Skip to main content

Advertisement

Log in

Utilizing Education and Perspective Taking to Remediate the Stigma of Taking Antidepressants

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

Abstract

The incidence of depression has been increasing. One of the best interventions for depression is taking antidepressant medications. However, the stigma of taking antidepressants has been shown to be a barrier not only to seeking an antidepressant regimen but also adhering to it. This may have negative consequences for people who suffer from depression. Thus, in two studies, we investigate the incidence of felt stigma of taking antidepressants among clinically depressed individuals who take antidepressants and the effectiveness of two possible interventions to reduce this stigma among others. Study 1 revealed that stigma toward individuals who take antidepressants is a reality, either because people were not educated about depression and antidepressants, or because they did not show empathy or did not take on perspectives from the victim’s point-of-view. Based on these results, we used an experimental design in Study 2 to investigate the effects of education and perspective-taking interventions in diminishing the stigma of taking antidepressants. These results suggest that participant gender played a moderating role in the effectiveness of education and perspective taking, such that a combination of the two interventions resulted in lower stigma for men but not for women. These results suggest that people can be trained (using a simple, low-fidelity intervention) to be more accepting of antidepressant use among their friends, family members, and colleagues, resulting in better outcomes for those who benefit from taking antidepressants.

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
Fig. 2

Similar content being viewed by others

References

  • Altindag, A., Yanik, M., Ucok, A., Alptekin, K., & Ozkan, M. (2006). Effects of an antistigma program on medical students’ attitudes towards people with schizophrenia. Psychiatry and Clinical Neurosciences, 60, 283–288.

    Article  PubMed  Google Scholar 

  • Batson, C. D., Polycarpou, M. P., Harmon-Jones, E., Imhoff, J. H., Mitchener, E. C., Bednar, L. L., & Highberger, L. (1997). Empathy and attitudes: Can feeling for a member of a stigmatized group improve feelings toward the group? Journal of Personality and Social Psychology, 72, 105–118.

    Article  CAS  PubMed  Google Scholar 

  • Bultman, D. C., & Svarstad, B. L. (2000). Effects of physician communication style on client medication beliefs and adherence with antidepressant treatment. Patient Education and Counseling, 40, 173–185.

    Article  CAS  PubMed  Google Scholar 

  • Button, K. S., Ioannidis, J. P., Mokrysz, C., Nosek, B. A., Flint, J., Robinson, E. S., & Munafò, M. R. (2013). Power failure: why small sample size undermines the reliability of neuroscience. Nature Reviews Neuroscience, 14, 365–376.

    Article  CAS  PubMed  Google Scholar 

  • Buus, N., Johannessen, H., & Stage, K. B. (2012). Explanatory models of depression and treatment adherence to antidepressant medication: a qualitative interview study. International Journal of Nursing Studies, 49, 1220–1229.

    Article  PubMed  Google Scholar 

  • Cassano, P., & Fava, M. (2002). Depression and public health: An overview. Journal of Psychosomatic Research, 53(4), 849–857.

    Article  PubMed  Google Scholar 

  • Cohen, J. (1992). Statistics a power primer. Psychology Bulletin, 112, 155–159.

    Article  CAS  Google Scholar 

  • Collado, A., Loya, J. M., & Yi, R. (2015). The interaction of HIV knowledge, perceived risk, and sex differences on risky sex. International Journal of Sexual Health, 27, 418–428.

    Article  Google Scholar 

  • Corrigan, P. (2004). How stigma interferes with mental health care. American Psychologist, 59, 614–625.

    Article  PubMed  Google Scholar 

  • Corrigan, P. W., River, L. P., Lundin, R. K., Penn, D. L., Uphoff-Wasowski, K., Campion, J., et al. (2001). Three strategies for changing attributions about severe mental illness. Schizophrenia Bulletin, 27, 187–195.

    Article  CAS  PubMed  Google Scholar 

  • Dalky, H. F. (2012). Mental illness stigma reduction interventions: Review of intervention trials. Western Journal of Nursing Research, 34, 520–547.

    Article  PubMed  Google Scholar 

  • DeRubeis, R. J., Hollon, S. D., Amsterdam, J. D., Shelton, R. C., Young, P. R., Salomon, R. M., et al. (2005). Cognitive therapy vs medications in the treatment of moderate to severe depression. Archives of General Psychiatry, 62, 409–416.

    Article  PubMed  Google Scholar 

  • Dimidjian, S., Hollon, S. D., Dobson, K. S., Schmaling, K. B., Kohlenberg, R. J., Addis, M. E., et al. (2006). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting and Clinical Psychology, 74, 658–670.

    Article  PubMed  Google Scholar 

  • Dovidio, J. F., ten Vergert, M., Stewart, T. L., Gaertner, S. L., Johnson, J. D., Esses, V., et al. (2004). Perspective and prejudice: Antecedents and mediating mechanisms. Personality and Social Psychology Bulletin, 30, 1537–1549.

