Skip to main content

Advertisement

Log in

A Pilot Study of a Novel Method of Measuring Stigma about Depression Developed for Latinos in the Faith-Based Setting

  • Original Paper
  • Published:
Community Mental Health Journal Aims and scope Submit manuscript

Abstract

In order to understand the effects of interventions designed to reduce stigma about mental illness, we need valid measures. However, the validity of commonly used measures is compromised by social desirability bias. The purpose of this pilot study was to test an anonymous method of measuring stigma in the community setting. The method of data collection, Preguntas con Cartas (Questions with Cards) used numbered playing cards to conduct anonymous group polling about stigmatizing beliefs during a mental health literacy intervention. An analysis of the difference between Preguntas con Cartas stigma votes and corresponding face-to-face individual survey results for the same seven stigma questions indicated that there was a statistically significant differences in the distributions between the two methods of data collection (χ2 = 8.27, p = 0.016). This exploratory study has shown the potential effectiveness of Preguntas con Cartas as a novel method of measuring stigma in the community-based setting.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  • Alegria, M., Chatterji, P., Wells, K., Cao, Z., Chen, C., Takeuchi, D., & Meng, X. L. (2008). Disparity in depression treatment among racial and ethnic minority populations in the United States. Psychiatric Services, 59, 1264–1272.

    Article  PubMed  PubMed Central  Google Scholar 

  • Alegria, M., Mulvaney-Day, N., Woo, M., Torres, M., Gao, S., & Oddo, V. (2007). Correlates of past-year mental health service use among Latinos: Results from the National Latino and Asian American study. American Journal of Public Health, 97, 76–83.

    Article  PubMed  PubMed Central  Google Scholar 

  • Brislin, R. W. (1970). Back-translation for cross-cultural research. Journal of Cross-Cultural Psychology, 1, 185–216.

    Article  Google Scholar 

  • Cabassa, L. J., Lester, R., & Zayas, L. H. (2007). “It’s like being in a labyrinth:” Hispanic immigrants’ perceptions of depression and attitudes toward treatments. Journal of Immigrant and Minority Health, 9(1), 1–16. Retrieved from http://dx.doi.org/10.1007/s10903-006-9010-1; http://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=N&PAGE=fulltext&AN=2007-09506-001&D=psyc5.

  • Caplan, S., & Cordero, C. (2015). Development of a Faith-Based Mental Health Literacy Program to Improve Treatment Engagement among Caribbean Latinos in the Northeastern United States of America. International Quarterly of Community Health Education, 35, 199–214.

    Article  PubMed  Google Scholar 

  • Caplan, S., Paris, M., Whittemore, R., Desai, M., Dixon, J., Alvidrez, J., et al. (2010). Correlates of religious, supernatural and psychosocial causal beliefs about depression among Latino immigrants in primary care. Mental Health, Religion and Culture, 13, 1469–1474. doi:10.1080/13674676.2010.497810.

  • Corrigan, P. W. (2003). An attribution model of public discrimination towards persons with mental illness. Journal of Health and Social Behavior, 44, 162–179.

    Article  PubMed  Google Scholar 

  • Corrigan, P. W., Morris, S. B., Michaels, P. J., Rafacz, J. D., & Rusch, N. (2012). Challenging the public stigma of mental illness: A meta-analysis of outcome studies. Psychiatric Services, 63(10), 963–973. doi:10.1176/appi.ps.201100529.

    Article  PubMed  Google Scholar 

  • Corrigan, P. W., & Penn, D. L. (1999). Lessons from social psychology on discrediting psychiatric stigma. American Psychologist, 54, 765–776.

    Article  CAS  PubMed  Google Scholar 

  • Corrigan, P. W., River, L. P., Lundin, R. K., Wasowski, K. U., Campion, J., Mathisen, J., et al. (2000). Stigmatizing Attributions about Mental Illness. Journal of Community Psychology, 28, 91–102.

    Article  Google Scholar 

  • Corrigan, P. W., & Shapiro, J. R. (2010). Measuring the impact of programs that challenge the public stigma of mental illness. Clinical Psychology Review, 30(8), 907–922. doi:10.1016/j.cpr.2010.06.004.

