors of stigma, and the interactions between gender and each predictor were included to test its gender difference. The mean score on DSS Scale was 13.71 ± 5.35, with males significantly higher than females (14.85 vs 12.99, P < 0.0001). Compared to females, males were more likely to agree with 'I would not vote for a class cadre if I knew they had been depressed' and 'I would not make friends with him if I knew he had been depressed'. Multivariate linear regression analysis revealed that males' personal stigma was predicted by being only child (ß = 1.01, P = 0.0083), moderate-to-severe depression (ß = 1.12, P = 0.0302), and lower self-rated academic core competitiveness (Competitive: ß = 1.29, P = 0.0088, Not at all/Somewhat competitive: ß = 1.04, P = 0.0381), while females' personal stigma was only associated with moderate-to-severe depression (ß = 1.75, P < 0.0001). Significant interactions were found between gender and self-rated academic core competitiveness. Stigmatizing attitudes toward depression were prevalent among Chinese medical students, especially male students. Gender differences were found in the predictors of stigma. Effective measures must be taken to reduce the stigma of mental health among Chinese medical students.
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Affiliation(s)
- Lei Qiu
- International School of Public Health and One Health, Hainan Medical University, Hainan, P. R. China
| | - Yawen Feng
- School of Management, Hainan Medical University, Hainan, P. R. China
| | - Jiaxin Luo
- School of Management, Hainan Medical University, Hainan, P. R. China
| | - Yinuo Zhang
- International School of Public Health and One Health, Hainan Medical University, Hainan, P. R. China
| | - Qin Yang
- Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, P. R. China
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Swed S, Shoib S, Khan U, El-Sakka AA, Almoshantaf MB, Hassan NAIF, Khairy LT, Bakkour A, Muwaili AHH, Motawea KR, Abdelmajid FAA, Mohammed Sharif Ahmad E, Alsharief Ahmed SM, Hasan MM, Sawaf B, Albuni MK, Battikh E, Zainabo A, Alibrahim H, Ghaith HS, Elkalagi NKH. Attitude of Syrian students toward GAD patients: An online cross-sectional study. Front Public Health 2022; 10:955321. [PMID: 36438207 PMCID: PMC9682247 DOI: 10.3389/fpubh.2022.955321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 09/21/2022] [Indexed: 11/11/2022] Open
Abstract
Generalized Anxiety Disorder (GAD) is a prevalent condition and a significant cause of mental disability and poor quality of life. People with GAD have chronic worrying, restlessness, and discrimination from the general public; Little is known about the stigmatizing attitudes toward people with GAD among Syrian students. The questionnaires contained demographic data about age, gender, social status, personal stigma toward GAD scale, perceived stigma toward GAD scale, social distance with those with GAD, the participants' usual source of their knowledge about GAD, helpful interventions, and supporting information. A total of 1,370 replies were collected, but only 1,358 were used for analysis as 12 participants declined to complete the survey. About 44.1% of participants agreed that people with GAD could snap out of the problem, most of them being females (32.4% of the total population). Compared to medical students, more non-medical students (7.1% of the total population) believed that anxiety is a sign of personal weakness. This study demonstrated that Syrian college students showed a high level of stigmatizing and socially distancing attitudes toward people with GAD, particularly female and non-medical students.
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Affiliation(s)
- Sarya Swed
- Faculty of Medicine, Aleppo University, Aleppo, Syria
| | - Sheikh Shoib
- Department of Psychiatry, Jawahar Lal Nehru Memorial Hospital, Srinagar, Kashmir, India
| | - Ubaid Khan
- Faculty of Medicine, King Edward Medical University Lahore, Lahore, Pakistan
| | | | - Mohammad Badr Almoshantaf
- Department of Neurosurgery, Ibn Al-Nafees Hospital, Damascus, Syria,*Correspondence: Mohammad Badr Almoshantaf
| | | | - Lina Taha Khairy
- Faculty of Medicine, The National Ribat University, Khartoum, Sudan
| | - Agyad Bakkour
- Faculty of Medicine, Albaath University, Homs, Syria
| | | | | | | | | | | | - Mohammad Mehedi Hasan
- Department of Biochemistry and Molecular Biology, Faculty of Life Science, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | - Bisher Sawaf
- Department of Internal Medicine, Syrian Private University, Damascus, Syria
| | | | - Elias Battikh
- Faculty of Medicine, Tishreen University, Lattakia, Syria
| | - Asmaa Zainabo
- Faculty of Medicine, Tishreen University, Lattakia, Syria
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11
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Implicit attitudes toward psychotherapy and explicit barriers to accessing psychotherapy in youths and parent–youth dyads. CLINICAL PSYCHOLOGY IN EUROPE 2022; 4:e7375. [DOI: 10.32872/cpe.7375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 06/14/2022] [Indexed: 11/25/2022] Open
Abstract
Background
Few studies have investigated implicit and explicit attitudes toward psychotherapy in youths (Study 1), although information about attitudes would improve interventions that aim to decrease barriers to accessing psychotherapy including parents (Study 2), who facilitate the help-seeking process of youths.
Method
The Study 1 sample comprised 96 youths (14–21 years) and the Study 2 sample 38 parent–youth dyads. Differences in implicit attitudes regarding psychotherapy and a medical treatment were measured with the Implicit Association Test, and psychotherapy knowledge and self-reported barriers to psychotherapy were assessed with questionnaires. The actor-partner interdependence model was used to test the dyadic effects of implicit attitudes on explicit attitudes in parents and youths.
Results
We did not find evidence for an implicit bias toward psychotherapy compared to a medical treatment, neither in youths, nor in parents. Self-reported barriers were a predictor for lower help-seeking intentions. Deficits in psychotherapy knowledge were more relevant in younger participants. Having a prior or current experience with psychotherapy and having a friend or family member with a prior or current experience with psychotherapy were predictors for better psychotherapy knowledge, but was not for lower barriers to accessing psychotherapy. Partner effects (degree to which the individual’s implicit attitudes are associated with explicit attitudes of the other dyad’s member) were not found.
Conclusion
Specific deficits in psychotherapy knowledge should be addressed in interventions to lower barriers accessing psychotherapy. Parents should be included in interventions as a valuable resource to support youths in seeking psychotherapy for mental disorders.
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12
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Sibeoni J, Orri M, Manolios E, Spodenkiewicz M, Labey M, Verneuil L, Revah-Levy A. Early-treatment stage for adolescents with depression and their parents: An IPSE qualitative study. Eur Child Adolesc Psychiatry 2022:10.1007/s00787-022-01952-5. [PMID: 35124719 DOI: 10.1007/s00787-022-01952-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 01/22/2022] [Indexed: 12/18/2022]
Abstract
The period at the start of treatment of adolescents with depression is both crucial and complex. Adolescents' and parents' perspectives on that early-treatment stage are important but have not yet been explored. The present study explores the lived experience of the early-treatment stage among adolescents with major depressive disorder and their parents and aims to cross their perspectives. This French qualitative multicentre study followed the five stages IPSE approach. Semi-structured interviews with adolescents with depression and with their parents were conducted. Data collection by purposive sampling continued until we reached theoretical sufficiency. Forty-seven participants-20 adolescents, 27 parents-were included. Data analysis produced a structure of lived experience based on two axes: (1) what leads to care: what is shown, what is seen, describing a dynamic process of showing and seeing around the start of treatment and (2) the start of treatment: knowing and sharing everyone's explanations. Results suggest some early therapeutic alliance facilitators, that is, first to be able to see the depressive manifestations and directly address the issue of depression based on what is shown and seen, second to give the opportunity to both adolescents and parents to share their views and explanations about the adolescent's distress, and finally to explicitly name this distress depression to first agree on the term to use.
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Affiliation(s)
- Jordan Sibeoni
- Service Universitaire de Psychiatrie de L'Adolescent, Argenteuil Hospital Centre, 69 Rue du Lieutenant Colonel Prudhon, 95100, Argenteuil, France.
- ECSTRRA Team, UMR-1153, Inserm, Université de Paris, Paris, France.
| | - Massimiliano Orri
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Montreal, Québec, Canada
- Bordeaux Population Health Research Centre, INSERM U1219, University of Bordeaux, Bordeaux, France
| | - Emilie Manolios
- ECSTRRA Team, UMR-1153, Inserm, Université de Paris, Paris, France
- Service de Psychologie Et Psychiatrie de Liaison Et d'Urgences, Hôpital Européen Georges Pompidou AP-HP, Hôpitaux Universitaires Paris Ouest, Paris, France
| | - Michel Spodenkiewicz
- Sorbonne Universités, UPMC Univ Paris 06, CNRS UMR 7222, Institut Des Systèmes Intelligents Et de Robotique, Paris, France
- CEPOI EA 7388, Unité de Pédopsychiatrie de Liaison, Pôle de Santé Mentale, CHU Sud Réunion, Université de La Réunion, Saint-Pierre, France
- Groupe IPSOM, CESP Inserm U1178, Paris, France
| | - Mathilde Labey
- Hôpitaux de Saint-Maurice, pôle de psychiatrie adulte Paris 11, Saint-Maurice, France
| | - Laurence Verneuil
- ECSTRRA Team, UMR-1153, Inserm, Université de Paris, Paris, France
- Pôle Précarité, GHU Paris psychiatrie & neurosciences Site Sainte-Anne, Paris, France
| | - Anne Revah-Levy
- Service Universitaire de Psychiatrie de L'Adolescent, Argenteuil Hospital Centre, 69 Rue du Lieutenant Colonel Prudhon, 95100, Argenteuil, France
- ECSTRRA Team, UMR-1153, Inserm, Université de Paris, Paris, France
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13
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Sarfika R, Effendi N, Malini H, Edwin Nurdin A. Personal and Perceived Stigmas in Adolescents toward Peers with Mental Disorders in West Sumatra Indonesia. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The number of mental disorders in adolescents tends to increase every year in Indonesia. However, the stigma of mental disorders is a crucial factor that makes teens hide their mental health problem.
