Self-stigma, empowerment and perceived discrimination among people with bipolar disorder or depression in 13 European countries: The GAMIAN-Europe study

Health Service and Population Research Department, Institute of Psychiatry, King's College London, England.
Journal of Affective Disorders (Impact Factor: 3.38). 09/2010; 129(1-3):56-63. DOI: 10.1016/j.jad.2010.09.001
Source: PubMed


There is little information on the degree to which self-stigma is experienced by individuals with a diagnosis of bipolar disorder or depression across Europe. This study describes the levels of self-stigma, stigma resistance, empowerment and perceived discrimination reported in these groups.
Data were collected from 1182 people with bipolar disorder or depression using a mail survey with members of national mental health non-governmental organisations.
Over one fifth of the participants (21.7%) reported moderate or high levels of self-stigma, 59.7% moderate or high stigma resistance, 63% moderate or high empowerment, and 71.6% moderate or high perceived discrimination. In a reduced multivariate model 27% of the variance in self-stigma scores, among people with a diagnosis of bipolar disorder or depression, was accounted for by levels of empowerment, perceived discrimination, number of areas of social contact, education and employment.
Findings are limited by the use of an unweighted sample of members of mental health charity organisations which may be unrepresentative of the reference population.
These findings suggest that self-stigma occurs among approximately 1 in 5 people with bipolar disorder or depression in Europe. The tailoring of interventions to counteract (or fight against) the elements of self-stigma which are most problematic for the group, be they alienation, stereotype endorsement, social withdrawal or discrimination experience, may confer benefit to people with such disorders.

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    • "Incidence studies have revealed that high levels of self-stigma are experienced by approximately one third of people with severe mental illness (Brohan et al., 2010; West et al., 2011), 25 per cent of people with HIV/ AIDS (Lee et al., 2002), and 20–25 per cent of people with depressive and bipolar disorders (Brohan et al., 2011; Yen et al., 2005). In addition, stigma from within the community can hamper recovery from mental illness and can put individuals subjected to stigma from physical health problems at increased risk of developing mental health problems (Manzo, 2004), which may further compound the presence and severity of self-stigma. "
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    ABSTRACT: A number of health problems are associated with significant stigma, a social phenomenon in which individuals become the object of negative stereotypes. In addition to experiencing negative reactions from others, stigmatised individuals and groups can experience harmful consequences when they internalise these negative prevailing attitudes. The objective of this paper was to consider the potential to develop Internet-based health-related interventions explicitly targeting the effects of stigma on the individual. A review of the literature was conducted to synthesise current conceptualisations of stigma and self-stigma across a number of groups, and to identify current intervention developments. Self-stigma reduction strategies developed for in-person services include cognitive reframing, myth busting, contact with other members of the stigmatised group, and disclosure promotion. The development and provision of interventions targeting self-stigma within an online environment is in its infancy. Our review considers there to be particular potential of online interventions for this target, associated with the capacity of the Internet to promote having contact with peers within one’s stigmatised group, and for user interaction and empowerment. We conclude that self-stigma is a domain in which there is significant potential for innovation with health-related interventions, and provide a number of recommendations for online intervention development.
    Internet Interventions 02/2015; 15. DOI:10.1016/j.invent.2015.01.003
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    • "The convenience and attraction of the internet already has created dependence in some adolescents whose lives are negatively affected, some of whom have become completely isolated from reality [22]. For people with mental health problems, who have existing problems of social withdrawal or alienation may be at risk of further withdrawal and this needs to be considered in the planning and implementation of material and the interface [16]. While encouraging, the results do deserve further discussion and careful exploration to ensure proper application of internet applications for people with mental illness. "
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    ABSTRACT: Background The easy accessibility, increasing usage, and low cost of internet make it a desirable way of providing health information and delivering interventions for health consumers. Studies in other countries have verified and confirmed the effectiveness of internet-based interventions among people with mental health problems. Similar programs have yet to commence in China. Purpose This study investigated the willingness for, and attitude toward internet-based intervention in Chinese mental health service users and explored the feasibility of such an intervention. Methods A cross-sectional survey utilizing a self-developed questionnaire was administered to 186 mental health service users in Beijing, between April and May 2011. Results Most participants held a positive attitude toward online information and expressed interest in getting assistance from the internet. Some advice and suggestions were provided such as more ways of getting assistance, setting up more professional websites, increasing interaction, as well as having government funding and guidance. Conclusion Internet-based programs are feasible and applicable, and worth implementing with Chinese people with mental illness.
    03/2014; 1(1):28–33. DOI:10.1016/j.ijnss.2014.02.008
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    • "Hence, data need to be interpreted with caution, since reports of low social capital may reflect a consequence of depression's severity and negative cognitive style [42] rather than representing an independent variable. In line with previous research, we found that most participants reported low levels of self-stigma [7] [14] and moderate to high levels of social support and social networks [39]. Potential selection bias should be taken into account. "
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    ABSTRACT: Introduction Individual social capital has been recognized as having an important role for health and well-being. We tested the hypothesis that poor social capital increases internalized stigma and, in turn, can reduce empowerment among people with major depressive disorder (MDD). Materials and methods This is a cross-sectional multisite study conducted on a sample of 516 people with MDD in 19 European countries. Structural Equation Models were developed to examine the direct and indirect effects of self-stigma and social capital on empowerment. Results Social capital and self-stigma accounted for 56% of the variability in empowerment. Higher social capital was related to lower self-stigma (r = –0.72, P < 0.001) which, in turn, partially mediated the relationship between social capital and empowerment (r = 0.38, P < 0.001). Conclusions Social capital plays a key role in the appraisal of empowerment, both directly and through the indirect effect mediated by self-stigma. In order to improve empowerment of people with MDD, we identify strategies to foster individual social capital, and to overcome the negative consequences related to self-stigma for attainment of life goals.
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