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

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.