Stigma is an important barrier to recovery from depression. Individuals of Asian origin show greater levels of depression stigma compared with individuals of European origin. This study examined the mediators of the relationship between ethnicity and depression stigma in a North American context. A sample of university students, including 199 Canadian Europeans and 249 Canadian Asians, completed a variety of measures through an online study. Stigma toward an individual with depression was measured using both the Depression Attribution Questionnaire-27 and a Social Distance Scale. The perception of social norms, the belief that depression brings shame to one’s family, a social dominance orientation, and conservative values mediated the relationship between ethnicity and depression stigma with perceived norms and familial shame having the largest indirect effects. These findings are consistent with social identity theory and suggest avenues for anti-stigma interventions.
AbdullaT.BrownT. L. (2011). Mental illness stigma and ethnocultural beliefs, values, and norms: An integrative review. Clinical Psychology Review, 31, 934-948.
2.
AlexanderL. A.LinkB. G. (2003). The impact of contact on stigmatizing attitudes toward people with mental illness. Journal of Mental Health, 12, 271-289.
3.
American Psychological Association. (2009). Publication manual of the American Psychological Association (6th ed.). Washington, DC: Author.
4.
AndradeL.Caraveo-AnduagaJ. J.BerglundP.BijlR. V.De GraafR.VolleberghW.. . . WittchenH. U. (2003). The epidemiology of major depressive episodes: Results from the International Consortium of Psychiatric Epidemiology (ICPE) surveys. International Journal of Methods in Psychiatric Research, 12, 3-21.
5.
BardiA.SchwartzS. H. (2003). Values and behavior: Strength and structure of relations. Personality and Social Psychology Bulletin, 29, 1207-1220.
6.
BizerG. Y.HartJ.JokegianA. M. (2012). Belief in a just world and social dominance orientation: Evidence for a mediational pathway predicting negative attitudes and discrimination against individuals with mental illness. Personality and Individual Differences, 52, 428-432.
7.
CampbellD. T. (1982). Legal and primary-group social controls. Journal of Social and Biological Structures, 5, 431-438.
8.
CheonB. K.ChiaoI, Y. (2012). Cultural variation in implicit mental illness stigma. Journal of Cross-Cultural Psychology, 43(7), 1058-1062.
9.
CheungA. H.DewaC. S. (2007). Mental health service use among adolescents and young adults with major depressive disorder and suicidality. Canadian Journal of Psychiatry, 52, 228-232.
10.
CorriganP. W.WasselA. (2008). Understanding and influencing the stigma of mental illness. Journal of Psychosocial Nursing, 46, 42-48.
11.
CrandallC. S.EshlemanA.O’BrienL. (2002). Social norms and the expression and suppression of prejudice: The struggle for internalization. Journal of Personality & Social Psychology, 82, 359-378.
12.
CrowneD. P.MarloweD. (1960). A new scale of social desirability independent of psychopathology. Journal of Consulting Psychology, 24, 349-354.
13.
D’AndradeR. (2008). A study of personal and cultural values: American, Japanese, and Vietnamese. Los Angeles, CA: Palgrave Macmillan.
14.
FischerR.HankeK.SibleyC. G. (2012). Cultural and institutional determinants of social dominance orientation: A cross-cultural meta-analysis of 27 societies. Political Psychology, 33, 437-467. doi:10.1111/j.1467-9221.2012.00884.x
15.
GaebelW.BaumannA. E. (2003). Interventions to reduce the stigma associated with severe mental illness: Experiences from the open the doors program in Germany. Canadian Journal of Psychiatry, 48, 657-662.
16.
GoffmanE. (1963). Stigma. New York, NY: Touchstone.
17.
HayesA. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression based approach. New York, NY: Guilford.
18.
HoggM. A.SmithJ. R. (2007). Attitudes in social context: A social identity perspective. European Review of Social Psychology, 18, 89-131.
19.
