Does stigmatization moderate the association between intention and implementation of learned prevention-strategies at work after a depressive episode? – a cross-sectional pilot study

Abstract

BackgroundA depressive episode is a frequent reason for production loss due to long periods of absence at work. To maintain work ability after depression, affected employees need to implement learned coping strategies from interventions at work. Based on the theory of planned behavior, this paper examines how stigmatization relates to the implementation of the learned strategies at the workplace. Further, differences between employees with single or recurrent depressive episode were considered.MethodsData of an online survey from 112 participants who returned to work after sick leave because of a depressive episode were analyzed [men = 28 (25%); Age: mean = 42.3, SD = 10.9]. The strategies learned were asked openly, intention and implementation with a questionnaire based on the theory of planned behavior and stigmatization with an adapted version of the German inventory of subjective stigma experience.ResultsIntention is positively (β = .46, p < .001) and anticipated (β = −.18, p = .052) and experienced stigmatization not (β = −.11, p = .27) correlated with implementation. Only anticipated stigmatization moderates the association between intention and implementation (β = .26, p = .003). If individuals report a high intention to implement the learned strategies, stigmatization has no influence on implementation. Under low intention, stigmatization leads to less implementation. Participants with recurrent depressive episodes report higher anticipated stigmatization than participants with a single episode.ConclusionWhen employees return to work after a depressive episode, it is important to address anticipated stigmatization and to develop an organizational culture that helps them to reduce their fear of stigmatization and strengthens their work ability via implementing learned prevention-strategies. The reduction of patient’s anticipated stigmatization should already be considered in the therapy and reduced in cooperation with occupational physicians.

The Moderating Power of Impulsivity: A Systematic Literature Review Examining the Theory of Planned Behavior

“…The initial search yielded 822 hits, with 698 after the removal of duplicates ( Figure 1 ). After title and abstract review, 41 full-text articles were assessed for eligibility, and 33 studies met the inclusion criteria and were retained in the final review [ 16 , 21 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 ]. The majority of the studies utilized a noncontrolled timeseries or pre-post design, with follow-up periods ranging from 1 week to 6 months ( Table 1 ).…”

“…Two studies found particular perceptions or beliefs that moderated the intention–behavior gap ( Table 1 and Table 2 c, and Figure 3 ) [ 56 , 57 ]. Specifically, Gaum and colleagues [ 56 ] found that lower anticipated stigma resulted in the increased implementation of depression prevention strategies in the workplace.…”

“…Two studies found particular perceptions or beliefs that moderated the intention–behavior gap ( Table 1 and Table 2 c, and Figure 3 ) [ 56 , 57 ]. Specifically, Gaum and colleagues [ 56 ] found that lower anticipated stigma resulted in the increased implementation of depression prevention strategies in the workplace. Likewise, Bauman [ 57 ] demonstrated that those with higher normative belief incongruence (changes in normative beliefs over time) were more likely to consume alcohol despite the opposite intention.…”

Sustainable return to work after depression - A comparative study among occupational physicians and affected employees

“…Nielsen et al ( 45 ) have argued that stigma attached to mental health problems may even lead to dismissal when the employer anticipates low productivity after RTW. For employees, especially anticipated stigmatization can interfere with the RTW process ( 46 ).…”