Skip to main content

Advertisement

Log in

Psychometric Properties of Three Measures of Stigma Among Hispanics with Depression

  • Original Paper
  • Published:
Journal of Immigrant and Minority Health Aims and scope Submit manuscript

Abstract

While many measures of mental illness stigma have been developed, few have been validated in Hispanic populations. This study examined the psychometric properties of three stigma measures (Stigma Concerns about Mental Health Care [SCMHC], Social Distance Scale [SDS], and Latino Scale for Antidepressant Stigma [LSAS]) among a depressed, Hispanic sample. Data were collected during baseline assessments for two studies taking place in primary care settings (N = 500). Psychometric and factor validity were tested for each measure. Confirmatory factor analyses indicated adequate model fit, and adequate internal consistency reliability was found for all three measures. Stigma scores significantly differed by education level and gender. Findings from this analysis provide support for the use of the SCMHC, SDS, and LSAS in a depressed, Hispanic population. Assessing barriers to depression treatment, including stigma, are critical in engaging Hispanics in care and eliminating disparities for the population.

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.

Similar content being viewed by others

References

  1. Bureau USC. QuickFacts. https://www.census.gov/quickfacts/fact/table/US/RHI725219. Accessed 1 March 2020.

  2. Colby SL, Ortman JM. Projections of the size and composition of the U.S. population: 2014 to 2060. Washington, DC; 2015. Contract no.: P25–1143.

  3. Hernandez A, Plant EA, Sachs-Ericsson N, Joiner TE. Mental health among Hispanics and Caucasians: risk and protective factors contributing to prevalence rates of psychiatric disorders. J Anxiety Disord. 2005;19(8):844–60.

    Article  PubMed  Google Scholar 

  4. Olfson M, Marcus SC, Tedeschi M, Wan GJ. Continuity of antidepressant treatment for adults with depression in the United States. Am J Psychiatry. 2006;163(1):101–8.

    Article  PubMed  Google Scholar 

  5. Olfson M, Mojtabai R, Sampson NA, Hwang I, Druss B, Wang PS, et al. Dropout from outpatient mental health care in the United States. Psychiatr Serv. 2009;60(7):898–907.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Cabassa LJ, Zayas LH, Hansen MC. Latino adults’ access to mental health care: a review of epidemiological studies. Adm Policy Ment Health. 2006;33(3):316–30.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Paulose-Ram R, Safran MA, Jonas BS, Gu Q, Orwig D. Trends in psychotropic medication use among U.S. adults. Pharmacoepidemiol Drug Saf. 2007;16(5):560–70.

    Article  PubMed  Google Scholar 

  8. Interian A, Ang A, Gara MA, Link BG, Rodriguez MA, Vega WA. Stigma and depression treatment utilization among Latinos: utility of four stigma measures. Psychiatr Serv. 2010;61(4):373–9.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Van Voorhees BW, Walters AE, Prochaska M, Quinn MT. Reducing health disparities in depressive disorders outcomes between non-Hispanic Whites and ethnic minorities: a call for pragmatic strategies over the life course. Med Care Res Rev. 2007;64(5 Suppl):157S-S194.

    Article  PubMed  Google Scholar 

  10. Clement S, Schauman O, Graham T, Maggioni F, Evans-Lacko S, Bezborodovs N, et al. What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychol Med. 2015;45(1):11–27.

    Article  CAS  PubMed  Google Scholar 

  11. Abdullah T, Brown TL. Mental illness stigma and ethnocultural beliefs, values, and norms: an integrative review. Clin Psychol Rev. 2011;31(6):934–48.

    Article  PubMed  Google Scholar 

  12. Jimenez DE, Bartels SJ, Cardenas V, Alegría M. Stigmatizing attitudes toward mental illness among racial/ethnic older adults in primary care. Int J Geriatr Psychiatry. 2013;28(10):1061–8.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Cabassa LJ, Lester R, Zayas LH. “It’s like being in a labyrinth:” Hispanic immigrants’ perceptions of depression and attitudes toward treatments. J Immigr Minor Health. 2007;9(1):1–16.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Givens JL, Houston TK, Van Voorhees BW, Ford DE, Cooper LA. Ethnicity and preferences for depression treatment. Gen Hosp Psychiatry. 2007;29(3):182–91.