    Article  PubMed  Google Scholar 

  • Eisenberg, N., & Lennon, R. (1983). Sex differences in empathy and related capacities. Psychological Bulletin, 94, 100–131.

    Article  Google Scholar 

  • Fortney, J. C., Pyne, J. M., Edlund, M. J., Stecker, T., Mittal, D., Robinson, D. E., & Henderson, K. L. (2011). Reasons for nonadherence among veterans treated in primary care clinics. Journal of Clinical Psychiatry, 72, 827–834.

    Article  PubMed  Google Scholar 

  • Frasure-Smith, N., Lesperance, F., Juneau, M., Talajic, M., & Bourassa, M. G. (1999). Gender, depression, and one-year prognosis after myocardial infarction. Psychosomatic Medicine, 61, 26–37.

    Article  CAS  PubMed  Google Scholar 

  • Galinsky, A. D., & Ku, G. (2004). The effects of perspective-taking on prejudice: The moderating role of self-evaluation. Personality and Social Psychology Bulletin, 30, 594–604.

    Article  PubMed  Google Scholar 

  • Galinsky, A. D., & Moskowitz, G. B. (2000). Perspective-taking: Decreasing stereotype expression, stereotype accessibility, and ingroup favoritism. Journal of Personality and Social Psychology, 78, 708–724.

    Article  CAS  PubMed  Google Scholar 

  • Geddes, J. R., Carney, S. M., Davies, C., Furukawa, T. A., Kupfer, D. J., Frank, E., & Goodwin, G. M. (2003). Relapse prevention with antidepressant drug treatment in depressive disorders: A systematic review. Lancet, 361, 653–661.

    Article  CAS  PubMed  Google Scholar 

  • Gottlieb, S. S., Khatta, M., Friedmann, E., Einbinder, L., Katzen, S., Baker, B., … Potenza, M. (2004). The influence of age, gender, and race on the prevalence of depression in heart failure patients. Journal of the American College of Cardiology, 43, 1542–1549.

    Article  PubMed  Google Scholar 

  • Helweg-Larsen, M., & Collins, B. E. (1997). A social psychological perspective on the role of knowledge about AIDS in AIDS prevention. Current Directions in Psychological Science, 6, 23–26.

    Article  Google Scholar 

  • Keller, M. B., Hirschfield, R. M. A., Demyttenaere, K., & Baldwin, D. S. (2002). Optimizing outcomes in depression: Focus on antidepressant compliance. International Clinical Psychopharmacology, 17, 65–71.

    Article  Google Scholar 

  • Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distribution of DSM-IV disorders in the national comorbidity survey replication. Archives of General Psychiatry, 62, 593–603.

    Article  PubMed  Google Scholar 

  • Landers, R. N., & Behrend, T. S. (2015). An inconvenient truth: Arbitrary distinctions between organizational, mechanical Turk, and other convenience samples. Industrial and Organizational Psychology, 8, 142–164.

    Article  Google Scholar 

  • Lindsey, A. (2016). Explaining for whom, how, when, and why diversity training works (Doctoral dissertation, George Mason University).

  • Macrae, C. N., Milne, A. B., & Bodenhousen, G. V. (1994). Stereotypes as energy-saving devices: A peek inside the cognitive toolbox. Journal of Personality and Social Psychology, 66, 37–47.

    Article  Google Scholar 

  • Madera, J. M., Neal, J. A., & Dawson, M. (2011). A strategy for diversity training: Focusing on empathy in the workplace. Journal of Hospitality and Tourism Research, 35, 469–487.

    Article  Google Scholar 

  • Malpass, A., Shaw, A., Sharp, D., Walter, F., Feder, G., Ridd, M., & Kessler, D. (2009). Medication career or moral career? The two sides of managing antidepressants: A meta-ethnography of patients’ experience of antidepressants. Social Science and Medicine, 68, 154–168.

    Article  PubMed  Google Scholar 

  • Mann, C. E., & Himelein, M. J. (2008). Putting the person back into psychopathology: An intervention to reduce mental illness stigma in the classroom. Social Psychiatry and Psychiatric Epidemiology, 43, 545–551.

    Article  PubMed  Google Scholar 

  • Masuda, A., Hayes, S. C., Fletcher, L. B., Seignourel, P. J., Bunting, K., Herbst, S. A., et al. (2007). Impact of acceptance and commitment therapy versus education on stigma toward people with psychological disorders. Behaviour Research and Therapy, 45, 2764–2772.

    Article  PubMed  Google Scholar 

  • Mathers, C. D., & Loncar, D. (2006). Updated projections of global and mortality and burden of disease, 2002–2030: Data sources, methods and results. World Health Organization.

  • McConahay, J. B. (1986). Modern racism, ambivalence, and the Modern Racism Scale. Burlington, MA: Academic Press.

