How Quality Improvement Interventions for Depression Affect Stigma Concerns Over Time: A Nine-Year Follow-Up Study

Klap, Ruth; Tang, Lingqi; Schell, Terry L.; Duan, Naihua; Wells, Melissa; Miranda, Jeanne; Sherbourne, Cathy D.

doi:10.1176/appi.ps.60.2.258

Cited by 2 publications

(2 citation statements)

References 11 publications

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“…Such an explanation is broadly consistent with research on social distance, wherein exposure to the stigmatized context (that is, treatment) can lead to decreases in desired social distance (19). Second, the results are also consistent with research showing that levels of stigma change in association with treatment (31). Finally, the relationship between PDD and depression had already been established (7), and the current measures’ correlations with depression were comparable with those of the PDD.…”

Section: Discussionsupporting

confidence: 87%

Stigma and Depression Treatment Utilization Among Latinos: Utility of Four Stigma Measures

Interian¹,

Ang²,

Gara³

et al. 2010

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Objectives-Stigma associated with mental illness is an important yet understudied issue among Latinos. This study examined the psychometric properties of four stigma measures with a sample of Spanish-speaking Latino primary care patients. The study evaluated the scale for Perceived Discrimination Devaluation (PDD), Stigma Concerns About Mental Health Care (SCMHC), the Latino Scale for Antidepressant Stigma (LSAS), and the Social Distance (SD) scale.Methods-Participants (N=200) were low-income Latinos who were screened for depression with the Patient Health Questionnaire (PHQ-2) and asked about their depression treatment history, and they completed the four stigma measures at two time points. The four stigma measures were examined for internal consistency, convergent validity, construct validity, and criterion-related validity.Results-The factor-analytic results generally provided support for the construct validity of the measures. The four stigma measures also demonstrated internal consistency between two time points. Patients who reported greater social distance from individuals with depression were more likely to have been receiving treatment for emotional care in the past three months (OR=.70, p<. 05). Also, Latinos who scored high on the SCMHC (OR=.64, p<.05) and LSAS (OR=.77, p<.05) were less likely to have been taking antidepressant medications.Conclusions-The SCMHC, LSAS, and SD scales received support for their reliability and construct validity. Results also showed some support for their criterion-related validity. A more disclosures The authors report no competing interests. NIH Public Access Author ManuscriptPsychiatr Serv. Author manuscript; available in PMC 2011 November 22. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript mixed picture emerged for the PDD. Stigma ratings were associated with depression treatment utilization. Stigma ratings changed over time and were associated with treatment experiences.Depression stigma among Latinos is an important issue but one that is considerably understudied. Given the increasing size of the U.S. Latino population, the relatively common occurrence of major depression, and the significant treatment-seeking barriers posed by stigma, more research on this topic among Latinos is needed (1-3). Stigma research in the Latino culture requires adequate measures for key stigma constructs in order to investigate processes by which stigma beliefs deter treatment utilization (4). Concerns about the cultural and linguistic appropriateness of measures underscore the need to ensure that adequate stigma measures are available for Latinos.Depression stigma among Latinos may be an underlying factor in deterring help seeking. The label of depression can signify a number of stereotypes (personal weakness, for example). Therefore, people may seek social distance from stigmatized persons and impede their social role development and occupational mobility (5). This type of social labeling negatively affects patients and their families (6-10). In ad...

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Section: Discussionsupporting

confidence: 87%

Stigma and Depression Treatment Utilization Among Latinos: Utility of Four Stigma Measures

Interian¹,

Ang²,

Gara³

et al. 2010

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“…Our informants received a range of treatments, and some received no treatment despite a positive screen. However, in a separate analysis, participants from the PIC study treated by primary care clinicians receiving enhanced resources for the delivery of therapy showed reduced stigma concerns compared to other participants; while those participants treated by clinicians receiving enhanced resources to support medication management showed increased stigma concerns compared to others (Klap, et al 2009). As do informants' narratives, these analyses suggest that primary care pharmaceutical treatment of depression may increase stigma.…”

Section: Resultsmentioning

confidence: 97%

The Fracture of Relational Space in Depression: Predicaments in Primary Care Help Seeking

Bromley¹,

Kennedy

Miranda³

et al. 2016

Current Anthropology

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Primary care clinicians treat the majority of cases of depression in the United States. The primary care clinic is also a site for enactment of a disease-oriented concept of depression that locates disorder within an individual body. Drawing on theories of the self and stigma, this article highlights problematics of primary care depression treatment by examining the lived experience of depression. The data come from individuals who screened positive for depressive symptoms in primary care settings and were followed over ten years. After iterative mixed-methodological exploration of a large dataset, we analyzed interviews from a purposive sample of 46 individuals using grounded and phenomenological approaches. We describe two major results. First, we note that depression is experienced as located within and inextricable from relational space and that the self is experienced as relational, rather than autonomous, in depression. Second, we describe the ways in which the experience of depression contradicts a disease-oriented concept such that help-seeking intensifies rather than alleviates the relational problem of depression. We conclude by highlighting that an understanding of illness experience may be essential to improving primary care depression treatment and by questioning the bracketing of relational concerns in depression within the construct of stigma.

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How Quality Improvement Interventions for Depression Affect Stigma Concerns Over Time: A Nine-Year Follow-Up Study

Cited by 2 publications

References 11 publications

Stigma and Depression Treatment Utilization Among Latinos: Utility of Four Stigma Measures

Stigma and Depression Treatment Utilization Among Latinos: Utility of Four Stigma Measures

The Fracture of Relational Space in Depression: Predicaments in Primary Care Help Seeking

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