AIM: This study aimed to examine personal and perceived among adolescents towards peers with mental disorders (PMD) and to identify predictors of these constructs.
METHODS: This quantitative study with a cross-sectional design recruited 977 adolescents using a cluster random sampling technique. Adolescent stigma was assessed using the Peer Mental Health Stigmatization Scale (PMHSS). Multivariable general linear models (GLMs) was used for analysis.
RESULTS: The study shows that the perceived stigma (M = 36.62, SD = 5,183) tends to be higher than personal stigma (M = 39.49, SD = 5,495). Higher personal stigma was predicted by a lower level of academic (P < 0.01), lower levels of family monthly income (P < 0.01), and higher perceived stigma (P < 0.001). Higher perceived stigma was predicted by younger age (P < 0.05), lower levels of academic (P < 0.05), higher levels of family monthly income (P < 0.05), and higher personal stigma (P < 0.001).
CONCLUSION: The Findings suggest that stigmatization towards PMD is common among adolescents. The development of intervention programs should be directed at reducing negative perceptions of the environment. The identified predictors must also be considered in the development of future anti-stigma programs.
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Bhat AS, Boersma C, Meijer MJ, Dokter M, Bohlmeijer E, Li J. Plant Robot for At-Home Behavioral Activation Therapy Reminders to Young Adults with Depression. ACM TRANSACTIONS ON HUMAN-ROBOT INTERACTION 2021. [DOI: 10.1145/3442680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Adolescents with depression who participate in behavioral activation therapy may find it hard to be motivated to perform tasks at home that their therapists recommend. We describe the initial design and usability evaluation of a home device (“PlantBot”) that could be used to remind young adults with depression at home of their behavioral activation therapy-related tasks. The prototype features electronics in a two-layer base, with a fake plant on top and supported using the Amazon Echo voice agent. We use an online panel study to evaluate the usability of our system with youth with past depression (
N
= 30). Initial findings highlight the device’s usability, potential benefit, and attractiveness of the plant component, as well as multiple improvements to be made.
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Affiliation(s)
| | | | | | | | | | - Jamy Li
- University of Twente, The Netherlands
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15
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Chang C, Wang TJ, Chen MJ, Liang SY, Wu SF, Bai MJ. Factors influencing readiness to change in patients with alcoholic liver disease: A cross-sectional study. J Psychiatr Ment Health Nurs 2021; 28:344-355. [PMID: 32667735 DOI: 10.1111/jpm.12677] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 06/19/2020] [Accepted: 07/08/2020] [Indexed: 12/20/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Readiness to change has been documented as a factor affecting alcohol treatment attendance, engagement and outcome. Knowledge regarding readiness to change and its influencing factors in patients with alcoholic liver diseases will inform the development of relevant interventions to help these patients to successfully stop drinking. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The scores in all three dimensions of readiness, recognition, ambivalence and taking steps, were low. For the recognition stage, age, drinking severity and stigma are important factors to be considered. For the ambivalence stage, age and drinking severity are important influencing factors. For the taking steps stage, drinking refusal self-efficacy and depression should be the focus. Instead of negative associations, we found that age and drinking severity, self-stigma and depression were positively associated with readiness to change. Patients who are younger and have higher drinking severity, higher self-stigma, higher self-efficacy and severe depression are more likely to change alcohol use. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Age, drinking severity, self-stigma, drinking refusal self-efficacy and depression are important factors to be considered when mental health nurses try to increase psychological preparedness for changing alcohol use in patients with alcoholic liver diseases. Different factors must be considered for patients in different stages of readiness to change. Different alcohol treatments are needed for different patient populations. ABSTRACT: Introduction Readiness to change (RC) refers to the willingness or psychological preparedness for changing alcohol use. Knowledge regarding factors influencing RC is crucial for developing alcohol treatment plans. Aims The study's purpose was to investigate RC and its influencing factors in patients with alcoholic liver disease (ALD). The factors explored include demographics, disease characteristics, drinking severity, self-stigma, depression, social support and self-efficacy. Method This is a cross-sectional study using self-reported questionnaires. Results Eighty-seven patients with ALD were recruited. Their scores in all three dimensions of readiness, recognition, ambivalence and taking steps, were low. Self-stigma, age and drinking severity explained 32.3% variation in recognition. Drinking severity and age explained 21.5% variation in ambivalence. Self-efficacy, depression and age explained 19.3% variation in taking steps. Discussion Instead of negative associations, we found that age, drinking severity, self-stigma and depression were positively associated with RC. Younger patients with higher drinking severity, higher self-stigma, higher self-efficacy and severe depression are more likely to change alcohol use. Implications for practice Mental health nurses should consider factors such as age, drinking severity, self-stigma, self-efficacy and depression, while trying to increase patients' RC. More specifically, strategies to increase self-efficacy and interventions to support coping are needed. Relevance statement Many ALD patients needing treatment for problematic alcohol use can be effectively managed in primary care with appropriate specialist support. An experienced specialist mental health nurse can play this role. Mental health nurses are important members of alcohol addiction treatment teams. Traditionally, most nurses working in alcohol therapy services have been mental health specialists and work in a partnership model with physicians and other healthcare professionals. The influencing factors found in this study can further inform mental health nurses to recognize and work more effectively with ALD patients' alcohol problems.
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Affiliation(s)
- Chi Chang
- Department of Nursing, Mackay Memorial Hospital, Taipei, Taiwan.,School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Tsae-Jyy Wang
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Ming-Jen Chen
- Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Shu-Yuan Liang
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Shu-Fang Wu
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Ming-Jong Bai
- Division of Gastroenterology, Department of Internal Medicine, Taitung Mackay Memorial Hospital, Taitung, Taiwan
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16
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Heinz I, Baldofski S, Beesdo-Baum K, Knappe S, Kohls E, Rummel-Kluge C. "Doctor, my back hurts and I cannot sleep." Depression in primary care patients: Reasons for consultation and perceived depression stigma. PLoS One 2021; 16:e0248069. [PMID: 33667268 PMCID: PMC7935275 DOI: 10.1371/journal.pone.0248069] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 02/18/2021] [Indexed: 12/03/2022] Open
Abstract
Background General practitioners (GPs) play a significant role in depression care. Recognition of depression is crucial for adequate treatment but is impeded by a high portion of depressed patients only reporting physical symptoms to their GP. Among the many reasons for this phenomenon is mental health stigma. We investigated how patients with depression differed from patients without depression regarding the types and number of complaints presented to their GP, as well as their depression stigma. For the subgroup of patients with depression, potential associations between perceived depression stigma and number and types of presented complaints were investigated to see if these might reflect the patient’s intention to conceal mental health symptoms due to fear of being stigmatized by others. Further, we investigated if perceived depression stigma is related to depression treatment. Methods Data on depressive symptoms (assessed by the Depression Screening Questionnaire; DSQ), depression stigma (assessed by the Depressions Stigma Scale; DSS), type of complaints reported to the GP and treatment-related factors were collected from 3,563 unselected primary care patients of 253 GPs in a cross-sectional epidemiological study (“VERA study”) in six different German regions. Data of a total of 3,069 patients was used for analysis on complaints reported to the GP (subsample of the VERA study), and for 2,682 out of 3,069 patients data on a stigma questionnaire was available. Results Nearly half of the primary care patients with depression (42.2%) reported only physical complaints to their GP. Compared to patients without a depression diagnosis, patients with depression reported twice as many complaints to their GP with a mean of 2.02 (1.33) vs. 1.2 (0.69), including a more frequent combination of physical and mental symptoms (28.8% vs. 3.5%). Patients with depression showed higher total stigma compared to patients without depression, Mdn = 48 (IQR 40–54) vs. Mdn = 46.3 (IQR 29–53), due to higher perceived stigma, Mdn = 27 (IQR 21–32) vs. Mdn = 25.9 (IQR 20–29). Perceived stigma was associated with male gender (beta -.14, p = .005) and a lack of pharmacological treatment (beta -.14, p = .021) in patients with a depression diagnosis. Conclusion The number of complaints presented to the GP might function as a marker to actively explore depression in primary care patients, in particular when both physical and mental symptoms are reported. Perceived depression stigma should also be addressed especially in male patients. Further research should clarify the role of perceived stigma as a potential inhibitor of pharmacological treatment of depression in primary care.
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Affiliation(s)
- Ines Heinz
- Department of Psychiatry and Psychotherapy, Medical Faculty, University Leipzig, Leipzig, Germany
- German Alliance Against Depression, Leipzig, Germany
- * E-mail:
| | - Sabrina Baldofski
- Department of Psychiatry and Psychotherapy, Medical Faculty, University Leipzig, Leipzig, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany
| | - Susanne Knappe
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany
| | - Elisabeth Kohls
- Department of Psychiatry and Psychotherapy, Medical Faculty, University Leipzig, Leipzig, Germany
| | - Christine Rummel-Kluge
- Department of Psychiatry and Psychotherapy, Medical Faculty, University Leipzig, Leipzig, Germany
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17
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Lynch H, McDonagh C, Hennessy E. Social Anxiety and Depression Stigma Among Adolescents. J Affect Disord 2021; 281:744-750. [PMID: 33257039 DOI: 10.1016/j.jad.2020.11.073] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/06/2020] [Accepted: 11/08/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND The stigma associated with mental disorders in adolescence has a range of detrimental consequences, negatively impacting help-seeking behaviours and quality of life. Social anxiety typically has its onset during adolescence, but the associated stigma is not well understood. This study was designed to improve understanding of social anxiety and depression stigma in adolescence by examining demographic and personal variables that predict them both. METHODS Three hundred and fifteen adolescents (150 males, 165 females), from 2nd and 4th year of secondary school (mean ages 13.92 and 15.92 years respectively), completed the Peer Mental Health Stigmatization Scale to measure both personal and perceived stigma towards vignettes depicting social anxiety and depression. They also answered demographic questions and completed the Social Anxiety Scale for Adolescents. RESULTS Hierarchical multiple regression revealed that gender predicted both personal and perceived stigma towards depression and personal stigma towards social anxiety. Males scored higher on measures of personal stigma whereas females had higher scores on perceived stigma. Ability to accurately identify symptoms described in a vignette, predicted lower personal stigma towards social anxiety and higher perceived stigma towards depression. Depression was more stigmatized than social anxiety. LIMITATIONS The study used vignettes to represent individuals with depression and social anxiety so participant responses may not reflect their behaviour towards real peers. CONCLUSIONS Findings emphasise the importance of separately considering personal and perceived stigma for each condition and highlight gender differences in stigma responses that need to be considered in intervention design.
