Comparing Affiliate Stigma Between Family Caregivers of People With Different Severe Mental Illness in Taiwan

Abstract

The family caregivers of people with mental illness may internalize the public stereotypes into the affiliate stigma (i.e., the self-stigma of family members). This study aimed to compare the affiliate stigma across schizophrenia, bipolar disorder, and major depressive disorder, and to investigate potential factors associated with affiliate stigma. Each caregiver of family members with schizophrenia (n = 215), bipolar disorder (n = 85), and major depressive disorder (n = 159) completed the Affiliate Stigma Scale, Rosenberg Self-Esteem Scale, Caregiver Burden Inventory, Taiwanese Depression Questionnaire, and Beck Anxiety Inventory. After controlling for potential confounders, the hierarchical regression models showed that caregivers of a family member with schizophrenia had a higher level of affiliate stigma than those of bipolar disorder (β = -0.109; p < 0.05) and major depressive disorder (β = -0.230; p < 0.001). Self-esteem, developmental burden, and emotional burden were significant factors for affiliate stigma. The affiliate stigma of caregivers is associated with their self-esteem, caregiver burden, and by the diagnosis.

Correlates of affiliate stigma among family caregivers of people with mental illness: A systematic review and meta‐analysis

“…Table presents the characteristics of the eligible studies. All these studies were published between 1994 and 2017 and conducted in the United States (Bassirnia et al., ; Biegel, Milligan, Putnam, & Song, ; Greenberg, Kim, & Greenley, ), Hong Kong (Chen et al., ; Mak & Cheung, , ), Taiwan (Chang, Yen, Jang, Su, & Lin, ; Chang et al., ; Wu & Chen, ), UK (Kingston, Onwumere, Keen, Ruffell, & Kuipers, ; Whitney, Haigh, Weinman, & Treasure, ), India (Koschorke, Thornicroft, Thara, Balaji, & Patel, ; Singh, Mattoo, & Grover, ), Israel (Hasson‐Ohayon, Levy, Kravetz, Vollanski‐Narkis, & Roe, ), Sri Lanka (Fernando, Deane, & McLeod, ; Fernando, Deane, McLeod, et al., ), Ethiopia (Girma et al., ; Weldeslasie Hailemariam, ), Turkey and Brazil (Ferreira de Araujo Jorge & Chaves, ), Portugal (Gonçalves‐Pereira et al., ), and Japan and Korea (Hanzawa et al., , ). All studies were cross‐sectional, except for one follow‐up study.…”

“…Another study indicated that a high level of caregiver self‐stigma was independently associated with the highest education level in the household being secondary school level (9th to 12th Standard) (Koschorke et al., ). Two cross‐sectional studies reported that young age was associated with high level of affiliate stigma (Koschorke et al., ; Singh et al., ), whereas another study found no relationship between age and affiliate stigma (Chang et al., ).…”

“…Three studies reported that age was negatively associated with affiliate stigma (Bassirnia et al., ; Greenberg et al., ; Singh et al., ). Two studies indicated that age was positively associated with affiliate stigma (Chang et al., ; Mak & Cheung, ). The remaining one study found no relationship between age and affiliate stigma (Weldeslasie Hailemariam, ).…”

“…The remaining one study found no relationship between age and affiliate stigma (Weldeslasie Hailemariam, ). Moreover, several studies reported that education level (Chang et al., ; Greenberg et al., ; Wu & Chen, ) and gender (Fernando, Deane, & McLeod, et al., ; Greenberg et al., ; Mak & Cheung, ) were not related to affiliate stigma. The levels of affiliate stigma varied among different settings (rural and urban) (Girma et al., ; Koschorke et al., ) and different relationships of caregivers to patients (Bassirnia et al., ; Chang et al., ).…”

Development of an 18‐item abbreviated Chinese version of Berger's HIV Stigma Scale

“…Health-related stigma are associated with various conditions, such as mental illnesses (Chang, Wu, Chen, & Lin, 2016;Chang, Yen, Jang, Su, & Lin, 2017;Corrigan, 2000), infectious diseases (Mak et al, 2006;Zhang, Liu, Bromley, & Tang, 2007), sexual orientations (Herek, 2007), race, and obesity (Dean, Roth, & Bobko, 2008;Lin & Lee, 2017;Roehling, Roehling, & Pichler, 2007). Manifestations of stigma vary in the context of diverse health conditions and cultures (Parker & Aggleton, 2003).…”