Internalized Stigma in Adolescents With Major Depressive Disorder and Their Parents: Associations With Functioning, Help-Seeking, Beliefs, and Social Support.
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引用次数: 0
Abstract
Background: Adolescents with major depressive disorder (MDD) often internalize stigma, undermining functioning and help-seeking. Parents may likewise internalize stigma about their child's condition, shaping family dynamics and care engagement.
Aim: To examine internalized stigma in adolescents with MDD and their parents, and its associations with adolescent depressive severity, perceived social support, beliefs about mental illness, help-seeking attitudes, and adolescents' global functioning.
Method: Cross-sectional tertiary-clinic study (July-October 2023) of 55 adolescents (12-18 years) with DSM-5 MDD and one parent each (n = 55); 81.8% of adolescents were female. Adolescents completed BDI, SSDS, ISMI-CA, BTMI, MSPSS, and ATSPPH-SF; clinicians rated GAF. Parents completed BDI, P-ISMI, BTMI, and ATSPPH-SF. Group comparisons, correlations, and multivariable linear regression were used.
Results: Parents of adolescents with a suicide attempt or non-suicidal self-injury (NSSI) reported higher P-ISMI (higher alienation and stereotype endorsement; for NSSI also higher perceived discrimination and social withdrawal). Greater adolescent depressive severity correlated with higher self-stigma across SSDS subscales, which related to poorer GAF and lower MSPSS. Higher parental depressive symptoms correlated with higher P-ISMI. Adolescents' social-inadequacy self-stigma was associated with parental social withdrawal. Help-seeking attitudes were more positive with increasing adolescent age and education. Longer psychiatric follow-up related to higher parental stereotype endorsement and social withdrawal, whereas higher parental education related to lower perceived discrimination. In multivariable models, adolescent depressive symptoms predicted poorer functioning, and parental depressive symptoms explained substantial variance in parental internalized stigma, whereas other predictors showed more limited independent effects.
Conclusion: Internalized stigma in adolescents with MDD and their parents is strongly associated with clinical burden and functioning in this clinical, predominantly female sample. Findings underscore internalized stigma as a family-embedded, interconnected process and suggest that integrating family-inclusive, stigma-informed care that strengthens social support may improve youth depression management and treatment engagement.
期刊介绍：
The International Journal of Social Psychiatry, established in 1954, is a leading publication dedicated to the field of social psychiatry. It serves as a platform for the exchange of research findings and discussions on the influence of social, environmental, and cultural factors on mental health and well-being. The journal is particularly relevant to psychiatrists and multidisciplinary professionals globally who are interested in understanding the broader context of psychiatric disorders and their impact on individuals and communities.
Social psychiatry, as a discipline, focuses on the origins and outcomes of mental health issues within a social framework, recognizing the interplay between societal structures and individual mental health. The journal draws connections with related fields such as social anthropology, cultural psychiatry, and sociology, and is influenced by the latest developments in these areas.
The journal also places a special emphasis on fast-track publication for brief communications, ensuring that timely and significant research can be disseminated quickly. Additionally, it strives to reflect its international readership by publishing state-of-the-art reviews from various regions around the world, showcasing the diverse practices and perspectives within the psychiatric disciplines. This approach not only contributes to the scientific understanding of social psychiatry but also supports the global exchange of knowledge and best practices in mental health care.
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