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18
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Calear AL, Batterham PJ, Torok M, McCallum S. Help-seeking attitudes and intentions for generalised anxiety disorder in adolescents: the role of anxiety literacy and stigma. Eur Child Adolesc Psychiatry 2021; 30:243-251. [PMID: 32180026 DOI: 10.1007/s00787-020-01512-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 03/10/2020] [Indexed: 01/24/2023]
Abstract
Help seeking for anxiety tends to be low in adolescents. Identifying modifiable factors that may facilitate help seeking is important. The aim of the current study is to test the effects of generalized anxiety disorder (GAD) literacy and stigma (personal and perceived) on attitudes and intentions toward seeking help from professionals and key adult sources. 1767 adolescents aged 12-18 years participated in the current study and completed measures of GAD literacy, GAD stigma, professional help-seeking attitudes, and intentions to seek help from a range of sources. The results of the study found that participants had limited GAD literacy and up to 20% personally agreed with stigmatising statements about GAD. Participants reported greater intentions to seek help from parents than from formal sources. More positive attitudes toward seeking help were associated with higher levels of GAD literacy (p < 0.001) and lower personal GAD stigma (p < 0.001). Lower perceived GAD stigma was associated with increased intentions to seek help from their mothers (p < 0.05) or fathers (p < 0.01), while lower personal GAD stigma was also associated with help-seeking intentions from their mothers (p < 0.05). Higher perceived GAD stigma was associated with intentions to seek help from nobody (p < 0.001). Overall, the current study highlights the important role that parents can play in the help-seeking process for adolescents, with parents often the most accessible source of help. Improving parent and adolescent knowledge and attitudes towards GAD may help to improve early help seeking in young people.
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Affiliation(s)
- Alison L Calear
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, 63 Eggleston Road, Acton , ACT, 2601, Australia.
| | - Philip J Batterham
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, 63 Eggleston Road, Acton , ACT, 2601, Australia
| | - Michelle Torok
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, 2031, Australia
| | - Sonia McCallum
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, 63 Eggleston Road, Acton , ACT, 2601, Australia
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19
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Martínez V, Crockett MA, Jiménez-Molina Á, Espinosa-Duque HD, Barrientos E, Ordóñez-Carrasco JL. Stigmatizing Beliefs and Attitudes to Depression in Adolescent School Students in Chile and Colombia. Front Psychol 2020; 11:577177. [PMID: 33192890 PMCID: PMC7645029 DOI: 10.3389/fpsyg.2020.577177] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 09/22/2020] [Indexed: 11/13/2022] Open
Abstract
Major depressive disorder (MDD) affects between 4 and 5% of adolescents. However, there is still a huge gap between adolescents who meet criteria for MDD and those who receive mental health care. Stigmatizing attitudes toward depression are among the main barriers to seeking professional help. The aim of this article is to examine the individual characteristics associated with stigmatizing attitudes toward depression in a sample of adolescent school students from Chile and Colombia, and present the adaptation and psychometric properties of the Personal Depression Stigma Scale (DSS-Personal) for both countries. A total of 2971 adolescents, aged 10–19 (M = 14.6, SD = 1.5), who were recruited from eight schools in Santiago, Chile (n = 2022), and eight schools in Medellín, Colombia (n = 949), completed the DSS-Personal, the Patient Health Questionnaire (PHQ-9), and a questionnaire of individual sociodemographic characteristics. Factor structure, internal consistency, and validity of the DSS-Personal were assessed. Multiple linear regression models were used to evaluate the association between DSS-Personal scores and sociodemographic information, depression scores, and the use of health services by country. Confirmatory factor analysis supported the unidimensional structure of the DSS-Personal, while the estimated reliability of its scores was acceptable. Results show that DSS-Personal scores were higher in adolescents in Colombia than in Chile (U = 9.36, p < 0.001). Immigrant status was the only variable significantly related to personal depression stigma in both samples. Being female was associated with lower levels of stigma in adolescents in Chile, while depressive symptoms were associated with lower levels of stigma in adolescents in Colombia. Age, having been diagnosed with depression, and being in pharmacological or psychological treatment were not related to levels of personal depression stigma in either sample. The identified associated factors of personal depression stigma should be considered in the development of anti-stigma campaigns; also, gender differences require special attention. The results of this study suggest that it is important to offer school-based programs to reduce personal stigma, and that specific anti-stigma campaigns should address personal stigma in men and immigrants.
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Affiliation(s)
- Vania Martínez
- Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente (CEMERA), Facultad de Medicina, Universidad de Chile, Santiago, Chile.,ANID, Millennium Science Initiative Program, Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile.,ANID, Millennium Science Initiative Program, Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile
| | - Marcelo A Crockett
- ANID, Millennium Science Initiative Program, Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile.,ANID, Millennium Science Initiative Program, Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile.,Doctorado en Salud Pública, Escuela de Salud Pública, Universidad de Chile, Santiago, Chile
| | - Álvaro Jiménez-Molina
- Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente (CEMERA), Facultad de Medicina, Universidad de Chile, Santiago, Chile.,ANID, Millennium Science Initiative Program, Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile.,ANID, Millennium Science Initiative Program, Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile.,ANID, Millennium Science Initiative Program, Millennium Nucleus in Social Development (DESOC), Santiago, Chile.,Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
| | - H Daniel Espinosa-Duque
- ANID, Millennium Science Initiative Program, Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile.,Facultad de Psicología, Universidad CES, Medellín, Colombia
| | - Elisa Barrientos
- ANID, Millennium Science Initiative Program, Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile.,Departamento de Psiquiatría y Salud Mental Oriente, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Jorge L Ordóñez-Carrasco
- ANID, Millennium Science Initiative Program, Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile.,Departamento de Psicología, Universidad de Almería, Almería, Spain
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20
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Ferrari S, Bressi C, Busnelli E, Mattei G, Pozzoli S, Oliva A, Galeazzi GM, Pingani L. Stigma on Mental Health among High School Students: Validation of the Italian Version of the Attribution Questionnaire-27 (AQ-27-I) in a High School Student Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145207. [PMID: 32707640 PMCID: PMC7400441 DOI: 10.3390/ijerph17145207] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/16/2020] [Accepted: 07/17/2020] [Indexed: 12/12/2022]
Abstract
The purpose of this study was to describe the psychometric characteristics of the AQ-27-I in a high school student population. Students aged between 17 and 20 years and attending the fourth and fifth year of a scientific high school in Milan were approached at the school and were asked to fill in an anonymous socio-demographic form and the AQ-27-I. Cronbach’s alpha was used to estimate the instrument reliability and confirmatory factor analysis (CFA) was conducted and compared to the original English version factor structure. The AQ-27-I demonstrated acceptable internal consistency, with a Cronbach’s alpha of 0.87 and only one subscale (Personal responsibility) with an alpha lower than 0.60. Fit indices were very positive for the Dangerousness Model supporting the factor structure and paths of the original version. The Personal Responsibility Model, on the other hand, showed some weakness, concerning the process dynamics of the model. The results obtained are similar with those from other studies carried out in Italy and other countries. The questionnaire can be used for the quantitative description of stereotypes, emotions and behaviors associated with stigma in mental health in high school student populations.
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Affiliation(s)
- Silvia Ferrari
- Department of Biomedical, Metabolic Sciences and Neurosciences, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124 Modena, Italy; (S.F.); (G.M.); (L.P.)
| | - Cinzia Bressi
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milano, Italy; (C.B.); (E.B.); (S.P.); (A.O.)
| | - Elisa Busnelli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milano, Italy; (C.B.); (E.B.); (S.P.); (A.O.)
| | - Giorgio Mattei
- Department of Biomedical, Metabolic Sciences and Neurosciences, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124 Modena, Italy; (S.F.); (G.M.); (L.P.)
- Department of Economics “Marco Biagi”, University of Modena and Reggio Emilia, Via Jacopo Berengario 51, 41121 Modena, Italy
| | - Sara Pozzoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milano, Italy; (C.B.); (E.B.); (S.P.); (A.O.)
| | - Anna Oliva
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milano, Italy; (C.B.); (E.B.); (S.P.); (A.O.)
| | - Gian Maria Galeazzi
- Department of Biomedical, Metabolic Sciences and Neurosciences, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124 Modena, Italy; (S.F.); (G.M.); (L.P.)
- Correspondence: ; Tel.: +39-059-422-2193
| | - Luca Pingani
- Department of Biomedical, Metabolic Sciences and Neurosciences, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124 Modena, Italy; (S.F.); (G.M.); (L.P.)
- Department of Health Professions, Azienda USL–IRCCS di Reggio Emilia, Via Amendola 2, 42122 Reggio Emilia, Italy
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Stigma towards depression in a community-based sample in China. Compr Psychiatry 2020; 97:152152. [PMID: 31838297 DOI: 10.1016/j.comppsych.2019.152152] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 11/12/2019] [Accepted: 11/29/2019] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE Understanding the general public's beliefs about depression is essential if public education and anti-stigma interventions are to be effective. This study aimed to examine Chinese respondents' personal attitudes towards depression and their perceptions about the attitudes of others regarding depression and to identify the correlates of personal stigma and perceived stigma towards depression. METHODS A community survey was conducted among 1697 residents aged between 16 and 89 years of a large city in central China using the Depression Stigma Scale. Participants completed questionnaires assessing experiences of depression and family functioning. RESULTS Participants reported high levels of stigma towards depression, with greater perceived stigma than personal stigma. Increasing age was correlated with greater personal stigma and perceived stigma. Higher personal stigma was also significantly correlated with being male, unemployed and good family function. CONCLUSION Concerningly high levels of stigmatizing beliefs towards depression were prevalent among the public. This may be a reason why people with mental disorders do not seek assistance. This highlights the importance of the need for health education and promotion activities. Findings from this study suggest that targeted, culturally appropriate education programs are needed to improve knowledge about depression in the broader community.