    Article  PubMed  PubMed Central  Google Scholar 

  • Dijker, A. J., & Koomen, W. (2006). A psychological model of social control and stigmatization: Evolutionary background and practical implications. Psychology, Health and Medicine, 11(3), 296–306.

    Article  PubMed  Google Scholar 

  • Gawronski, B., & Bodenhausen, G. V. (2006). Associative and propositional processes in evaluation: An integrative review of implicit and explicit attitude change. Psychological Bulletin, 132, 692–731.

    Article  PubMed  Google Scholar 

  • Goffman, E. (1963). Stigma: Notes on the Management of Spoiled Identity (p. 3). Englewood Cliffs, NJ: Prentice Hall.

    Google Scholar 

  • González, H. M., Vega, W. A., Williams, D. R., Tarraf, W., West, B. T., & Neighbors, H. W. (2010). Depression care in the United States: Too little for too few. Archives of General Psychiatry, 67, 37–46. doi:10.1001/archgenpsychiatry.2009.168.

    Article  PubMed  PubMed Central  Google Scholar 

  • Griffiths, K., Christensen, H., & Jorm, A. F. (2008). Predictors of depression stigma. BMC Psychiatry, 8, 25–29.

    Article  PubMed  PubMed Central  Google Scholar 

  • Griffiths, K. M., Christensen, H., Jorm, A. F., Evans, K., & Groves, C. (2004). Effect of web-based depression literacy and cognitive-behavioural therapy interventions on stigmatising attitudes to depression: Randomised controlled trial. The British Journal of Psychiatry, 185(4), 342–349.

  • Interian, A., Martinez, I. E., Guarnaccia, P. J., Vega, W. A., & Escobar, J. I. (2007). A qualitative analysis of the perception of stigma among Latinos receiving antidepressants. Psychiatric Services, 58(12), 1591–1594. doi:10.1037/a0012820.

    Article  PubMed  PubMed Central  Google Scholar 

  • Jang, Y., Chiriboga, D. A., Herrera, J. R., Martinez Tyson, D., & Schonfeld, L. (2011). Attitudes toward mental health services in hispanic older adults: The role of misconceptions and personal beliefs. Community Mental Health Journal, 47, 164–170.

    Article  PubMed  Google Scholar 

  • Jimenez, D. E., Bartels, S. J., Cardenas, V., & Alegria, M. (2013). Stigmatizing attitudes toward mental illness among racial/ethnic older adults in primary care. International Journal of Geriatric Psychiatry, 28, 1061–1068. doi:10.1002/gps.3928.

    Article  PubMed  PubMed Central  Google Scholar 

  • Jorm, A. F., Christensen, H., & Griffiths, K. M. (2006). The public’s ability to recognize mental disorders and their beliefs about treatment: changes in Australia over 8 years. Australian and New Zealand Journal of Psychiatry, 40, 36–41.

    Article  PubMed  Google Scholar 

  • Jorm, A. F., Reavley, N. J., & Ross, A. M. (2012). Belief in dangerousness of people with mental disorders: A review. Australian and New Zealand Journal of Psychiatry, 46, 1029–1045.

    Article  PubMed  Google Scholar 

  • Krogstad, J. M. (2014). With fewer new arrivals, Census lowers Hispanic population projections. Pew Research Center. Retrieved from http://www.pewresearch.org/fact-tank/2014/12/16/with-fewer-new-arrivals-census-lowers-hispanic-population-projections-2/.

  • Leavey, G., Loewenthal, K., & King, M.. (2016). Locating the Social Origins of Mental Illness: The Explanatory Models of Mental Illness Among Clergy from Different Ethnic and Faith Backgrounds. Journal of Religion and Health. Feb 13. [e-pub ahead of print] 1–16. doi:10.1007/s10943-016-0191-1.

  • Link, B., & Phelan, J. C. (2001). Conceptualizing Stigma. Annual Review of Sociology, 27, 363–385.

    Article  Google Scholar 

  • Link, B., Yang, L. H., Phelan, J. C., & Collins, P. Y. (2004). Measuring mental illness stigma. Schizophrenia Bulletin, 30(3), 511–541.

    Article  PubMed  Google Scholar 

  • Macmillan. (2016). i>clicker student remote (Gen1): Radio Frequency Classroom Response System. https://www1.iclicker.com/about-i-clicker/.

