Mediators of change in the stigmatization of depression among Caucasian and Asian populations

Public stigma negatively impacts public health by discouraging people with depression from seeking help. In North America, Asians reliably report higher levels of stigma and lower levels of help-seeking than do Caucasians. The reasons for this discrepancy and possible methods of reducing this have, however, rarely been explored. In Study 1, undergraduate students (n = 573) completed several questionnaires related to public stigma, values and ideological beliefs, attitudes and beliefs regarding people with depression and perceived norms. At least one week afterward, participants completed the second part of Study 1, where they were presented with contrived articles highlighting a biological cause for depression, a contextual causal for depression, or hope for recovery from depression, or were assigned to a control condition. Asian participants reported higher levels of stigma and increased desired social distance from people with depression compared to Caucasian participants. This difference was mediated by perceived norms, social dominance orientation, conservatism, and the belief that people with depression brings shame to their families. The articles presented were largely ineffective in reducing stigma or desired social distance. In Study 2, undergraduate students (n = 287), were presented with one of four anti-stigma videos with two actresses portraying a student with depression and a professor, respectively. The videos used the concept of social proof to effect change and presented either positive or negative descriptive norms. All videos were effective in reducing preferred social distance towards people with depression relative to the control condition for Asians, but not Caucasians. The effectiveness of the positive descriptive norm video was mediated through perceived norms, empathy, and self-efficacy. The effectiveness of the negative norm video was mediated through perceived norms and empathy only. Differences in preferred social distance between Asian and Caucasian participants were no longer significant. The findings can help guide interventions encouraging social engagement with people with depression among Asian student populations. Manipulating social norms and increasing self-efficacy may be especially effective, while changing attitudes may be less important in an Asian student population