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Chen S, Ma Y, Cai W, Moretta T, Wang X, Liu T, Potenza MN. Factorial validity of a substance-use stigma scale in methamphetamine-using adults in China. Drug Alcohol Depend 2020; 206:107677. [PMID: 31732296 PMCID: PMC6980741 DOI: 10.1016/j.drugalcdep.2019.107677] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 09/29/2019] [Accepted: 10/01/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND Despite the large number of individuals who use substances of abuse and the stigma of such behaviors in China, scales have not been developed and validated for assessing substance-use stigma. Given its importance for targeting interventions, the aim of the present study was to validate a Chinese substance-use stigma measure including three dimensions of substance-use-disorder-related stigma (personal stigma, perceived stigma and social distance) by modifying a pre-existing scale measuring mental illness-related stigma and social distance. METHODS A convenience sample of eight-hundred-and-twelve individuals with substance abuse (aged 18-68 years) from different drug rehabilitation centers completed a self-reported survey including their demographics and drug use, and the stigma and social distance scales. The adapted, translated from English to Chinese, and back-translated scales were an 18-items stigma scale including personal stigma and perceived stigma subscales and a 5-items one domain social distance scale. Confirmatory factor analysis and multigroup confirmatory factor analysis tested factorial validity and measurement invariance of the scales, respectively. RESULTS For the stigma scale, by deleting one low correlation dimension (named "weak-not-sick"), personal stigma and perceived stigma showed acceptable fit indices and internal consistency with two dimensions (named "dangerous/unpredictable" and "social discrimination"), separately. The social distance scale showed good fit indices and internal consistency as a separate facet of stigma-related substance-use problems. Invariance of the model across drug-rehabilitation centers was found. CONCLUSIONS The Chinese substance-use stigma scale may serve as a valuable tool for better understanding substance-use stigma among adults in China who abuse substances.
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Affiliation(s)
- Shubao Chen
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Chinese National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, China; Chinese National Technology Institute on Mental Disorders, Changsha, Hunan, China; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China; Mental Health Institute of Central South University, Changsha, Hunan, China; Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Yuejiao Ma
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Chinese National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, China; Chinese National Technology Institute on Mental Disorders, Changsha, Hunan, China; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China; Mental Health Institute of Central South University, Changsha, Hunan, China
| | - Weifu Cai
- Department of Psychiatry, People's Hospital of Zhuhai, Zhuhai, Guangzhou, China
| | - Tania Moretta
- Department of General Psychology, University of Padova, Italy
| | - Xuyi Wang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Chinese National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, China; Chinese National Technology Institute on Mental Disorders, Changsha, Hunan, China; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China; Mental Health Institute of Central South University, Changsha, Hunan, China.
| | - Tieqiao Liu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Chinese National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, China; Chinese National Technology Institute on Mental Disorders, Changsha, Hunan, China; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China; Mental Health Institute of Central South University, Changsha, Hunan, China.
| | - Marc N Potenza
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Connecticut Mental Health Center, New Haven, CT, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA; Department of Neuroscience, Yale School of Medicine, New Haven, CT, USA; Child Study Center, Yale School of Medicine, New Haven, CT, USA
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Heinz I, Mergl R, Hegerl U, Rummel-Kluge C, Kohls E. Depression stigma and management of suicidal callers: a cross-sectional survey of crisis hotline counselors. BMC Psychiatry 2019; 19:342. [PMID: 31694588 PMCID: PMC6836490 DOI: 10.1186/s12888-019-2325-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 10/15/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Crisis hotlines play a key role in suicide prevention worldwide following different approaches regarding risk assessment and management of suicidality. This is to our knowledge the first study investigating depression stigma in crisis hotline counselors. The association between stigma and self-rated knowledge and their exploration of suicide risk and consecutive management of suicidal callers is being investigated. METHODS Data on depression stigma, self-rated knowledge, self-reported exploration and management of suicidality was collected from 893 counselors working for the German crisis hotline. Stigma in counselors had been compared to matched population sample (1002). RESULTS Crisis hotline counselors reported significantly lower depression stigma compared to the general population. Depression stigma and age associations differed in both samples. The reported exploration of suicide risk in callers differed depending on the self-rated knowledge about suicidality and depending on the personal depression stigma, but not the reported consecutive management. CONCLUSION Compared to the general population, crisis hotline counselors seem to have fewer stigmatizing attitudes toward depression. Attitudes and self-rated knowledge seem to influence the confidence in counselors regarding the exploration of suicidal callers, but not the consecutive management. The results indicate that a profound training and hands-on information about depression and suicide risk seem to be essential.
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Affiliation(s)
- Ines Heinz
- Department of Psychiatry and Psychotherapy, Medical Faculty, University Leipzig, Semmelweisstr. 10, Haus 13, 04103, Leipzig, Germany. .,German Alliance Against Depression, Goerdelerring 9, 04109, Leipzig, Germany.
| | - Roland Mergl
- 0000 0000 8801 1556grid.7752.7Bundeswehr University Munich, Institute of Clinical Psychology and Psychotherapy, Werner-Heisenberg-Weg 39, 85577 Neubiberg, Germany
| | - Ulrich Hegerl
- German Alliance Against Depression, Goerdelerring 9, 04109 Leipzig, Germany ,0000 0004 1936 9721grid.7839.5Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University Frankfurt (Distinguished Professorship funded by Dr. Senckenbergische Stiftung), Heinrich-Hoffmann-Strasse 10, 60528 Frankfurt am Main, Germany
| | - Christine Rummel-Kluge
- 0000 0001 2230 9752grid.9647.cDepartment of Psychiatry and Psychotherapy, Medical Faculty, University Leipzig, Semmelweisstr. 10, Haus 13, 04103 Leipzig, Germany
| | - Elisabeth Kohls
- 0000 0001 2230 9752grid.9647.cDepartment of Psychiatry and Psychotherapy, Medical Faculty, University Leipzig, Semmelweisstr. 10, Haus 13, 04103 Leipzig, Germany
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Göpfert NC, Conrad von Heydendorff S, Dreßing H, Bailer J. Applying Corrigan's progressive model of self-stigma to people with depression. PLoS One 2019; 14:e0224418. [PMID: 31661518 PMCID: PMC6818799 DOI: 10.1371/journal.pone.0224418] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 10/14/2019] [Indexed: 11/18/2022] Open
Abstract
Background The progressive model of self-stigma describes four stages of internalizing stereotypes of mental illness: stereotype awareness, personal agreement, self-concurrence, and harm to self (i.e., self-esteem). Successive stages are postulated to be the most highly related. Endorsement is presumed to decrease by stage. The model has been supported in most but not all elements in various studies. The procedural character has not yet been investigated in one integrative model. The aim of this study was to test the progressive model of self-stigma in three respects: I) successive stages have the strongest associations, II) endorsements decrease with each stage, and III) the procedural character can be represented by one serial mediation model. Methods A cross-sectional computer-based survey was conducted in two samples of patients with depression; one online sample (NA = 550; only self-report) and one clinical face-to-face sample (NB = 180; screening by treatment staff). The inclusion criteria were, age of 18–70 years, sufficient cognitive abilities and German language skills. IBM SPSS statistics 24 was used for Cronbach’s alphas, descriptive statistics, Spearman correlations, and Mann-Whitney-U tests. The PROCESS procedure for SPSS Version 3.00 was used for mediation analyses. Results The results support the progressive model of self-stigma in people with depression in most respects: Endorsements for stereotype awareness were higher than for personal agreement and self-concurrence, and no relevant difference was found between personal agreement and self-concurrence. Successive stages had the strongest associations, with the exception of the association between stereotype awareness and self-esteem, which was higher than the association between stereotype awareness and personal agreement and self-concurrence. The association between stereotype awareness and self-esteem was mediated via personal agreement and self-concurrence. Conclusion The progressive model of self-stigma offers a theoretical foundation for the process research of self-stigma. Longitudinal research may investigate predictive effects and whether different stages of self-stigma require specific consideration in their prediction, consequences, and potential interventions.
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Affiliation(s)
- Nele Cornelia Göpfert
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim / University Heidelberg, Mannheim, Germany
- * E-mail:
| | - Steffen Conrad von Heydendorff
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim / University Heidelberg, Mannheim, Germany
| | - Harald Dreßing
- Department of Forensic Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim / University Heidelberg, Mannheim, Germany
| | - Josef Bailer
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim / University Heidelberg, Mannheim, Germany
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Zhu L, Yao J, Wu L, Wang J, Qiu M, Zhang C, Zhang H, Xie J, Liu A, Ranchor A, Schroevers M. Psychometric properties of the Depression Stigma Scale (DSS) in Chinese cancer patients: a cross-sectional study. BMJ Open 2019; 9:e028429. [PMID: 31340966 PMCID: PMC6661685 DOI: 10.1136/bmjopen-2018-028429] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES The Depression Stigma Scale (DSS) is commonly used to assess depression stigma in the general population and in people with depression. The DSS includes two 9-item subscales assumed to measure personal depression stigma (ie, personal perceptions of depression) and perceived depression stigma (ie, perceptions of how others perceive depression). The aim of the present study was to examine its psychometric properties in terms of validity and reliability in Chinese cancer patients. DESIGN A cross-sectional study design. PARTICIPANTS AND SETTINGS This study focused on 301 Chinese cancer patients recruited from two hospitals in Xi'an, China. METHODS Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to assess the factor structure. Internal consistency was assessed using Cronbach's alpha. To examine concurrent validity, symptoms of depression were used as the criterion. RESULTS For each subscale of the DSS (ie, personal and perceived depression stigma), the EFA and CFA confirmed a two-factor structure: weak-not-sick (ie, perceiving that depression is not a real illness, but rather a sign of weakness) and discrimination (ie, perceiving that depressed people are discriminated against). The Cronbach's alphas were adequate, ranging from 0.70 to 0.80. Symptoms of depression were positively but weakly correlated to personal and perceived depression stigma. CONCLUSIONS The DSS appeared to show satisfactory psychometric properties in our sample of cancer patients. Both personal depression stigma and perceived depression stigma subscales consisted of two underlying aspects.
