Research Article
BibTex RIS Cite

Exploring Internalized Stigma, Self-Esteem, and Symptom Severity in Depression: A Comparative Study of Active and Remitted Phases

Year 2024, , 253 - 260, 29.09.2024
https://doi.org/10.17343/sdutfd.1483806

Abstract

Objective: Internalized stigma, which refers to the internalization of negative attitudes and beliefs towards persons with mental illness, significantly impacts their self-perception and overall well-being. This research examines the correlations among internalized stigma, the severity of symptoms, and self-esteem in individuals diagnosed with major depressive disorder (MDD), specifically comparing those currently experiencing active depression with those who are in remission.
Material and Method: Participants were selected from a psychiatric outpatient unit based on their diagnosis of MDD. Participants provided sociodemographic information and completed assessments measuring the severity of depression, level of anxiety, self-esteem, and internalized stigma.
Results: Participants experiencing active depression exhibited elevated levels of depression severity, anxiety severity, and internalized stigma, while also reporting diminished self-esteem in comparison to those who were in a state of remission. Strong positive relationships were observed between the severity of depression and internalized stigma where self-esteem was negatively correlated with the stigma. The results of the regression analysis showed that there was a significant relationship between the severity of depression, self-esteem, and internalized stigma in the group of individuals with active MDD.
Conclusion: This study underscores the impact of depression severity and self-esteem on internalized stigma in individuals with MDD. The findings indicate the need to implement comprehensive treatment techniques that address psychological and social variables like self-esteem and internalized stigma in addition to symptom management. Future studies should investigate the long-term connections and assess the efficacy of interventions in reducing the obstacles caused by stigma in the process of recovering from depression.

References

  • 1. Calear AL, Griffiths KM, Christensen H. Personal and perceived depression stigma in Australian adolescents: magnitude and predictors. J Affect Disord 2011;129(1–3):104–8.
  • 2. Corrigan PW, Morris SB, Michaels PJ et al. Challenging the public stigma of mental illness: a meta-analysis of outcome studies. Psychiatr Serv 2012;63(10):963–73.
  • 3. Du N, Chong ESK, Wei D et al. Prevalence, risk, and protective factors of self-stigma for people living with depression: A systematic review and meta-analysis. J Affect Disord 2023;332:327–40.
  • 4. Fan C-W, Chang K-C, Lee K-Y et al. Rasch modelling and differential item functioning of the self-stigma scale-short version among people with three different psychiatric disorders. Int J Environ Res Public Health 2022;19(14):8843.
  • 5. Dubreucq J, Plasse J, Franck N. Self-stigma in serious mental illness: A systematic review of frequency, correlates, and consequences. Schizophr Bull 2021;47(5):1261–87.
  • 6. Çilek NZ, Akkaya C. A Review on Mental Illness and Stigma. Psikiyatride Güncel Yaklaşımlar - Current Approaches in Psychiatry. December 2022;14(4):545-54.
  • 7. Suwalska J, Suwalska A, Szczygieł M et al. Medical students and stigma of depression. Part 2. Self-stigma. Psychiatr Pol 2017;51(3):503–13.
  • 8. Yang F, Yang BX, Stone TE et al. Stigma towards depression in a community-based sample in China. Compr Psychiatry 2020;97:152152.
  • 9. Grant JB, Bruce CP, Batterham PJ. Predictors of personal, perceived and self-stigma towards anxiety and depression. Epidemiol Psychiatr Sci 2016;25(3):247–54.
  • 10. Kanter JW, Rusch LC, Brondino MJ. Depression self-stigma: a new measure and preliminary findings. J Nerv Ment Dis 2008;196(9):663–70.
