An exploration of implicit associations regarding mental Illness, self-reported internalised stigma, and their links to help seeking symptom thresholds amongst individuals experiencing depressive symptoms

Objectives It has been theorised that individuals have less awareness of implicit attitudes (Greenwald & Banaji, 1995). Amongst a currently depressed sample, implicit associations regarding mental illness were measured using the Brief Implicit Association Test (BIAT; Sriram & Greenwald, 2009). Self-reported, internalised stigma was also explored. It was hypothesized that negative implicit associations regarding mental illness would positively correlate with increased help seeking depressive symptom thresholds. The relationships between stigma and depression severity and between depression severity and help seeking symptom thresholds were also explored. The associations between stigma and self-esteem and between implicit and explicit measures were also explored. Method This study utilised a cross-sectional design. Individuals with current depressive symptoms (N = 35) were recruited from mental health teams and voluntary organisations. Participants completed self-report measures and two computerised BIATs, which measured implicit associations regarding mental illness compared to physical disability and implicit self-esteem. Results Contrary to the hypothesis, implicit associations regarding mental illness were unrelated to help seeking symptom thresholds. Implicit associations were also unrelated to depression severity or implicit self-esteem. Furthermore, implicit associations were positive amongst over half of the sample, in comparison to physical disability. Self-reported internalised stigma was positively associated with increased help seeking symptom thresholds, depression severity, and self-reported x self-esteem. Consistent with Dual Process Theory (Fazio & Olson, 2003), implicit and self-report measures were unrelated. Despite evidence of positive implicit associations regarding mental illness, self-reported internalised stigma amongst the sample was high. Conclusions Future research should continue to explore implicit associations regarding mental illness amongst clinical populations. These should experiment with different measurement tools, to further the understanding of implicit associations regarding mental illness and their potential application to mental illness stigma. Efforts to improve help seeking and overall treatment outcomes for depressed individuals should consider the impact of mental illness stigma