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Affiliation(s)
- Lei Zhu
- School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Juntao Yao
- Shaanxi Provincial Tumor Hospital, Xi'an, China
| | - Liyang Wu
- School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Jun Wang
- School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Mengting Qiu
- School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Chunyu Zhang
- School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Hongmei Zhang
- Department of Oncology, Xijing Hospital attached to the Medical University of the Air Force, Xi'an, China
| | - Juan Xie
- Shaanxi Provincial Tumor Hospital, Xi'an, China
| | - Ailan Liu
- Shaanxi Provincial Tumor Hospital, Xi'an, China
| | - Adelita Ranchor
- Department of Health Psychology, University Medical Center Groningen, Groningen, The Netherlands
| | - Maya Schroevers
- Department of Health Psychology, University Medical Center Groningen, Groningen, The Netherlands
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Singh S, Zaki RA, Farid NDN. A systematic review of depression literacy: Knowledge, help-seeking and stigmatising attitudes among adolescents. J Adolesc 2019; 74:154-172. [DOI: 10.1016/j.adolescence.2019.06.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 05/14/2019] [Accepted: 06/07/2019] [Indexed: 01/11/2023]
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Karaffa KM, Hancock TS. Mental Health Stigma and Veterinary Medical Students' Attitudes Toward Seeking Professional Psychological Help. JOURNAL OF VETERINARY MEDICAL EDUCATION 2019; 46:459-469. [PMID: 30920943 DOI: 10.3138/jvme.1217-185r] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Veterinary medical students may be at increased risk for a variety of mental health problems. However, research with student samples suggests that students in distress may not seek professional help, even when mental health services are available. The purpose of this study was to explore veterinary students' willingness to seek mental health services for several common presenting concerns, as well as their perceptions of their peers' willingness to seek help for the same concerns. We also sought to explore the roles of public stigma, self-stigma, and attitudes toward seeking professional psychological help in explaining students' willingness to seek services using a serial mediation analysis. Study participants were 573 veterinary medical students currently enrolled in accredited programs in the United States. Participants reported being most willing to seek mental health services for issues regarding substance abuse, traumatic experiences, and anxiety. They also tended to perceive other students were less willing to seek mental health services for most presenting issues than they actually were. As expected, self-stigma and attitudes toward seeking professional psychological help serially mediated the relationship between public stigma and willingness to seek mental health services. Public stigma was positively related to self-stigma, self-stigma was negatively related to attitudes toward seeking professional psychological help, and attitudes toward seeking help were positively related to willingness to seek mental health services. Implications for outreach, research, and education are discussed.
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Sutherland S, Brunwasser SM, Nestor BA, McCauley E, Diamond G, Schloredt K, Garber J. Prospective Relations between Parents' Depressive Symptoms and Children's Attributional Style. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2019; 50:77-87. [PMID: 30908080 DOI: 10.1080/15374416.2019.1567346] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Children of parents with depression are at increased risk for developing psychopathology. The purpose of the current longitudinal study was to examine the dynamic relations between parents' depressive symptoms and children's cognitions, specifically their attributions for the causes of life events. Participants were 227 parent-child dyads with one parent (Mage = 42.19, SD = 6.82; 76% female) and one child (Mage = 12.53, SD = 2.33; 53% female) per family. Parents either were diagnosed with a current major depressive disorder (n= 129; 72.9% female) or were lifetime-free of mood disorders (n= 98; 79.6% female). The Beck Depression Inventory-II was used to obtain a dimensional measure of parents' depressive symptoms, and the Children's Attributional Style Questionnaire-Revised was used to assess children's attributions of negative and positive events. Evaluations were conducted 5 times across 22 months. We used latent difference score (LDS) modeling to examine the relations between changes in parents' depressive symptoms and changes in children's attributional style over time. The final model provided a close fit to the data: χ2(30) = 35.22, p = .24; comparative fit index = .995, root mean square error of approximation = .028, 90% confidence interval (CI) [.000, .060], standardized root mean square residual = .024. Parents' levels of depressive symptoms significantly predicted the worsening of children's attributions (i.e., becoming more pessimistic) over the 22 months, whereas children's attributions did not significantly predict changes in parents' depressive symptoms at the next time point. Preventive interventions should aim to both reduce parents' depression and teach children strategies for examining the accuracy of their beliefs regarding the causes of life events.
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Affiliation(s)
| | | | - Bridget A Nestor
- Department of Psychology and Human Development, Vanderbilt University
| | | | - Guy Diamond
- Counseling and Family Therapy, Drexel University
| | - Kelly Schloredt
- Psychiatry and Behavioral Medicine, Seattle Children's Hospital
| | - Judy Garber
- Department of Psychology and Human Development, Vanderbilt University
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Thorsteinsson EB, Loi NM, Farr K. Changes in stigma and help-seeking in relation to postpartum depression: non-clinical parenting intervention sample. PeerJ 2018; 6:e5893. [PMID: 30425892 PMCID: PMC6230434 DOI: 10.7717/peerj.5893] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 10/08/2018] [Indexed: 01/03/2023] Open
Abstract
Postpartum depression (PPD) is a prevalent mental illness affecting women, and less commonly, men in the weeks and months after giving birth. Despite the high incidence of PPD in Australia, rates for help-seeking remain low, with stigma and discrimination frequently cited as the most common deterrents to seeking help from a professional source. The present study sought to investigate PPD stigma in a sample of parents and to examine the effects of an intervention on stigma and help-seeking behaviour. A total of 212 parents aged 18-71 years (M = 36.88, 194 females) completed measures of personal and perceived PPD stigma and attitudes towards seeking mental health services and were randomly assigned to one of four groups: an intervention group (video documentary or factsheet related to PPD) or a control group (video documentary or factsheet not related to PPD). Results showed that there were no effects for type of intervention on either personal or perceived PPD stigma scores. No effect was found for help-seeking propensity. Males had higher personal PPD stigma than females and older age was associated with lower personal PPD stigma. Familiarity with PPD was associated with perceived PPD stigma in others but not personal PPD stigma. More work needs to be conducted to develop interventions to reduce PPD stigma in the community.
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Affiliation(s)
| | - Natasha M. Loi
- Psychology, University of New England, Armidale, NSW, Australia
| | - Kathryn Farr
- Psychology, University of New England, Armidale, NSW, Australia
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L Williams C, Cero I, Gauthier JM, K Witte T. Examination of the latent factor structure and construct validity of the stigma of suicide scale-short form. DEATH STUDIES 2018; 42:616-626. [PMID: 29364787 DOI: 10.1080/07481187.2017.1416431] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A major limitation of research on attitudes toward suicide is that most measures lack evidence of a stable factor structure. To investigate the structure of recently developed stigma of suicide scale-short form (SOSS-SF), we conducted an exploratory factor analysis in a sample of 499 undergraduates. Results revealed a three-factor structure: Stigma, Isolation/Depression, and Glorification/Normalization. We also identified good convergent and discriminant validity between the SOSS-SF and related constructs. In a separate sample of 570 undergraduates, a confirmatory factor analysis (CFA) demonstrated adequate fit for the three-factor model. In addition, a multiple-group CFA demonstrated invariance across gender.
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Affiliation(s)
| | - Ian Cero
- a Department of Psychology , Auburn University , Auburn , AL , USA
| | - Jami M Gauthier
- b Department of Psychiatry and Human Behavior , University of Mississippi Medical Center , Jackson , United States
| | - Tracy K Witte
- a Department of Psychology , Auburn University , Auburn , AL , USA
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Dardas LA, Silva SG, Scott J, Gondwe KW, Smoski MJ, Noonan D, Simmons LA. Do beliefs about depression etiologies influence the type and severity of depression stigma? The case of Arab adolescents. Perspect Psychiatr Care 2018; 54:547-556. [PMID: 29570796 DOI: 10.1111/ppc.12270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 01/20/2018] [Accepted: 02/10/2018] [Indexed: 12/30/2022] Open
Abstract
PURPOSE Research has documented that holding certain etiological beliefs about depression can determine the level of stigma experienced by individuals with depression. To date, no studies have yet examined this relationship among adolescents. Using a sample of Arab adolescents, the purpose of this study was to describe adolescents' beliefs about the etiology of depression, and examine whether these beliefs influence the type and severity of depression stigma. METHODS A nationwide school survey was conducted in a representative sample of Jordanian public and private schools located in Jordan, a Middle-Eastern Arab country. A total of 2,349 adolescents aged 12-17 (59% female) completed and returned an anonymous survey that included measures on adolescents' sociodemographic and health characteristics, depression symptoms, depression stigma, and depression etiological beliefs. An exploratory factor analysis with principal components analysis (PCA) was used to examine the factor structure of the Depression Etiological Beliefs Scale. The stability of the PCA findings was tested using a cross-validation method. Regression analyses were performed to examine whether depression etiological beliefs, depression severity, or their interaction are associated with depression stigma. RESULTS Adolescents endorsed multiple etiological beliefs about depression. The beliefs in which likely or very likely was most often reported were stressful events in one's life (72%), social factors (65%), and one's weak will (56%). On the other hand, the least reported beliefs were genetic or inherited problems (24%), chemical imbalance (30%), and punishment for wrong doings (35%). The interaction between adolescents' depression severity and depression beliefs significantly predicted personal stigma. Adolescent sex, age, and region of residence significantly affected the relationship between depression beliefs and stigma. CONCLUSIONS Nurses need to consider the beliefs and attitudes their patients have around depression, as these can influence symptom severity, comprehensive treatment plans, and adherence to provider recommendations. This study provides a better understanding of how depression beliefs affect Jordanian adolescents' attitudes toward depression, which can guide intervention programs to increase awareness about depression and promote treatment utilization.
