Category: Adult Depression / Dysthymia
Background: Depression stigma is a regrettably common and serious concern for Individuals with depression (McNair et al, 2002). Depression stigma may not only be experienced as coming from others, but may also be internalized by the sufferer (Kanter et al., 2008). Subjective Social Status (SSS) is the individual’s perceived standing within their community (Adler et al., 2007). SSS has been shown to be associated with a variety of health outcomes (Singh-Manoux, 2005) as well as with depression (Aslund et al., 2009). The inverse relationship between level of depression and SSS is well documented, however, whether SSS has an independent effect on the social burden of depression, such as depression self-stigma, is not yet known. Thus, the goal of this study is to understand the effect of SSS on depression self-stigma and its components.
Methods: A total of 230 participants screening positive for depression were recruited to an online study. Participants completed questionnaires that included demographic variables (e.g., age, gender, marital status, and education level), as well as the MacArthur Subjective Social Status scale (Adler et al., 2000), Depression Self-Stigma Scale (Kanter et al., 2008), and Quick Inventory of Depressive Symptomatology (Rush et al., 2003). The Depression Self Stigma Scale has five subscales: General Self-Stigma, Secrecy, Public Stigma, Treatment Stigma, and Stigmatizing Experiences. The effect of SSS on stigma was determined via a MANCOVA, predicting self-stigma subscale scores as concurrent dependent variables from SSS ratings, controlling for depression level and other demographic variables.
Results: MANCOVA revealed a significant inverse relationship between SSS and self-stigma (Wilk’s lambda=0.946, p=0.035, partial eta squared=0.054), thus, individuals with higher SSS had lower depression self-stigma scores. Examining the contribution of specific subscales, it appeared that this effect was driven by the inverse associations between SSS and General Self-Stigma subscale (F(1, 220)=6.12, p < 0.05, partial eta squared=0.027) and between SSS and Stigmatizing Experiences subscale (F(1, 220)=6.09, p < 0.05; partial eta squared=0.027).
Conclusion: Individuals who see themselves as having lower subjective social status may experience more stigmatization because of their depression, and are more likely to internalize negative stigmatizing attitude related to depression, and these effects are independent of their levels of depression. Thus, in addition to the well-documented negative physical and mental health outcomes of lower SSS, individuals perceiving themselves to be lower on the social hierarchy may also experience a greater social burden of their illness, such as stigma.