HsuL. K. G.WanY. M.ChangeH.SummergradP.TsangB. Y. P.ChenH. (2008). Stigma of depression is more severe in Chinese Americans than Caucasian Americans. Psychiatry, 71, 210-218.
20.
JormA. F.OhE. (2009). Desire for social distance from people with mental disorders: A review. Australian & New Zealand Journal of Psychiatry, 43, 183-200.
21.
KalibatsevaZ.LeongF. T. L. (2011). Depression among Asian Americans: Review and recommendations. Depression Research and Treatment, 2011 Article 320902. doi:10.1155/2011/320902
22.
KanterJ. W.RuschL. C.BrondinoM. J. (2008). Depression self-stigma: A new measure and preliminary findings. The Journal of Nervous and Mental Disease, 196, 663-670.
23.
LamC. S.TsangH.ChanF.CorriganP. W. (2006). Chinese and American perspectives on stigma. Rehabilitation Education, 20, 269-276.
24.
LauberC.NordtC.FalcatoL.RosslerW. (2004). Factors influencing social distance toward people with mental illness. Community Mental Health Journal, 40, 265-274.
25.
LeongF. T. L.ChouE. L. (2002). Counseling international students and sojourners. In PedersenP. B.DragunsJ. G.LonnerW. J.TrimbleJ. E. (Eds.), Counseling across cultures (5th ed., pp. 185-208). Thousand Oaks, CA: Sage.
26.
LepineJ. P.BrileyM. (2011). The increasing burden of depression. Neuropsychiatric Disease and Treatment, 7, 3-7.
27.
LinvilleP. W. (1985). Self-complexity and affective extremity: Don’t put all your eggs in one cognitive basket. Social Cognition, 3, 94-120.
28.
MacKinnonD. P.LockwoodC. M.WilliamsJ. (2004). Confidence limits for the indirect effect: Distribution of the product and resampling methods. Multivariate Behavioral Research, 39, 99-128.
29.
MallinckrodtB.ShigeokaS.SuzukiL. A. (2005). Asian and Pacific Island American students’ acculturation and etiology beliefs about typical counseling presenting problems. Cultural Diversity and Ethnic Minority Psychology, 11(3), 227-238.
30.
McGartyC.HaslamS. A.HutchisonK. J.TurnerJ. C. (1994). The effects of salient group membership on social persuasion. Small Group Research, 25, 267-293.
31.
MillerM. J. (2007). A bilinear multidimensional measurement model of Asian American acculturation and enculturation: Implications for counseling interventions. Journal of Counseling Psychology, 54, 118-131.
32.
NormanR. M. G.SorrentinoR. M.WindellD.ManchandaR. (2008a). Are personal values of importance in the stigmatization of people with mental illness?Canadian Journal of Psychiatry, 53, 848-856.
33.
NormanR. M. G.SorrentinoR. M.WindellD.ManchandaR. (2008b). The role of perceived norms in the stigmatization of mental illness. Social Psychiatry and Psychiatric Epidemiology, 43, 851-859.
34.
NormanR. M. G.WindellD.ManchandaR. (2010). Examining differences in the stigma of depression and schizophrenia. International Journal of Social Psychiatry, 58, 69-78.
35.
PaykelE. S.HartD.PriestR. G. (1998). Changes in public attitudes to depression during the defeat depression campaign. British Journal of Psychiatry, 173, 519-522.
36.
PhelanJ. E.BasowS. A. (2007). College students’ attitudes toward mental illness: An examination of the stigma process. Journal of Applied Social Psychology, 37, 2877-2902.
37.
PinfoldV.HuxleyP.ThornicroftG.FarmerP.ToulminH.GrahamT. (2003). Reducing psychiatric stigma and discrimination– evaluating an educational intervention with the police force in England. Social Psychiatry and Psychiatric Epidemiology, 38, 337-344.
38.
PrattoF.LiuJ. H.LevinS.SidaniusJ.ShihM.BachrachH.HegartyP. (2000). Social dominance orientation and the legitimization of inequality across cultures. Journal of Cross-Cultural Psychology, 31, 369-409.