  • Martin, J. K., Lang, A., & Olafsdottir, S. (2008). Rethinking theoretical approaches to stigma: A framework integrating normative influences on stigma (FINIS). Social Science and Medicine, 67, 431–440. doi:10.1016/j.socscimed.2008.03.018.

    Article  PubMed  PubMed Central  Google Scholar 

  • Nadeem, E., Lange, H. M., Edge, D., Fongwa, M., Berlin, T., & Miranda, J. (2007). Does stigma keep poor young immigrant and U.S.-born Black and Latina women from seeking mental health care? Psychiatric Services, 58, 1547–1554.

    Article  PubMed  Google Scholar 

  • Osgood, C. E., Suci, G., & Tannenbaum, P. (1957). The measurement of meaning. Urbana, IL: University of Illinois Press.

    Google Scholar 

  • Parcesepe, A. M., & Cabassa, L. J. (2013). Public stigma of mental illness in the United States: A systematic literature review. Administration and Policy in Mental Health and Mental Health Services Research, 40, 384–399.

    Article  Google Scholar 

  • Pargament, K. I. (1997). An introduction to the psychology of religion and coping. The Psychology of Religion and Coping. New York, NY: Guilford Press.

    Google Scholar 

  • Pargament, K. I., Koenig, H. G., & Perez, L. M. (2000). The many methods of religious coping: Development and initial validation of the RCOPE. Journal of Clinical Psychology, 56, 519–543.

    Article  CAS  PubMed  Google Scholar 

  • Pescosolido, B. A., Martin, J. K., Long, J. S., Medina, T. R., Phelan, J. C., & Link, B. G. (2010). ‘‘A disease like any other’’? A decade of change in public reactions to schizophrenia, depression, and alcohol dependence. The American Journal of Psychiatry, 167, 1321–1330. doi:10.1176/appi.ajp.2010.09121743.

    Article  PubMed  PubMed Central  Google Scholar 

  • Pyne, J. M., Kuc, E. J., Schroeder, P. J., Fortney, J. C., Edlund, M., & Sullivan, G. (2004). Relationship between perceived stigma and depression severity. Journal of Nervous and Mental Disease, 192, 278–283.

    Article  PubMed  Google Scholar 

  • Sanchez, M., Cardemil, E., Adams, S. T., Calista, J. L., Connell, J., DePalo, A., & Rivera, I. (2014). Brave new world: Mental health experiences of Puerto Ricans, immigrant Latinos, and Brazilians in Massachusetts. Cultural Diversity and Ethnic Minority Psychology, 20(1), 16–26. doi:10.1037/a0034093.

    Article  PubMed  Google Scholar 

  • Sriram, N., & Greenwald, A. G. (2009). The brief implicit association test. Experimental Psychology, 56, 283–294.

    Article  CAS  PubMed  Google Scholar 

  • Substance Abuse and Mental Health Services Administration, (SAMSHA). (2015). Racial/Ethnic Differences in Mental Health Service Use among Adults. HHS Publication No. SMA-15-4906. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2015.

  • Taylor, S. M., & Dear, M. J. (1981). Scaling community attitudes toward the mentally ill. Schizophrenia Bulletin, 7, 225–240.

    Article  CAS  PubMed  Google Scholar 

  • United States Census Bureau. (2013). ACS Demographic and Housing Estimates 2012 American Community Survey 1-Year Estimates. Retrieved from http://factfinder2.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_12_1YR_DP05&prodType=table.

  • Van Brakel, W. H. (2006). Measuring health-related stigma—A literature review. Psychology, Health & Medicine, 11, 307–334.

    Article  Google Scholar 

  • VanderWaal, C. J., Sandman, A., Linton, S.-A., Hernandez, E. I., & Ippel, P. (2011). Clergy as gatekeepers to mental health and substance abuse services. Connections for Communities That Care, 1–3. https://www.macmhb.org/sites/default/files/attachments/files/ConnectionsSpring%202011WEB.pdf.

  • Vargas, S. M., Cabassa, L. J., Nicasio, A., De La Cruz, A., Jackson, E., Rosario, M., et al. (2015). Toward a cultural adaptation of pharmacotherapy: Latino views of depression and antidepressant therapy. Transcultural Psychiatry, 52, 244–273. doi:10.1177/1363461515574159.