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Affiliation(s)
| | - Susan G Silva
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Jewel Scott
- School of Nursing, Duke University, Durham, NC, USA
| | | | - Moria J Smoski
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Devon Noonan
- School of Nursing, Duke University, Durham, NC, USA
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Chai YC, Mahadevan R, Ng CG, Chan LF, Md Dai F. Caregiver depression: The contributing role of depression in patients, stigma, social support and religiosity. Int J Soc Psychiatry 2018; 64:578-588. [PMID: 30074421 DOI: 10.1177/0020764018792585] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Depression has been well studied as part of caregiver burden among patients with severe mental illnesses. Curiously, though, there has been little data in terms of caregiver burden with specific focus on depression among caregivers of patients with major depressive disorder (MDD). AIM This study aims to determine the rate of depression among caregivers of person with depression and its psychosocial correlates, which include stigma, perceived social support, religious commitment and the severity of the patient's symptoms. METHODS A cross-sectional study was conducted among 165 patients diagnosed with MDD using the Mini-International Neuropsychiatric Interview (M.I.N.I.) together with their caregivers. Apart from gathering social demographic data, patients were administered the 16-item Quick Inventory of Depressive Symptomatology-Self-Rated Version (QIDS-SR 16), whereas the caregivers were required to answer Patient Health Questionnaire-9 (PHQ-9), Multidimensional Scale of Perceived Social Support (MSPSS), Duke University Religion Index (DUREL) and Depression Stigma Scale (DSS). Those who scored ⩾5 on PHQ-9 were further assessed with interviewer-rated M.I.N.I. to diagnose the presence of depression. RESULTS A total of 47 (28.5%) caregivers were found to have depressive symptoms. Out of that total, 13 (7.9%) were diagnosed to have MDD using M.I.N.I. From univariate analysis, factors associated with depression in caregivers were the severity of symptoms in patients ( p < .001), personal stigma in caregivers ( p = .037), the patients' current depressive episode ( p = .026) and lower perceived social support from friends ( p = .048). From multivariate analysis, only the patients' severity of depressive symptoms ( p < .001) and personal stigma in caregivers ( p = .048) were significantly associated with the caregivers' depressive symptoms. CONCLUSION Our findings suggested that the severity of patient depression and personal stigma of the caregivers were significant factors correlated with caregiver depression. Therefore, beyond optimizing the treatment of depression in patients, the issue of stigma among caregivers also needs to be addressed as a potential target of intervention.
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Affiliation(s)
- Yee Chin Chai
- 1 Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.,2 Department of Mental Health and Psychiatry, Hospital Sultanah Aminah, Johor Bahru, Malaysia
| | - Raynuha Mahadevan
- 1 Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Chong Guan Ng
- 3 Department of Psychological Medicine, Faculty of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Lai Fong Chan
- 1 Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Farahidah Md Dai
- 2 Department of Mental Health and Psychiatry, Hospital Sultanah Aminah, Johor Bahru, Malaysia
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Personal and perceived public mental-health stigma as predictors of help-seeking intentions in adolescents. J Adolesc 2018; 66:83-90. [DOI: 10.1016/j.adolescence.2018.05.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 05/08/2018] [Accepted: 05/09/2018] [Indexed: 11/19/2022]
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Yokoya S, Maeno T, Sakamoto N, Goto R, Maeno T. A Brief Survey of Public Knowledge and Stigma Towards Depression. J Clin Med Res 2018; 10:202-209. [PMID: 29416578 PMCID: PMC5798266 DOI: 10.14740/jocmr3282w] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Accepted: 12/27/2017] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The burden from depression is affected by the public's beliefs, stigma, and resulting behavior. Lack of knowledge, misunderstanding, and stigma about depressed people and their surroundings are barriers to improving their mental health. This study aimed to examine public beliefs regarding depression, especially how to recognize depression, treatment, and stigma. METHODS A self-administered questionnaire was distributed to participants receiving an annual health checkup. We asked whether they agreed with four short sentences: "it is not necessary to worry about depression in a person behaving brightly" (misunderstanding about the behavior of depressed people), "rest is important for treating depression" (belief about the necessity of rest), "medicine is effective for treating depression" (belief about the effectiveness of pharmacotherapy) and "a weak personality causes depression" (stigma about the cause of depression). We also analyzed the association between these beliefs and factors such as health literacy, regularly visiting an outpatient clinic, history of depression, and demographic variables. RESULTS Among 1,085 respondents (75.0% response rate), 54.5%, 75.6%, 58.9%, and 70.8% responded appropriately to the "misunderstanding about the behavior of depressed people", "necessity of rest", "effectiveness of pharmacotherapy", and "stigma about the cause of depression" items, respectively. Regarding stigma about the cause of depression, 30.7% of respondents agreed that a weak personality caused depression. Female sex and younger age group were associated with appropriate answers. Health literacy was only associated with appropriate beliefs about the effectiveness of pharmacotherapy. CONCLUSIONS Thirty percent of participants had the stigmatizing belief that a weak personality causes depression and only 58.9% believed in the effectiveness of pharmacotherapy for depression. Over 70% understood the necessity of rest and knew that depression is possible in those who act brighter. General health literacy alone might not improve knowledge and beliefs about depression. An educational intervention or campaign to reduce stigma toward depression and improve knowledge about the treatment of depression is needed.
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Affiliation(s)
- Shoji Yokoya
- Community-Based Medicine Education Station Kitaibaraki, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Takami Maeno
- Department of Primary Care and Medical Education, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Naoto Sakamoto
- Department of Primary Care and Medical Education, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Ryohei Goto
- Department of Primary Care and Medical Education, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Tetsuhiro Maeno
- Department of Primary Care and Medical Education, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
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Lally J, ó Conghaile A, Quigley S, Bainbridge E, McDonald C. Stigma of mental illness and help-seeking intention in university students. ACTA ACUST UNITED AC 2018. [DOI: 10.1192/pb.bp.112.041483] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Aims and methodA cross-sectional study to ascertain levels of personal and perceived public mental illness stigma in a university student population and the association between the respective levels of stigma and help-seeking intention. An adaptation of the Discrimination-Devaluation scale was used.ResultsA total of 735 students participated in the study (response rate 77%). There were higher mean perceived public stigma levels than personal stigma levels. Perceived public stigma was not significantly associated with future non-help-seeking intention (odds ratio (OR) = 0.871, P = 0.428). Personal stigma was significantly associated with a decreased likelihood of future help-seeking intention (OR = 1.44, P = 0.043). Being younger than 25, having no history of or treatment for mental illness and having no personal contact with someone with a history of mental illness were all associated with higher personal stigma levels.Clinical implicationsThis study indicates that personal stigma as distinct from perceived public stigma is a significant barrier to mental health utilisation for a student population and future stigma reduction campaigns could strategically focus on this.
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Personal and Perceived Depression Stigma among Arab Adolescents: Associations with Depression Severity and Personal Characteristics. Arch Psychiatr Nurs 2017; 31:499-506. [PMID: 28927515 DOI: 10.1016/j.apnu.2017.06.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 04/23/2017] [Accepted: 06/04/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND In Arab communities, the selection, utilization, and attitudes towards mental health services are substantially affected by existing mental illness stigma. However, little is known about how the stigma of depression manifests among Arab adolescents, which makes it difficult to design, implement, and disseminate effective anti-stigma interventions for this vulnerable population. Therefore, the purpose of this study was to determine levels of depression stigma among Arab adolescents. The specific aims were to (1) describe the severity of personal and perceived depression stigma among Arab adolescents and its relationship to severity of depression, and (2) determine characteristics associated with severity of depression stigma among Arab adolescents. METHODS This study was conducted in Jordan, a Middle Eastern Arab country. A nationally representative, school-based survey was utilized. A total of 2349 Jordanian adolescents aged 12-17 completed and returned the survey packets, which included measures on individual characteristics, depression severity, and depression stigma. RESULTS The majority of the adolescents (88%) reported scores indicating moderate to high depression stigma. Adolescents reported higher rates of perceived stigma than personal stigma. Depression stigma was not significantly associated with severity of depression, but with adolescent's sex, age, region of residence, parents' education, and history of mental health problem. CONCLUSIONS This is the first Arab study to isolate the influence of adolescent depression and personal characteristics on personal and perceived depression stigmas, and highlight the presence of these distinctions early in adolescence. Such distinction can inform the design and implementation of policies and interventions to reduce both personal and perceived stigma. The study provides important recommendations on when, how, and why to utilize school settings for anti-depression stigma interventions.
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Dardas LA, Silva SG, van de Water B, Vance A, Smoski MJ, Noonan D, Simmons LA. Psychosocial Correlates of Jordanian Adolescents' Help-Seeking Intentions for Depression: Findings From a Nationally Representative School Survey. J Sch Nurs 2017; 35:117-127. [PMID: 28946797 DOI: 10.1177/1059840517731493] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Little is known about help-seeking for depression among Jordanian adolescents who are a vulnerable population with high rates of depressive symptoms and few mental health services. The purpose of this study was to (1) explore Jordanian adolescents' helpseeking intentions for depression and (2) examine whether depression stigma, depression severity, or their interaction are associated with Jordanian adolescents' willingness to seek help for depression and the type of treatment they would seek. In collaboration with the Jordanian Ministry of Education, we conducted a nationally representative, school-based survey of adolescents aged 12-17 years ( N = 2,349). One fourth of the adolescents reported they would not seek professional help for depression, and those respondents had higher average depression scores. Among those adolescents willing to seek help, the most likely sources included family member (57%), school counselor (46%), psychiatrist (43%), religious leader (39%), and general health practitioner (28%). Lower stigma scores were associated with greater likelihood to seek psychotherapy or visit a psychiatrist, while higher stigma scores were associated with increased likelihood to seek help from a school counselor or a family member. Jordanian adolescents experience significant barriers to seeking professional help for depression. However, even among adolescents with greater depression severity and depression stigma, school counselors were identified as a key resource for help. These findings suggest that school-based interventions may fill a critical service need for adolescents with depression and other mental health problems. School nurses should be leveraged along with counselors to address mental health issues in this vulnerable population.
