Dimensionality and risk factors of the personal stigma of depression in adults aged 50 years and older at risk of depression

Abstract

Objectives: Knowledge about the mechanism of the personal stigma of depression may inform strategies to reduce stigma and promote help-seeking. We examined the dimensionality and risk factors of the personal stigma of depression in older adults at risk of depression.

Methods: Seven-hundred and one Hong Kong adults aged 50 years and older at risk of depression completed the personal stigma subscale of the depression Stigma Scale (DSS-personal) at two-time points. We used exploratory factor analysis (EFA) to explore the factor structure of DSS personal and confirmatory factor analysis to examine the model fit of the EFA-informed factor structure and structures proposed in previous studies. Regression analyses examined the relationships between risk factors and personal stigma dimensions.

Results: Factor analyses identified a 3-factor structure of DSS-personal resembling the social-cognitive model consistent over time and included stereotype, prejudice, and discrimination (CFI = 0.95, TLI = 0.92, RMSEA = 0.05). Regression analyses indicated all stigma dimensions were associated with older age, less education, and no personal history of depression (B = –0.44 to 0.06); discrimination was also associated with more depressive symptoms (B = 0.10 to 0.12).

Conclusion: Findings illustrated the potential theoretical underpinning of DSS-personal. Stigma reduction interventions could target and tailor to older adults with risk factors to enhance effectiveness and promote help-seeking.

Keywords:

• Stereotype
• prejudice
• discrimination
• psychometrics
• social-cognitive model

Acknowledgement

The authors would like to thank the respondents who took part in the Mental Health First Aid program, as well as the trainers and social workers who organized and delivered the training program.

Statement of ethics

The study was approved by the Human Research Ethics Committee at The University of Hong Kong (reference number: EA2004028). Written consent were obtained from participants to participate in the study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

Data are available upon reasonable request.

Additional information

Funding

This work is supported by the Hong Kong Jockey Club Charites Trust for The University of Hong Kong for the Project JC JoyAge: Jockey Club Holistic Support Project for Elderly Mental Wellness (HKU Project Code: AR160026 and AR190017). The funder has no role in the preparation of data or the manuscript.