The Stigma of Depression Across Cultures: The Role of Theory of Mind

Date
2019-09-19
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Abstract
Stigma has a significant negative impact on individuals with mental health problems. The etiology, expression and conceptualization of stigma varies across cultures and is affected by factors such as levels of acculturation, individualism, and collectivism. To date, most studies have conflated culture with ethnicity or have measured it in a limited way without exploring interactive mechanisms of action that affect the proliferation of stigma. To address these gaps in the research, the goals of the present study were: 1) To evaluate cross-cultural differences in the relationships between etiological beliefs about mental illness, specifically depression, and stigmatizing attitudes and beliefs; and 2) To evaluate the role of theory of mind, perspective-taking and empathy in the stigma process and to compare this relationship between a Western and an Eastern culture. 392 university undergraduate students were recruited across three cultural groups: European Canadians (n = 169), Chinese Canadians (n = 167), and Hong-Kong Chinese (n = 56). The three groups were compared on measures of attitudes toward those with depression and toward seeking help for mental health problems, mental illness stigma, beliefs about where depression comes from, empathy and perspective-taking abilities, symptoms of depression, levels of acculturation, self-construals, and a behavioural task of social perception. The findings revealed significant cross-cultural differences in acceptance of depression, willingness to seek treatment for it, understanding of where depression comes from, and overall mental illness stigma. In addition, empathy, but not perspective-taking, was found to moderate the relationship between etiological beliefs of depression and stigmatizing beliefs. This mechanism of action also appeared to vary cross-culturally. The results of the study support the utility of explicitly measuring differences in facets of culture rather than ethnicity alone, as well as levels of acculturation and enculturation in investigations of mental illness stigma and theory of mind. The findings are discussed regarding their implications for cross-cultural theory of stigma, research, and clinical practice with recommendations for future research.
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Keywords
Culture, Theory of mind, Depression, Stigma
Citation
Prentice, J. L. (2019). The Stigma of Depression Across Cultures: The Role of Theory of Mind (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.