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Affiliation(s)
| | - Susan G Silva
- 2 School of Nursing, Duke University, Durham, NC, USA.,5 Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Brittney van de Water
- 3 Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Ashlee Vance
- 2 School of Nursing, Duke University, Durham, NC, USA
| | - Moria J Smoski
- 4 Department of Psychology and Neuroscience, Duke University, Durham, NC, USA.,5 Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Devon Noonan
- 2 School of Nursing, Duke University, Durham, NC, USA
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Seidler ZE, Rice SM, River J, Oliffe JL, Dhillon HM. Men’s Mental Health Services: The Case for a Masculinities Model. ACTA ACUST UNITED AC 2017. [DOI: 10.1177/1060826517729406] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | - Simon M. Rice
- The National Centre of Excellence in Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Jo River
- The University of Sydney, New South Wales, Australia
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Public attitudes toward depression and help-seeking: Impact of the OSPI-Europe depression awareness campaign in four European regions. J Affect Disord 2017; 217:252-259. [PMID: 28437762 DOI: 10.1016/j.jad.2017.04.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 02/28/2017] [Accepted: 04/02/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND Public attitudes toward depression and help-seeking behaviour are important factors influencing depressed people to obtain professional help and adequate treatment. OSPI-Europe is a multi-level suicide prevention programme including a public awareness campaign. It was implemented in four regions of four European countries (Germany, Hungary, Ireland and Portugal). This paper reports the results of the evaluation of the campaign, including its visibility and effects of the campaign on stigma associated with depression and help-seeking behaviour. METHODS A representative general population survey (N=4004) including measures on personal stigma, perceived stigma, openness to help, perceived value of help, and socio-demographic variables was conducted in the four intervention and four control regions in a cross-sectional pre-post design. RESULTS The public awareness campaign was considerably more visible in Germany and Portugal compared to Ireland and Hungary. Visibility was further affected by age and years of schooling. Personal stigma, perceived stigma and openness toward professional help varied significantly across the four countries. Respondents in the intervention regions showed significantly less personal depression stigma than respondents in the control regions after the campaign. Respondents of the intervention region who were aware of the campaign reported more openness toward seeking professional help than respondents who were unaware of it. CONCLUSION The OSPI-Europe awareness campaign was visible and produced some positive results. At the same time, it proved to be difficult to show strong, measurable and unambiguous effects, which is in line with previous studies. Public awareness campaigns as conducted within OSPI-Europe can contribute to improved attitudes and knowledge about depression in the general public and produce synergistic effects, in particular when the dissemination of awareness campaign materials is simultaneously reinforced by other intervention levels of a multi-level intervention programme. LIMITATIONS The survey was cross-sectional and based on self-report, so no causal inferences could be drawn.
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Jung H, von Sternberg K, Davis K. The impact of mental health literacy, stigma, and social support on attitudes toward mental health help-seeking. INTERNATIONAL JOURNAL OF MENTAL HEALTH PROMOTION 2017. [DOI: 10.1080/14623730.2017.1345687] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Hyejin Jung
- The Institute for Urban Policy Research & Analysis, University of Texas at Austin, Austin, TX, USA
- School of Social Work, University of Texas at Austin, Austin, TX, USA
- Department of Social Work, University of Texas at El Paso, El Paso, TX, USA
| | | | - King Davis
- The Institute for Urban Policy Research & Analysis, University of Texas at Austin, Austin, TX, USA
- School of Social Work, University of Texas at Austin, Austin, TX, USA
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A Little Effort Can Withstand the Hardship: Fielding an Internet-Based Intervention to Prevent Depression among Urban Racial/Ethnic Minority Adolescents in a Primary Care Setting. J Natl Med Assoc 2017; 110:130-142. [PMID: 29580446 DOI: 10.1016/j.jnma.2017.02.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 02/18/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND This study explored the implementation of Chicago Urban Resiliency Building (CURB), a randomized clinical trial designed as an Internet-based primary care depression prevention intervention for urban African American and Latino adolescents. METHODS We utilized a mixed methods analysis to explore four aims. First, we estimated the percent of at-risk adolescents that were successfully screened. Second, we examined clinic site factors and performance. Third, primary care providers (n = 10) and clinic staff (n = 18) were surveyed to assess their knowledge and attitudes about the intervention. Fourth, clinic staff (nursing and medical assistant) interviews were analyzed using thematic analysis to gather perspectives of the implementation process. RESULTS We found that the estimated percent of at-risk adolescents who were successfully screened in each clinic varied widely between clinics with a mean of 14.48%. Daily clinic communication was suggestive of greater successful screening. Feasibility of screening was high for both primary care providers and clinic staff. Clinic staff exit interviews indicated the presence of community barriers that inhibited successful implementation of the intervention. CONCLUSION This study shares the challenges and successes for depression screening and implementing Internet-based mental health interventions for urban racial/ethnic minority adolescents in primary care settings.
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Darraj HA, Mahfouz MS, Al Sanosi RM, Badedi M, Sabai A. The Self-Stigma of Depression Scale: Translation and Validation of the Arabic Version. J Neurosci Rural Pract 2017; 8:96-100. [PMID: 28149090 PMCID: PMC5225732 DOI: 10.4103/0976-3147.193552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Self-stigma may feature strongly and be detrimental for people with depression, but the understanding of its nature and prevalence is limited by the lack of psychometrically validated measures. This study is aimed to validate the Arabic version self-stigma of depression scale (SSDS) among adolescents. MATERIALS AND METHODS A cross-sectional study involved 100 adolescents randomly selected. The analyses include face validation, factor analysis, and reliability testing. A test-retest was conducted within a 2-week interval. RESULTS The mean score for self-stigma of depression among study participants was 68.9 (Standard deviation = 8.76) median equal to 71 and range was 47. Descriptive analysis showed that the percentage of those who scored below the mean score (41.7%) is shown less than those who scored above the mean score (58.3%). Preliminary construct validation analysis confirmed that factor analysis was appropriate for the Arabic-translated version of the SSDS. Furthermore, the factor analysis showed similar factor loadings to the original English version. The total internal consistency of the translated version, which was measured by Cronbach's alphas ranged from 0.70 to 0.77 for the four subscales and 0.84 for the total scale. Test-retest reliability was assessed in 65 respondents after 2 weeks. Cronbach's alphas ranged from 0.70 to 0.77 for the four subscales and 0.84 for the total scale. CONCLUSIONS Face validity, construct validity, and reliability analysis were found satisfactory for the Arabic-translated version of the SSDS. The Arabic-translated version of the SSDS was found valid and reliable to be used in future studies, with comparable properties to the original version and to previous studies.
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Affiliation(s)
| | - Mohamed Salih Mahfouz
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | | | - Mohammed Badedi
- Public Health Administration, Jazan Health Affairs, Ministry of Health, Jazan, Saudi Arabia
| | - Abdullah Sabai
- Public Health Administration, Jazan Health Affairs, Ministry of Health, Jazan, Saudi Arabia
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Melo AK, Siebra AJ, Moreira V. Depressão em Adolescentes: Revisão da Literatura e o Lugar da Pesquisa Fenomenológica. PSICOLOGIA: CIÊNCIA E PROFISSÃO 2017. [DOI: 10.1590/1982-37030001712014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Resumo Atualmente a depressão em adolescentes consiste em um fenômeno complexo e cada vez mais recorrente. Visando identificar e discutir os estudos que estão sendo produzidos sobre este tema, realizamos uma revisão de literatura com base em pesquisas indexadas nos bancos de dados SciELO; Portal de Periódicos da Capes; BDTD; APA; ScienceDirect; Redalyc; Lillacs e MedLine, mediante cruzamento das palavras-chave: depressão e adolescência; depressão em adolescentes; depression in adolescentes; depresión en adolescentes. Foram identificados 247 textos, sendo que, após apreciação baseando-se nos critérios de elegibilidade, restaram 159 estudos. Num primeiro momento, essas pesquisas foram organizadas quantitativamente e, a seguir, por uma análise qualitativa. Os estudos evidenciaram cinco categorias temáticas: sintomas depressivos; fatores associados à variabilidade sintomatológica; eventos estressores e fatores de risco; comorbidades associadas à depressão em adolescentes e depressão e suicídio em adolescentes. Os eixos abordados demonstram que ainda existe muito a discorrer sobre essa forma de adoecimento, em virtude dos múltiplos contornos que a constituem. Destacamos a escassez de trabalhos pautados em uma perspectiva fenomenológica, apesar do gradativo crescimento nos últimos anos. Sugere-se a fomentação, bem como a construção de novos espaços de discussão, no intuito de auxiliar os profissionais que estão envolvidos com essa temática em sua praxis.
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Wallace LN, Ménard KS. Friendships Lost: The Social Consequences of Violent Victimization. JOURNAL OF AGGRESSION, MALTREATMENT & TRAUMA 2016; 26:116-136. [PMID: 28638237 PMCID: PMC5476311 DOI: 10.1080/10926771.2016.1250852] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Accepted: 10/11/2016] [Indexed: 06/08/2023]
Abstract
Few studies have examined the impact of violent victimization on friendship networks. This study used two waves of data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) to examine the effects of violent victimization on number peer- and self-reported friendships. Guided by stigma theory (Goffman, 1963), fixed-effect regression models controlling for depression, delinquency, substance use, and school engagement were completed to predict changes in number of friends following victimization. Consistent with the theory, results indicate that experiencing violent victimization (e.g., jumped, stabbed, shot at) was associated with a decrease in number of friends. These effects were magnified for females and for individuals with a greater number of depressive symptoms. These results were consistent even when models were run separately for each individual type of victimization. Treatment and prevention implications are discussed.
