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Applying Corrigan’s progressive model of self-stigma to people with depression


Autoři: Nele Cornelia Göpfert aff001;  Steffen Conrad von Heydendorff aff002;  Harald Dreßing aff003;  Josef Bailer aff001
Působiště autorů: Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim / University Heidelberg, Mannheim, Germany aff001;  Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim / University Heidelberg, Mannheim, Germany aff002;  Department of Forensic Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim / University Heidelberg, Mannheim, Germany aff003
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0224418

Souhrn

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.

Klíčová slova:

Depression – Health education and awareness – Inpatients – Internet – Outpatients – Psychometrics – Suicide – Surveys


Zdroje

1. Corrigan PW, Watson AC, Barr L. The Self–Stigma of Mental Illness: Implications for Self–Esteem and Self–Efficacy. Journal of Social and Clinical Psychology. 2006;25(8):875–84. doi: 10.1521/jscp.2006.25.8.875

2. Picco L, Pang S, Lau YW, Jeyagurunathan A, Satghare P, Abdin E, et al. Internalized stigma among psychiatric outpatients: Associations with quality of life, functioning, hope and self-esteem. Psychiatry Research. 2016;246:500–6. doi: 10.1016/j.psychres.2016.10.041 27821360

3. Hasson-Ohayon I, Mashiach–Eizenberg M, Lysaker PH, Roe D. Self-clarity and different clusters of insight and self-stigma in mental illness. Psychiatry Research. 2016;240:308–13. doi: 10.1016/j.psychres.2016.04.060 27138823

4. Clement S, Schauman O, Graham T, Maggioni F, Evans-Lacko S, Bezborodovs N, et al. What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychological Medicine. 2014;45(1):11–27. Epub 02/21. doi: 10.1017/S0033291714000129 24569086

5. Corrigan PW, Druss BG, Perlick DA. The Impact of Mental Illness Stigma on Seeking and Participating in Mental Health Care. Psychol Sci Public Interest. 2014;15(2):37–70. doi: 10.1177/1529100614531398 26171956.

6. Drapalski AL, Lucksted A, Perrin PB, Aakre JM, Brown CH, DeForge BR, et al. A model of internalized stigma and its effects on people with mental illness. Psychiatr Serv. 2013;64(3):264–9. Epub 2013/04/11. doi: 10.1176/appi.ps.001322012 23573532.

7. Oexle N, Rüsch N, Viering S, Wyss C, Seifritz E, Xu Z, et al. Self-stigma and suicidality: a longitudinal study. Eur Arch Psychiatry Clin Neurosci. 2017;267(4):359–61. doi: 10.1007/s00406-016-0698-1 27169427

8. Oexle N, Waldmann T, Staiger T, Xu Z, Rüsch N. Mental illness stigma and suicidality: the role of public and individual stigma. Epidemiology and Psychiatric Sciences. 2016:1–7. Epub 12/06. doi: 10.1017/S2045796016000949 27919303

9. Goffman E. Stigma: Notes on the Management of Spoiled Identity. London: Penguin Books; 1963.

10. Corrigan PW, Watson AC. The Paradox of Self-Stigma and Mental Illness. Clin Psychol Sci Pract. 2002;9(1):35–53. doi: 10.1093/clipsy.9.1.35

11. Link BG. Understanding Labeling Effects in the Area of Mental Disorders: An Assessment of the Effects of Expectations of Rejection. Am Sociol Rev. 1987;52(1):96–112. doi: 10.2307/2095395

12. Rüsch N, Angermeyer MC, Corrigan PW. Das Stigma psychischer Erkrankung: Konzepte, Formen und Folgen. Psychiatrische Praxis. 2005;32:221–32. doi: 10.1055/s-2004-834566 15983885

13. Livingston JD, Boyd JE. Correlates and consequences of internalized stigma for people living with mental illness: A systematic review and meta-analysis. Social Science & Medicine. 2010;71(12):2150–61. http://dx.doi.org/10.1016/j.socscimed.2010.09.030.

14. Michaels P, López M, Rüsch N, Corrigan P. Constructs and concepts comprising the stigma of mental illness2017. 183 p.

