Predictors of Perceived, Personal, and Self- Stigma on Depression and Relevant Interventions

Abstract

Depression is a severe public health issue that affects millions of individuals throughout the world. However, more than half of patients with depression are reluctant to seek help, and the stigma of depression has been identified as the major barrier to their help-seeking. There are three kinds of stigma: perceived stigma, personal stigma, and self-stigma. However, the existing research lacks distinguishment and comparation among them. This study outlines the respective predictors of the three kinds of stigma, to fill this research gap. The findings of this review show that the three types of stigma have different predictors. People who are female, with greater depression severity, more contact with depression patients, and lower social support, reported higher perceived stigma. Higher personal stigma is predicted by being male, lower depression literacy, and less contact with depression. Moreover, greater depression symptomatology, less knowledge about depression, and less social support are associated with higher self-stigma. The existing studies on anti-stigma interventions suggest that personal stigma can be effectively reduced by the depression awareness campaign. Plus, group psychotherapy works well in decreasing self-stigma. However, existing interventions have a limited effect on reducing perceived stigma. Existing studies on predictors of stigma have some limitations: they are cross-sectional studies and usually focus on only one or two types of stigma. Therefore, future studies should conduct some longitudinal studies and investigate all three kinds of stigma simultaneously to make up for these shortcomings. The main contribution of this paper is distinguishing the predictors of perceived stigma, personal stigma, and self-stigma, providing a framework for future study on antecedents of different stigma and the design of stigma reduction interventions. This review can provide some guidance to the prevention and intervention programs for depression stigma at schools.