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Affiliation(s)
- Lacey N Wallace
- Penn State Altoona, Department of Criminal Justice, 101G Cypress Building, 3000 Ivyside Park, Altoona, PA 16601, , /
| | - Kim S Ménard
- Penn State Altoona, Department of Criminal Justice, 101H Cypress Building, 3000 Ivyside Park, Altoona, PA 16601, , /
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Shechtman Z, Vogel DL, Strass HA, Heath PJ. Stigma in help-seeking: the case of adolescents. BRITISH JOURNAL OF GUIDANCE & COUNSELLING 2016. [DOI: 10.1080/03069885.2016.1255717] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Zipora Shechtman
- Department of Counseling and Human Development, Haifa University, Haifa, Israel
| | - David L. Vogel
- Department of Psychology, Iowa State University, Ames, IA, USA
| | - Haley A. Strass
- Department of Psychology, Iowa State University, Ames, IA, USA
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Arora PG, Metz K, Carlson CI. Attitudes Toward Professional Psychological Help Seeking in South Asian Students: Role of Stigma and Gender. JOURNAL OF MULTICULTURAL COUNSELING AND DEVELOPMENT 2016. [DOI: 10.1002/jmcd.12053] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Prerna G. Arora
- Department of Psychology; Pace University and Division of Child and Adolescent Psychiatry, University of Maryland School of Medicine
| | | | - Cindy I. Carlson
- Department of Educational Psychology; University of Texas at Austin
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Boerema AM, van Zoonen K, Cuijpers P, Holtmaat CJM, Mokkink LB, Griffiths KM, Kleiboer AM. Psychometric Properties of the Dutch Depression Stigma Scale (DSS) and Associations with Personal and Perceived Stigma in a Depressed and Community Sample. PLoS One 2016; 11:e0160740. [PMID: 27500969 PMCID: PMC4976889 DOI: 10.1371/journal.pone.0160740] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 07/25/2016] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Research on depression stigma is needed to gain more insight into the underlying construct and to reduce the level of stigma in the community. However, few validated measurements of depression stigma are available in the Netherlands. Therefore, this study first sought to examine the psychometric properties of the Dutch translation of the Depression Stigma Scale (DSS). Second, we examined which demographic (gender, age, education, partner status) and other variables (anxiety and knowledge of depression) are associated with personal and perceived stigma within these samples. METHODS The study population consisted of an adult convenience sample (n = 253) (study 1) and a community adult sample with elevated depressive symptoms (n = 264) (study 2). Factor structure, internal consistency, and validity were assessed. The associations between stigma, demographic variables and anxiety level were examined with regression analyses. RESULTS Confirmatory factor analysis supported the validity and internal consistency of the DSS personal stigma scale. Internal consistency was sufficient (Cronbach's alpha = .70 (study 1) and .77 (study 2)). The results regarding the perceived stigma scale revealed no clear factor structure. Regression analyses showed that personal stigma was higher in younger people, those with no experience with depression, and those with lower education. CONCLUSIONS This study established the validity and internal consistency of the DSS personal scale in the Netherlands, in a community sample and in people with elevated depressive symptoms. However, additional research is needed to examine the factor structure of the DSS perceived scale and its use in other samples.
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Affiliation(s)
- A. M. Boerema
- Department of Clinical Neuro and Developmental Psychology, Section clinical psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
- EMGO+ institute for Health Care and Research, Vrije Universiteit Medical Centre, Amsterdam, the Netherlands
| | - K. van Zoonen
- Statistics Netherlands (CBS), Den Haag, the Netherlands
| | - P. Cuijpers
- Department of Clinical Neuro and Developmental Psychology, Section clinical psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
- EMGO+ institute for Health Care and Research, Vrije Universiteit Medical Centre, Amsterdam, the Netherlands
| | - C. J. M. Holtmaat
- Department of Clinical Neuro and Developmental Psychology, Section clinical psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
- EMGO+ institute for Health Care and Research, Vrije Universiteit Medical Centre, Amsterdam, the Netherlands
| | - L. B. Mokkink
- EMGO+ institute for Health Care and Research, Vrije Universiteit Medical Centre, Amsterdam, the Netherlands
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands
| | - K. M. Griffiths
- National Institute for Mental Health Research, The Australian National University, Acton, Canberra, Australia
| | - A. M. Kleiboer
- Department of Clinical Neuro and Developmental Psychology, Section clinical psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
- EMGO+ institute for Health Care and Research, Vrije Universiteit Medical Centre, Amsterdam, the Netherlands
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Abstract
Adolescent depression is a primary cause of global disability and burden with considerable variability across countries in its prevalence, diagnosis, management, and prognosis. No systematic reviews have been published on adolescent depression in Arab countries despite the unique sociocultural background that can play a major role in shaping Arab depressed adolescents' prognosis and response to treatment. The purpose of this study was to provide such a review with the goal of identifying the necessary foundations for culturally competent mental health care practices to address the unique needs of Arab adolescents and their families. We systematically reviewed PubMed, CINAHL, PsycINFO, and available Arabic databases. We adhered to the PRISMA statement to guide the process of identification, selection, and appraisal of the reviewed articles. No restrictions were applied on publication date. The search was completed in December 2015. A total of 199 unique articles met criteria for screening at the abstract level; 47 articles were selected for review in full text; and 27 articles were included in the final analysis. Four emerging themes were identified: (1) few robust prevalence estimates of adolescent depression are available in Arab countries; (2) depression varies based on the individual characteristics of Arab adolescents; (3) context influences Arab adolescents' risk of experiencing depression; and (4) the stigma of depression negatively impacts help-seeking process among Arab adolescents. This review highlights the need for more community-based detection efforts that employ developmentally and culturally appropriate measurement instruments for adolescent depression. Furthermore, findings suggest the need for culturally competent care that integrates indigenous health practices into modern mental health systems. Nurses, who form the greatest proportion of health personnel in all Arab countries, are uniquely situated to help Arab adolescents experiencing depression restore, maintain, and/or promote their mental health and wellbeing.
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49
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Patten SB, Williams JVA, Lavorato DH, Bulloch AGM, Charbonneau M, Gautam M, Moss P, Abbey S, Stuart H. Perceived Stigma among Recipients of Mental Health Care in the General Canadian Population. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2016; 61:480-8. [PMID: 27310227 PMCID: PMC4959645 DOI: 10.1177/0706743716639928] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The Mental Health Experiences Scale is a measure of perceived stigma, the perception of negative attitudes and behaviours by people with mental disorders. A recent Canadian survey (Canadian Community Health Survey-Mental Health) included this scale, providing an opportunity to describe perceived stigma in relation to diagnosis for the first time in the Canadian general population. METHODS The survey interview began with an assessment of whether respondents had utilised services for an "emotional or mental health problem" in the preceding 12 months. The subset reporting service utilisation were asked whether others "held negative opinions" about them or "treated them unfairly" for reasons related to their mental health. The analysis reported here used frequencies, means, cross-tabulation, and logistic regression, all incorporating recommended replicate sampling weights and bootstrap variance estimation procedures. RESULTS Stigma was perceived by 24.4% of respondents accessing mental health services. The frequency was higher among younger respondents (<55 years), those who were not working, those reporting only fair or poor mental health, and the subset who reported having received a diagnosis of a mental disorder. Sex and education level were not associated with perceived stigma. People with schizophrenia reported stigmatization only slightly more frequently than those with mood and anxiety disorders. CONCLUSIONS Stigmatization is a common, but not universal, experience among Canadians using services for mental health reasons. Stigmatization was a problem for a sizeable minority of respondents with mood, anxiety, and substance use disorders as well as bipolar and psychotic disorders.
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Affiliation(s)
- Scott B Patten
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta Department of Psychiatry, University of Calgary, Calgary, Alberta Mathison Centre for Research & Education in Mental Health, Hotchkiss Brain Institute, Calgary, Alberta Alberta Innovates, Health Solutions, Edmonton, Alberta
| | - Jeanne V A Williams
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta
| | - Dina H Lavorato
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta
| | - Andrew G M Bulloch
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta Department of Psychiatry, University of Calgary, Calgary, Alberta Mathison Centre for Research & Education in Mental Health, Hotchkiss Brain Institute, Calgary, Alberta
| | | | - Mamta Gautam
- Department of Psychiatry, University of Ottawa, Ottawa, Ontario Department of Psychiatry, Ottawa Hospital, Ottawa, Ontario
| | - Pippa Moss
- Western and Northern Health Zones, Tatamagouche, Nova Scotia
| | - Susan Abbey
- Department of Psychiatry, University of Toronto, Toronto, Ontario
| | - Heather Stuart
- Department of Public Health Sciences, Queen's University, Kingston, Ontario
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50
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Abstract
BACKGROUND Stigma towards individuals experiencing a mental illness is associated with a range of negative psychological, social and financial outcomes. Factors associated with stigma remain unclear; the relationship between stigma and various personal factors may depend on both the type of disorder being stigmatised and what type of stigma is assessed. Different forms of stigma include personal stigma (negative attitudes towards others), perceived stigma (perceived attitudes of others) and self-stigma (self-attribution of others' negative attitudes). METHOD Three hundred and fifty university students and members of the general public completed an online survey assessing contact with and knowledge of both depression and anxiety, age, gender, current depression and anxiety symptoms, and personal, perceived and self-stigma for both depression and anxiety. RESULTS Greater contact with, and knowledge of that illness predicted lower personal stigma for both anxiety and depression. Participants with greater levels of current depression symptomatology and females, reported higher perceived stigma towards depression. Males reported higher personal stigma for anxiety. For both anxiety and depression, higher current symptomatology was associated with greater levels of self-stigma towards the illness. CONCLUSIONS Findings confirm the role of contact and knowledge in personal stigma for both disorders, consistent with previous findings. This finding also supports evidence that interventions addressing these factors are associated with a decline in personal stigma. However, lack of relationship between contact with, and knowledge of a mental illness and perceived and self-stigma for either depression or anxiety suggests that these factors may not play a major role in perceived or self-stigma. The identification of symptomatology as a key factor associated with self-stigma for both anxiety and depression is significant, and has implications for community-wide interventions aiming to increase help-seeking behaviour, as well as individual treatment strategies for clinicians. Further research should examine whether these relationships hold for groups with clinically diagnosed depression and anxiety disorders.
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