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

Abstract

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 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.

Entertainment–Education? A Fotonovela? A New Strategy to Improve Depression Literacy and Help‐Seeking Behaviors in At‐Risk Immigrant Latinas

“…The psychometric properties of both scales were assessed with a sample of 200 low-income Latinos screened for depression. Latinos who scored high on both the SCMHC (OR .64, p \ .05) and the LSAS (OR .77, p \ .05) were less likely to take antidepressant medication (Interian et al 2010). The current study used Cronbach's alpha to measure each scale's internal consistency and found good internal reliability for both the SCMHC (.83) and the LSAS (.79).…”

“…Health Care (SCMHC) scale, and the Latino Scale for Antidepressant Stigma (LSAS) (Interian et al 2010). The SCMHC is a 3-item scale measuring stigma-related barriers to depression treatment (i.e., avoid seeking treatment due to embarrassment about discussing personal matters with others, fear of what others might think, or thoughts that family members would not approve of the treatment).…”

Perceived Alcohol Stigma: Factor Structure and Construct Validation

“…Models 1 and 2 sought to answer the question, do the data support perceived devaluation–discrimination as a single factor (model 1), or as 2 factors (model 2)? Model 3 attempted to determine the plausibility of positive and negative dimensions of perceived stigma as proposed by others (Interian et al., ). Finally, motivated by evidence from prior factor analytic studies that extracted separate “method factors” to adjust for positively and negatively worded items (Marsh et al., ), we specified models 4 (a single PDD factor) and 5 (two PDD factors) as analogs of models 1 and 2, while statistically adjusting for method effects.…”

“…However, the distinction between the 2 dimensions in the PDD has been obscured in some research, where a single score has been created from all items (Keyes et al., ), or 2 dimensions are assumed via creation of 2 subscales (Smith et al., ) but not psychometrically evaluated. Further, evidence from exploratory factor analysis has been presented that suggest that the positively and negatively worded items may induce separate latent factors that reflect “perceived acceptance and nonnegative evaluation” and “perceived discrimination and negative evaluation,” respectively (Interian et al., ). To our knowledge, there are no confirmatory factor analytic (CFA) studies that have described the factor structure of the PDD.…”

The Price of Sunshine: Open Dependency Courts and Their Risks to LGBTQ Child Abuse and Neglect Victims

“…Thus stigma is a prominent concern among racialethnic minority groups and a major contributor to lesser treatment involvement and lower adherence." 32 Since it is estimated that approximately twothirds of children in the juvenile court system have some form of mental health problem, 33 a substantial number of those children may fear disclosure of their mental health conditions or treatments. 34 Other groups of LGBTQ children may fear disclosure of their sexual orientation because of strict religious or cultural taboos.…”