39.
PrattoF.SidaniusJ.StallworthL.MalleB. (1994). Social dominance orientation: A personality variable predicting social and political attitudes. Journal of Personality and Social Psychology, 67, 741-763.
40.
PreacherK. J.HayesA. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40, 879-891.
41.
RaoD.FeinglassJ.CorriganP. (2007). Racial and ethnic disparities in mental illness stigma. The Journal of Nervous and Mental Disease, 195, 1020-1023.
42.
RieberR. W.RobinsonD. K. (2004). The essential Vygotsky (1896-1934). New York, NY: Kluwer Academic.
43.
RuschL. C.KanterJ. W.BrondinoM. J. (2009). A comparison of contextual and biomedical models of stigma reduction for depression with a nonclinical undergraduate sample. The Journal of Nervous and Mental Disease, 197, 104-110.
44.
RyderA. G.AldenL.PaulhusD. L. (2000). Is acculturation unidimensional or bidimensional?: A head-to-head comparison in the prediction of demographics, personality, self-identity, and adjustment. Journal of Personality and Social Psychology, 79, 49-65.
45.
SchmittM. J.SchwartzS. H.SteyerR.SchmittT. (1993). Measurement models for the Schwartz Values Inventory. European Journal of Psychological Assessment, 9, 107-121.
46.
SchwartzS. H. (1992). Universals in the content and structure of values: Theoretical advances and empirical tests in 20 countries. In ZannaM. (Ed.), Advances in experimental social psychology (Vol. 25, pp. 1-65). San Diego, CA: Academic Press.
47.
SchwartzS. H. (1994). Beyond individualism/collectivism: New dimensions of values. In KimU.TriandisH. C.KagitcibasiC.ChoiS. C.YoonG. (Eds.), Individualism and collectivism: Theory application and methods (pp. 85-119). Newbury Park, CA: Sage.
48.
SchwartzS. H. (2006). A theory of cultural value orientations: Explication and applications. Comparative Sociology, 5, 137-182.
49.
SchwartzS. H. (2007). A theory of cultural value orientations: Explication and applications. In EsmerY.PetterssonT. (Eds.), Measuring and mapping cultures: 25 years of comparative value surveys (pp. 33-78). Leiden, The Netherlands: Koninklijke Brill.
50.
SchwartzS. H. (2009). Draft users manual: Proper use of the Schwarz Value Survey (Version 14, compiled by LittrellR. F.). Auckland, New Zealand: Centre for Cross Cultural Comparisons. Retrieved from http://www.crossculturalcentre.homestead.com
51.
SchwartzS. H.BardiA. (2001). Value hierarchies across cultures: Taking a similarities perspective. Journal of Cross-Cultural Psychology, 32, 268-290.
52.
SheaM.YehC. J. (2008). Asian American students’ cultural values, stigma, and relational self-construal: Correlates of attitudes towards professional help seeking. Journal of Mental Health Counseling, 30, 157-172.
53.
SmithJ. R.HoggM. A. (2008). Social identity and attitudes. In CranoW.PrislinR. (Eds.), Attitudes and attitude change (pp. 337-360). New York, NY: Psychology Press.
54.
SueD. W.SueD. (2008). Counseling the culturally diverse: Theory and practice (5th ed.). Hoboken, NJ: Wiley.
55.
TurnerJ. C. (1991). Social influence. Pacific Grove, CA: Brooks/Cole.
56.
U.S. Public Health Service. (2001). A report of the surgeon general on minority mental health. Rockville, MD: U.S. Department of Health and Human Services.
57.
WeinerB. (1995). Judgments of responsibility: A foundation for a theory of social conduct. New York, NY: Guilford Press.
YangL. H. (2007). Application of mental illness stigma theory to Chinese societies: Synthesis and new directions. Singapore Medical Journal, 48, 977-985.
