title: Self-stigma in depressive patients: Association of cognitive schemata, depression, and self-esteem.
abstract: Many empirical studies have indicated that various psychosocial and psychiatric variables are correlated with levels of self-stigma. Treatment methods for reducing self-stigma have been investigated in recent years, especially those examining the relationship between negative cognitive schemata and self-stigma. This study examined the relationship of self-stigma with cognitive schemata, depression, and self-esteem in depressive patients. Furthermore, structural equation modeling (SEM) was conducted to evaluate three hypothetical models. Study participants were 110 patients with depression (54 men, 56 women; mean age=45.65years, SD=12.68; 83 diagnosed with mood disorders; 22 with neurotic, stress-related, or somatoform disorders; and 5 with other disorders) attending a psychiatric service. Outcomes were measured using the Japanese versions of the Devaluation-Discrimination Scale, Dysfunctional Attitude Scale, Center for Epidemiologic Studies Depression Scale, and Rosenberg's Self Esteem Scale. The analysis indicated a better fit of the model that assumed self-stigma as mediator, suggesting that cognitive schemata influence self-stigma, while self-stigma affects depression and self-esteem. The tested models using SEM indicated that (1) self-stigma has the potential to mediate the relationship between cognitive schemata and depression, and (2) depression and self-stigma have a similar influence on self-esteem. Although low self-esteem is considered one of the symptoms of depression, when we aim to recover self-esteem, we do not only observe improvement in depressive symptoms; thus, approaches that focus on the reduction of self-stigma are probably valid.
authors.affiliation: Faculty of Human Development and Education, Kyoto Women's University, Kyoto, Japan. Electronic address: shimotsu@kyoto-wu.ac.jp.
authors.forename: Sakie
authors.initials: S
authors.lastname: Shimotsu
authors.affiliation: Department of Psychiatry, Saitama Medical University, Saitama, Japan.
authors.forename: Naoshi
authors.initials: N
authors.lastname: Horikawa
mesh_terms: D000328:Adult; D003866:Depressive Disorder / Q000523:psychology*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D008875:Middle Aged; D012649:Self Concept; D057545:Social Stigma; D013850:Thinking / Q000502:physiology*
keywords: Cognitive schemata; Depression; Self-esteem; Self-stigma