  • 11. Manos RC, Rusch LC, Kanter JW et al. Depression self-stigma is a mediator of the relationship between depression severity and avoidance. J Soc Clin Psychol 2009;28(9):1128–43.
  • 12. Perlick DA, Miklowitz DJ, Link BG et al. Perceived stigma and depression among caregivers of patients with bipolar disorder. Br J Psychiatry 2007;190(6):535–6.
  • 13. Freidl M, Piralic Spitzl S, Aigner M. How depressive symptoms correlate with stigma perception of mental illness. Int Rev Psychiatry 2008;20(6):510–4.
  • 14. Jahn DR, Leith J, Muralidharan A et al. The influence of experiences of stigma on recovery: Mediating roles of internalized stigma, self-esteem, and self-efficacy. Psychiatr Rehabil J 2020;43(2):97.
  • 15. Bhattacharya S, Kennedy M, Miguel C et al. Effect of psychotherapy for adult depression on self-esteem: A systematic review and meta-analysis. J Affect Disord 2023;325:572–81.
  • 16. Boyd JE, Otilingam PG, DeForge BR. Brief version of the Internalized Stigma of Mental Illness (ISMI) scale: psychometric properties and relationship to depression, self-esteem, recovery orientation, empowerment, and perceived devaluation and discrimination. Psychiatr Rehabil J 2014;37(1):17.
  • 17. Livingston JD, Boyd JE. Correlates and consequences of internalized stigma for people living with mental illness: A systematic review and meta-analysis. Soc Sci Med 2010;71(12):2150–61.
  • 18. Alonso J, Buron A, Rojas-Farreras S et al. Perceived stigma among individuals with common mental disorders. J Affect Disord 2009;118(1–3):180–6.
  • 19. Akdemir A, Türkçapar MH, Örsel SD et al. Reliability and validity of the Turkish version of the Hamilton Depression Rating Scale. Compr Psychiatry 2001;42(2):161–5.
  • 20. Yazıcı MK, Demir B, Tanrıverdi N et al. Hamilton anksiyete değerlendirme öiçeği, değerlendiriciler arası güvenirlik ve geçerlik çalışması. Türk Psikiyatr Derg 1998;9(2):114–7.
  • 21. Çuhadaroğlu F. Adolesanlarda benlik saygısı. Hacettepe University, Faculty of Medicine, Department of Psychiatry Specialty Thesis. Ankara: Hacettepe University. 1986.
  • 22. Ersoy MA, Varan A. Reliability and validity of the Turkish version of the internalized stigma of mental illness scale. Turk Psikiyatr Derg 2007;18(2):163.
  • 23. Werner P, Aviv A, Barak Y. Self-stigma, self-esteem and age in persons with schizophrenia. Int Psychogeriatrics 2008;20(1):174–87.
  • 24. Picco L, Pang S, Lau YW et al. Internalized stigma among psychiatric outpatients: Associations with quality of life, functioning, hope and self-esteem. Psychiatry Res 2016;246:500–6.
  • 25. Kamış GZ, Aki ŞÖE, Yildiz MI et al. The Validity and the Reliability of the Turkish Version of the Self-Stigma of Depression Scale. Turk Psikiyatr Derg 2019;30(3).
  • 26. Ociskova M, Prasko J, Kamaradova D et al. Individual correlates of self-stigma in patients with anxiety disorders with and without comorbidities. Neuropsychiatr Dis Treat 2015;1767–79.
  • 27. Schmitz N, Kugler J, Rollnik J. On the relation between neuroticism, self-esteem, and depression: results from the National Comorbidity Survey. Compr Psychiatry 2003;44(3):169–76.
  • 28. Abo-Rass F, Werner P, Shinan-Altman S. Self-stigma formation process among younger and older Israeli Arabs diagnosed with depression. Aging Ment Health 2021;25(6):1071–6.
  • 29. Barney LJ, Griffiths KM, Christensen H et al. The Self‐Stigma of Depression Scale (SSDS): development and psychometric evaluation of a new instrument. Int J Methods Psychiatr Res 2010;19(4):243–54.
  • 30. Shimotsu S, Horikawa N. Self-stigma in depressive patients: Association of cognitive schemata, depression, and self-esteem. Asian J Psychiatr 2016;24:125–9.
Year 2024, , 253 - 260, 29.09.2024
https://doi.org/10.17343/sdutfd.1483806

