Stigmatising attitudes of undergraduates towards their peers with depression: a cross-sectional study in Sri Lanka

Abstract

BackgroundThere is limited research examining mental health-related stigma of undergraduates in non-western developing countries. This study examined stigma of undergraduates in Sri Lanka towards another depressed undergraduate.MethodsA hypothetical vignette of an undergraduate suffering from depression was presented. A total of 4650 undergraduates responded to scales assessing their personal stigma towards and desire for social distance from this individual. Exploratory structural equation modelling (ESEM) was performed to determine the dimensionality and loading pattern of the items on these two stigma scales. Multiple linear regressions were used to explore correlates of the identified dimensions of stigma.ResultsPrevious findings that the Social Distance Scale forms a single dimension and that the Personal Stigma Scale consists of two dimensions were supported. However, the measurement structure of the dimensions of stigma on the latter scales, labelled ‘Weak-not-Sick’ and ‘Dangerous-Undesirable’ , differed from previous work. A high level of stigma in relation to the ‘Weak-not-Sick’ Scale was observed. However, some correlates associated with lower levels of stigma on this scale, such as being in the Medical Faculty, were associated with higher levels of stigma on the ‘Dangerous-Undesirable’ and ‘Social Distance’ scales. In contrast, labelling the problem as a mental health-related problem, with absence of specific psychiatric terminology, was associated with lower levels of stigma on these latter two scales. Exposure to a mental health problem in family or friends or from personal experience was also associated with lower stigma on the Social Distance Scale. However, the effect sizes of these relationships were small.ConclusionsThe findings highlight differences in the measurement structure and score distribution of the ‘Weak-not-Sick’ and ‘Dangerous-Undesirable’ scales when used in different cultural and demographic contexts. The dimensionality of stigma relevant to these scales must always be established prior to their use in different contexts. Furthermore, campaigns targeted at improving knowledge about depression as a real illness and as a psychiatric condition need to ensure that such attempts are not associated with increases in other aspects of stigma.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-015-0523-9) contains supplementary material, which is available to authorized users.

Quantifying and predicting depression literacy of undergraduates: a cross sectional study in Sri Lanka

“…This cross-sectional study was conducted from June to November 2013 among undergraduates at the University of Colombo, one of the largest universities in Sri Lanka [ 30 ]. The present paper, the Amarasuriya et al [ 24 ] paper examining depression among undergraduates in Sri Lanka and the Amarasuriya et al [ 25 ] paper examining stigma among this population, were all based on the same Depression Literacy Survey conducted among this undergraduate population at the University of Colombo.…”

“…Scores obtained on the Personal Stigma and Social Distance Scales (continuous variables) were also examined as predictors of the scale scores. Amarasuriya et al [ 25 ] found that the Personal Stigma Scale consisted of two dimensions of stigma (i.e., the “Weak-not-Sick” and “Dangerous- Undesirable” dimensions), and that the Social Distance Scale consisted of one dimension (i.e., the “Social Distance” dimension). Hence, the participants’ stigma scores on these measures were entered into the model in relation to the Weak-not-Sick, Dangerous-Undesirable and Social Distance scales that were constructed in relation to the identified dimensions of stigma (the latter scale being the same as the original social distance measure) [ 25 ].…”

“…The importance of assessing the depression literacy of this group is also indicated by evidence of their stigmatising attitudes towards peers with depression (e.g. that the symptoms are due to a weakness and not a sickness ) [ 25 ] and findings indicating that such stigma might influence their beliefs about help-seeking [ 26 ].…”

The prevalence and associated factors of depression among medical students of Saudi Arabia: A systematic review

“…[ 13 ] Another reason is the stigma or negative attitude towards people with mental disorders. [ 13 14 ]…”

Evaluation of perceptions and knowledge of mental illness in the United States through crowdsourcing

“…The portrayal of mental illness in the media has also had an impact on the public's understanding of mental health and issues related to stigma 10,11. Reviews of university students described significant prevalence of illness, suggesting the need for both recognizing mental illness and improving education regarding stigma 12,13. Rusch and colleagues14 described 3 types of stigma: negative stereotypes, prejudice with negative emotional reactions, and discrimination.…”