  • Vega, W. A., Rodriguez, M. A., & Ang, A. (2010). Addressing stigma of depression in Latino primary care patients. General Hospital Psychiatry, 32, 182–191. doi:10.1016/j.genhosppsych.2009.10.008.

    Article  PubMed  Google Scholar 

  • Villatoro, A. P., Dixon, E., & Mays, V. M. (2016). Faith-based organizations and the Affordable Care Act: Reducing Latino mental health care disparities. Psychological Services, 13, 92–104.

    Article  PubMed  Google Scholar 

  • Villatoro, A. P., Morales, E. S., & Mays, V. M. (2014). Family culture in mental health help-seeking and utilization in a nationally representative sample of Latinos in the united states: The NLAAS. American Journal of Orthopsychiatry, 84(4), 353–363.

    Article  PubMed  PubMed Central  Google Scholar 

  • Warden, D., Trivedi, M. H., Wisniewski, S. R., Lesser, I. M., Mitchell, J., Balasubramani, G. K., & Rush, A. J. (2009). Identifying risk for attrition during treatment for depression. Psychotherapy and Psychosomatics, 78(6), 372–379. doi:10.1159/000235977.

    Article  PubMed  PubMed Central  Google Scholar 

  • Webb, M., Stetz, K., & Hedden, K. (2008). Representation of mental illness in Christian self-help bestsellers. Mental Health, Religion & Culture, 11, 697–717. doi:10.1080/13674670801978634.

    Article  Google Scholar 

  • Weiner, B., Perry, R. P., & Magnusson, J. (1988). An attributional analysis to stigmas. Journal of Personality and Social Psychology, 55, 738–748.

    Article  CAS  PubMed  Google Scholar 

  • Wesselmann, E. D., & Craziano, W. G. (2010). Sinful and/or possessed? Religious beliefs and mental illness stigma. Journal of Social and Clinical Psychology, 29(4), 402–437.

    Article  Google Scholar 

  • World Health Organization. (2013). Mental Health Action Plan 2013–2020. Accessed at: http://apps.who.int/iris/bitstream/10665/89966/1/9789241506021_eng.pdf?ua=1 ISBN 97892 4 150602 1

  • Yang, L. H., Kleinman, A., Link, B. G., Phelan, J. C., Lee, S., & Good, B. (2007). Culture and stigma: adding moral experience to stigma theory. Social Science and Medicine, 64(7), 1524–1535.

    Article  PubMed  Google Scholar 

  • Yang, L. H., Purdie-Vaughns, V., Kotabe, H., Link, B., Saw, A., Wong, G., & Phelan, J. (2013a). Culture, threat, and mental illness stigma: Identifying culture-specific threat among Chinese American groups. Social Science and Medicine, 88, 56–67.

    Article  PubMed  PubMed Central  Google Scholar 

  • Yang, L. H., Valencia, E., Alvarado, R., Link, B., Huynh, N., Nguyen, K., & Susser, E. (2013b). A theoretical and empirical framework for constructing culture-specific stigma instruments for Chile. Cadernos Saude Coletiva, 21(1), 71–79.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgments

Thanks to Dr. Dennis Carmody for his statistical support and methodological advice. For their enthusiastic support and dedication to their communities, I’d like to thank, Rev. Luis Espinosa, Ft. George Church, Glendaly Santos, Elder, Ft. George Church, Digna Carvajal, Elder Ft. George Church,, Rev. Luisa Martinez, Primera Metodista, Carolyn Cordero, Primera Metodista, Jorge Lockward, Global Health Ministries, United Methodist Church, Sacred Heart Church, Fanny Twohig, Sacred Heart Church and Sister Patricia Pora, Director of Hispanic pastoral outreach for the Diocese of Portland, Maine. Sacred Heart Church.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Susan Caplan.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Caplan, S. A Pilot Study of a Novel Method of Measuring Stigma about Depression Developed for Latinos in the Faith-Based Setting. Community Ment Health J 52, 701–709 (2016). https://doi.org/10.1007/s10597-016-0005-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10597-016-0005-7

Keywords

Navigation