Abstract

References

  • 1. Calear AL, Griffiths KM, Christensen H. Personal and perceived depression stigma in Australian adolescents: magnitude and predictors. J Affect Disord 2011;129(1–3):104–8.
  • 2. Corrigan PW, Morris SB, Michaels PJ et al. Challenging the public stigma of mental illness: a meta-analysis of outcome studies. Psychiatr Serv 2012;63(10):963–73.
  • 3. Du N, Chong ESK, Wei D et al. Prevalence, risk, and protective factors of self-stigma for people living with depression: A systematic review and meta-analysis. J Affect Disord 2023;332:327–40.
  • 4. Fan C-W, Chang K-C, Lee K-Y et al. Rasch modelling and differential item functioning of the self-stigma scale-short version among people with three different psychiatric disorders. Int J Environ Res Public Health 2022;19(14):8843.
  • 5. Dubreucq J, Plasse J, Franck N. Self-stigma in serious mental illness: A systematic review of frequency, correlates, and consequences. Schizophr Bull 2021;47(5):1261–87.
  • 6. Çilek NZ, Akkaya C. A Review on Mental Illness and Stigma. Psikiyatride Güncel Yaklaşımlar - Current Approaches in Psychiatry. December 2022;14(4):545-54.
  • 7. Suwalska J, Suwalska A, Szczygieł M et al. Medical students and stigma of depression. Part 2. Self-stigma. Psychiatr Pol 2017;51(3):503–13.
  • 8. Yang F, Yang BX, Stone TE et al. Stigma towards depression in a community-based sample in China. Compr Psychiatry 2020;97:152152.
  • 9. Grant JB, Bruce CP, Batterham PJ. Predictors of personal, perceived and self-stigma towards anxiety and depression. Epidemiol Psychiatr Sci 2016;25(3):247–54.
  • 10. Kanter JW, Rusch LC, Brondino MJ. Depression self-stigma: a new measure and preliminary findings. J Nerv Ment Dis 2008;196(9):663–70.
  • 11. Manos RC, Rusch LC, Kanter JW et al. Depression self-stigma is a mediator of the relationship between depression severity and avoidance. J Soc Clin Psychol 2009;28(9):1128–43.
  • 12. Perlick DA, Miklowitz DJ, Link BG et al. Perceived stigma and depression among caregivers of patients with bipolar disorder. Br J Psychiatry 2007;190(6):535–6.
  • 13. Freidl M, Piralic Spitzl S, Aigner M. How depressive symptoms correlate with stigma perception of mental illness. Int Rev Psychiatry 2008;20(6):510–4.
  • 14. Jahn DR, Leith J, Muralidharan A et al. The influence of experiences of stigma on recovery: Mediating roles of internalized stigma, self-esteem, and self-efficacy. Psychiatr Rehabil J 2020;43(2):97.
  • 15. Bhattacharya S, Kennedy M, Miguel C et al. Effect of psychotherapy for adult depression on self-esteem: A systematic review and meta-analysis. J Affect Disord 2023;325:572–81.
  • 16. Boyd JE, Otilingam PG, DeForge BR. Brief version of the Internalized Stigma of Mental Illness (ISMI) scale: psychometric properties and relationship to depression, self-esteem, recovery orientation, empowerment, and perceived devaluation and discrimination. Psychiatr Rehabil J 2014;37(1):17.
  • 17. Livingston JD, Boyd JE. Correlates and consequences of internalized stigma for people living with mental illness: A systematic review and meta-analysis. Soc Sci Med 2010;71(12):2150–61.
  • 18. Alonso J, Buron A, Rojas-Farreras S et al. Perceived stigma among individuals with common mental disorders. J Affect Disord 2009;118(1–3):180–6.
  • 19. Akdemir A, Türkçapar MH, Örsel SD et al. Reliability and validity of the Turkish version of the Hamilton Depression Rating Scale. Compr Psychiatry 2001;42(2):161–5.
  • 20. Yazıcı MK, Demir B, Tanrıverdi N et al. Hamilton anksiyete değerlendirme öiçeği, değerlendiriciler arası güvenirlik ve geçerlik çalışması. Türk Psikiyatr Derg 1998;9(2):114–7.
  • 21. Çuhadaroğlu F. Adolesanlarda benlik saygısı. Hacettepe University, Faculty of Medicine, Department of Psychiatry Specialty Thesis. Ankara: Hacettepe University. 1986.
  • 22. Ersoy MA, Varan A. Reliability and validity of the Turkish version of the internalized stigma of mental illness scale. Turk Psikiyatr Derg 2007;18(2):163.
  • 23. Werner P, Aviv A, Barak Y. Self-stigma, self-esteem and age in persons with schizophrenia. Int Psychogeriatrics 2008;20(1):174–87.
  • 24. Picco L, Pang S, Lau YW et al. Internalized stigma among psychiatric outpatients: Associations with quality of life, functioning, hope and self-esteem. Psychiatry Res 2016;246:500–6.
  • 25. Kamış GZ, Aki ŞÖE, Yildiz MI et al. The Validity and the Reliability of the Turkish Version of the Self-Stigma of Depression Scale. Turk Psikiyatr Derg 2019;30(3).
  • 26. Ociskova M, Prasko J, Kamaradova D et al. Individual correlates of self-stigma in patients with anxiety disorders with and without comorbidities. Neuropsychiatr Dis Treat 2015;1767–79.
  • 27. Schmitz N, Kugler J, Rollnik J. On the relation between neuroticism, self-esteem, and depression: results from the National Comorbidity Survey. Compr Psychiatry 2003;44(3):169–76.
  • 28. Abo-Rass F, Werner P, Shinan-Altman S. Self-stigma formation process among younger and older Israeli Arabs diagnosed with depression. Aging Ment Health 2021;25(6):1071–6.
  • 29. Barney LJ, Griffiths KM, Christensen H et al. The Self‐Stigma of Depression Scale (SSDS): development and psychometric evaluation of a new instrument. Int J Methods Psychiatr Res 2010;19(4):243–54.
  • 30. Shimotsu S, Horikawa N. Self-stigma in depressive patients: Association of cognitive schemata, depression, and self-esteem. Asian J Psychiatr 2016;24:125–9.
There are 30 citations in total.

Details

Primary Language English
Subjects Psychiatry
Journal Section Research Articles
Authors

Pınar Ünal Aydın 0000-0002-2297-1057

Emin Oryal Taşkın 0000-0002-9744-9618

Publication Date September 29, 2024
Submission Date May 14, 2024
Acceptance Date August 6, 2024
Published in Issue Year 2024

Cite

Vancouver Ünal Aydın P, Taşkın EO. Exploring Internalized Stigma, Self-Esteem, and Symptom Severity in Depression: A Comparative Study of Active and Remitted Phases. Med J SDU. 2024;31(3):253-60.

                                                                                               14791 


Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi/Medical Journal of Süleyman Demirel University is licensed under Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International.