15. Corrigan PW, Rafacz J, Rüsch N. Examining a Progressive Model of Self-Stigma and its Impact on People with Serious Mental Illness. Psychiatry research. 2011;189(3):339–43. doi: 10.1016/j.psychres.2011.05.024 PMC3185170. 21715017

16. Kao Y-C, Lien Y-J, Chang H-A, Wang S-C, Tzeng N-S, Loh C-H. Evidence for the indirect effects of perceived public stigma on psychosocial outcomes: The mediating role of self-stigma. Psychiatry Research. 2016;240:187–95. doi: 10.1016/j.psychres.2016.04.030 27111212

17. Goepfert NC, Conrad von Heydendorff S, Dreßing H, Bailer J. Effects of stigmatizing media coverage on stigma measures, self-esteem, and affectivity in persons with depression–an experimental controlled trial. BMC Psychiatry. 2019;19(1):138. doi: 10.1186/s12888-019-2123-6 31064374

18. Schiel S. Prädiktion des Erfolges der Dialektisch-Behavioralen Therapie bei Frauen mit Borderlinepersönlichkeitsstörung unter besonderer Berücksichtigung von Scham und Selbst-Stigmatisierung. 2005.

19. Watson AC, Corrigan P, Larson JE, Sells M. Self-stigma in people with mental illness. Schizophrenia bulletin. 2007;33(6):1312–8. doi: 10.1093/schbul/sbl076 17255118

20. Rosenberg M. The measurement of self-esteem. Society and the adolescent self image. 1965;297:V307.

21. Collani Gv, Herzberg PY. Eine revidierte Fassung der deutschsprachigen Skala zum Selbstwertgefühl von Rosenberg. Zeitschrift für Differentielle und Diagnostische Psychologie. 2003;24(1):3–7.

22. Löwe B, Spitzer R, Zipfel S, Herzog W. Gesundheitsfragebogen für Patienten2002.

23. Cohen J. A power primer. Psychological Bulletin. 1992;112(1):155–9. doi: 10.1037//0033-2909.112.1.155 19565683

24. Hayes AF. The PROCESS macro for SPSS and SAS 2018 [cited 2018 11.06.2018]. Available from: http://processmacro.org/download.html.

25. Hayes AF. Introduction to mediation, moderation, and conditional process analysis: a regression based approach. second ed. New York: Guilford Press; 2018.

26. Pedersen E, Paves A. Comparing perceived public stigma and personal stigma of mental health treatment seeking in a young adult sample2014. 143–50 p.

27. Dietrich S, Mergl R, Rummel-Kluge C. Personal and perceived stigmatization of depression: A comparison of data from the general population, participants of a depression congress and job placement officers in Germany. Psychiatry Research. 2014;220(1–2):598–603. doi: 10.1016/j.psychres.2014.06.044 25086761

28. Hasan AA-H, Musleh M. Self-stigma by people diagnosed with schizophrenia, depression and anxiety: Cross-sectional survey design. Perspectives in Psychiatric Care. 2017:n/a-n/a. doi: 10.1111/ppc.12213 28198022

29. Griffiths KM, Christensen H, Jorm AF, Evans K, Groves C. Effect of web-based depression literacy and cognitive–behavioural therapy interventions on stigmatising attitudes to depression. Randomised controlled trial. 2004;185(4):342–9. doi: 10.1192/bjp.185.4.342 15458995

30. Calear AL, Griffiths KM, Christensen H. Personal and perceived depression stigma in Australian adolescents: Magnitude and predictors. Journal of Affective Disorders. 2011;129:104–8. UBHD. doi: 10.1016/j.jad.2010.08.019 20863571

31. Kohls E, Coppens E, Hug J, Wittevrongel E, Van Audenhove C, Koburger N, et al. Public attitudes toward depression and help-seeking: Impact of the OSPI-Europe depression awareness campaign in four European regions. Journal of Affective Disorders. 2017;217:252–9. doi: 10.1016/j.jad.2017.04.006 28437762

32. Wang K, Weiss NH, Pachankis JE, Link BG. Emotional clarity as a buffer in the association between perceived mental illness stigma and suicide risk. Stigma and Health. 2016;1(4):252–62. doi: 10.1037/sah0000032 28090587


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