    Google Scholar 

  • Melfi, C. A., Chawla, A. J., Croghan, T. W., Hanna, M. P., Kennedy, S., & Sredl, K. (1998). The effects of adherence to antidepressant treatment: Guidelines on relapse and recurrence of depression. Archives of General Psychiatry, 55, 1128–1132.

    Article  CAS  PubMed  Google Scholar 

  • Oberle, C. D., Nagurney, A. J., & Lee, C. N. (2011). Implicit prejudicial biases in student learning: The effects of sexual orientation. Journal of Homosexuality, 58, 447–461.

    Article  PubMed  Google Scholar 

  • Petty, R. E., & Cacioppo, J. T. (1984). The effects of involvement on responses to argument quantity and quality: Central and peripheral routes to persuasion. Journal of Personality and Social Psychology, 46, 69–81.

    Article  Google Scholar 

  • Petty, R. E., & Cacioppo, J. T. (1986). The elaboration likelihood model of persuasion. In R. E. Petty & J. T. Capioppo (Eds.), Communication and persuasion (pp. 1–24). New York, NY: Springer.

    Chapter  Google Scholar 

  • Sansone, R. A., & Sansone, L. A. (2012). Antidepressant adherence. Innovations in Clinical Neuroscience, 9, 41–46.

    PubMed  PubMed Central  Google Scholar 

  • Sirey, J. A., Bruce, M. L., Alexopoulos, G. S., Perlick, D. A., Friedman, S. J., & Meyers, B. S. (2011). Perceived stigma and patient-rated severity of illness as predictors of antidepressant drug adherence. Psychiatric Services, 52, 1615–1620.

    Article  Google Scholar 

  • Sirey, J. A., Bruce, M. L., Alexopoulos, G. S., Perlick, D. A., Raue, Pl. Friedman, S. J., & Meyers, B. S. (2001). Perceived stigma as a predictor of treatment discontinuation in young and older outpatients with depression. American Journal of Psychiatry, 158, 479–481.

    Article  CAS  PubMed  Google Scholar 

  • Smith, N. A., Sabat, I. E., Martinez, L. R., Weaver, K., & Xu, S. (2015). A convenient solution: Using MTurk to sample from hard-to-reach populations. Industrial and Organizational Psychology: Perspectives on Science and Practice, 8, 220–228.

    Article  Google Scholar 

  • Tajfel, H., Billig, M. G., Bundy, R. P., & Flament, C. (1971). Social categorization and intergroup behavior. European Journal of Social Psychology, 1, 149–178.

    Article  Google Scholar 

  • Tajfel, H., & Turner, J. C. (1986). The social identity theory of intergroup behavior. In S. Worchel & W. G. Austin (Eds.), Psychology of intergroup relations (2nd edn., pp. 7–24). Chicago, IL: Nelson-Hall.

    Google Scholar 

  • Trivedi, M. H., Lin, E. H., & Katon, W. J. (2007). Consensus recommendations for improving adherence, self-management, and outcomes in patients with depression. CNS Spectrums, 12, 1–27.

    PubMed  Google Scholar 

  • Trobst, K. K., Collins, R. L., & Embree, J. M. (1994). The role of emotion in social support provision: Gender, empathy and expressions of distress. Journal of Social and Personal Relationships, 11, 45–62.

    Article  Google Scholar 

  • Wang, J., Patten, S., Currie, S., Sareen, J., & Schmitz, N. (2011). Perceived needs for and use of workplace accommodations by individuals with a depressive and/or anxiety disorder. Journal of Occupational and Environmental Medicine, 53, 1268–1272.

    Article  PubMed  Google Scholar 

  • Weaver, P., Wilborn, L., McCleary, K., & Lekagul, A. (2003). Diversity training management initiatives in the lodging industry: An exploratory analysis of underlying dimensions. Journal of Hospitality and Tourism Research, 27, 237–253.

    Article  Google Scholar 

  • Witters, D., Agrawal, S., & Liu, D. (2013). Depression Costs U.S. Workplaces $23 Billion in Absenteeism. Retrieved from http://www.gallup.com/poll/163619/depression-costs-workplaces-billion-absenteeism.aspx.

  • Yamaguchi, S., Mino, Y., & Uddin, S. (2011). Strategies and future attempts to reduce stigmatization and increase awareness of mental health problems among young people: a narrative review of educational interventions. Psychiatry and Clinical Neurosciences, 65, 405–415.

    Article  PubMed  Google Scholar 

  • Young, A. S., Klap, R., Sherbourne, C. D., & Wells, K. B. (2001). The quality of care for depressive and anxiety disorders in the United States. Archives of General Psychiatry, 58, 55–61.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Shi Xu.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

This research has been approved by the institutional review board at the Pennsylvania State University.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Martinez, L.R., Xu, S. & Hebl, M. Utilizing Education and Perspective Taking to Remediate the Stigma of Taking Antidepressants. Community Ment Health J 54, 450–459 (2018). https://doi.org/10.1007/s10597-017-0174-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10597-017-0174-z

Keywords

Navigation