(PS3-A10) Depression-related Stigma Adversely Affects Functioning Beyond Depression Symptoms

Background: Depression can lead to significant decline in individuals’ psychosocial functioning. Depression is also a stigmatized condition, both in terms of stigma perceived from society, as well as internalized stigma. The social consequences of stigma as well as stress associated with it may also affect one’s functioning in several domains, including work performance and absenteeism (Fox et al., 2016) and social functioning (Lasalvia et al., 2013). The goal of this study was to better understand the association of facets of depression-related stigma with facets of functioning (self-care, productivity, and social) among individuals with symptoms of depression.

Method: Participants were individuals screening positive for a current Major Depressive Episode (N = 313). Participants from two broad cultural groups (Latin America; n = 184) and Western English-speaking countries (e.g., US, UK, Australia; n = 129) completed an online survey regarding their perceptions of depression and its effects and treatments.  The survey included the Depression Self-Stigma Scale (Kanter et al., 2008), which assesses for 6 types of stigma: General self-stigma (internalized stigma), secrecy (efforts to hide one’s depression or concern about others learning of their depression), public stigma (judgment of others because they have depression), treatment stigma (stigma due to seeking or receiving treatment), stigmatizing experiences (actual experience of being judged because of their depression), a demographics measure, and a self-assessment of depression effects on various areas of one’s functioning, along with several other measures.

Results: All analyses controlled for levels of depression as well as other variables likely to affect stigma and/or functioning. Overall, the results suggest that different types of stigmas have distinct effects on areas of functioning. Thus, self-care functioning was inversely related with level of general self-stigma (p = .003), secrecy (p = .013), and stigma experiences (p < .001). Only general self-stigma was inversely related to productivity functioning (p = .014). Finally, social functioning was inversely related to general self-stigma (p < .001) and stigmatizing experiences (p = .005). 

Conclusions: These results suggest that some aspects of stigma, such as internalized self-stigma may affect functioning overall, whereas other components of stigma may only affect specific types of functioning. It is likewise possible that decline in functioning may bring out social stigma. Importantly, these relationships exist independent of level of depression. Regardless of the direction of causality, it appears that individuals with depression are likely to experience mutually deleterious consequences of social stigma and poor functioning.