    Article  PubMed  Google Scholar 

  15. Interian A, Martinez IE, Guarnaccia PJ, Vega WA, Escobar JI. A qualitative analysis of the perception of stigma among Latinos receiving antidepressants. Psychiatr Serv. 2007;58(12):1591–4.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Nadeem E, Lange JM, Edge D, Fongwa M, Belin T, Miranda J. Does stigma keep poor young immigrant and U.S. -born Black and Latina women from seeking mental health care? Psychiatr Serv. 2007;58(12):1547–54.

    Article  PubMed  Google Scholar 

  17. Vega WA, Rodriguez MA, Ang A. Addressing stigma of depression in Latino primary care patients. Gen Hosp Psychiatry. 2010;32(2):182–91.

    Article  PubMed  Google Scholar 

  18. Fox AB, Earnshaw VA, Taverna EC, Vogt D. Conceptualizing and measuring mental illness stigma: the mental illness stigma framework and critical review of measures. Stigma Health. 2018;3(4):348–76.

    Article  PubMed  Google Scholar 

  19. Schomerus G, Angermeyer MC. Stigma and its impact on help-seeking for mental disorders: what do we know? Epidemiol Psichiatr Soc. 2008;17(1):31–7.

    Article  PubMed  Google Scholar 

  20. Tucker JR, Hammer JH, Vogel DL, Bitman RL, Wade NG, Maier EJ. Disentangling self-stigma: are mental illness and help-seeking self-stigmas different? J Couns Psychol. 2013;60(4):520–31.

    Article  PubMed  Google Scholar 

  21. Corrigan PW, Druss BG, Perlick DA. The impact of mental illness stigma on seeking and participating in mental health care. Psychol Sci Public Interest. 2014;15(2):37–70.

    Article  PubMed  Google Scholar 

  22. Yang LH, Kleinman A, Link BG, Phelan JC, Lee S, Good B. Culture and stigma: adding moral experience to stigma theory. Soc Sci Med. 2007;64(7):1524–35.

    Article  PubMed  Google Scholar 

  23. Yang LH, Thornicroft G, Alvarado R, Vega E, Link BG. Recent advances in cross-cultural measurement in psychiatric epidemiology: utilizing “what matters most” to identify culture-specific aspects of stigma. Int J Epidemiol. 2014;43(2):494–510.

    Article  PubMed  Google Scholar 

  24. Geisinger KF. Cross-cultural normative assessment: Translation and adaptation issues influencing the normative interpretation of assessment instruments. Psychol Assess. 1994;6(4):304–12.

    Article  Google Scholar 

  25. Wright J. Perceptions of mental health stigma and discrimination in a Mexican American sample. Denver: University of Denver; 2009.

    Google Scholar 

  26. Eghaneyan BH, Murphy ER. Measuring mental illness stigma among Hispanics: a systematic review. Stigma Health. 2020;5(3):351–63.

    Article  Google Scholar 

  27. Bogardus ES. A social distance scale. Sociol Soc Res. 1933;17:265–71.

    Google Scholar 

  28. Unger JB, Cabassa LJ, Molina GB, Contreras S, Baron M. Evaluation of a fotonovela to increase depression knowledge and reduce stigma among Hispanic adults. J Immigr Minor Health. 2013;15(2):398–406.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Hernandez MY, Organista KC. Entertainment-education? A fotonovela? A new strategy to improve depression literacy and help-seeking behaviors in at-risk immigrant Latinas. Am J Commun Psychol. 2013;52(3–4):224–35.

    Article  Google Scholar 

  30. Cabassa LJ, Oh H, Humensky JL, Unger JB, Molina GB, Baron M. Comparing the impact on Latinos of a depression brochure and an entertainment-education depression fotonovela. Psychiatr Serv. 2015;66(3):313–6.

    Article  PubMed  Google Scholar 

  31. Dueweke AR, Bridges AJ. The effects of brief, passive psychoeducation on suicide literacy, stigma, and attitudes toward help-seeking among Latino immigrants living in the United States. Stigma Health. 2017;2(1):28–42.

    Article  Google Scholar 

  32. Hirschfeld RM. The comorbidity of major depression and anxiety disorders: recognition and management in primary care. Prim Care Companion J Clin Psychiatry. 2001;3(6):244–54.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Sanchez K, Eghaneyan BH, Trivedi MH. Depression screening and education: options to reduce barriers to treatment (DESEO): protocol for an educational intervention study. BMC Health Serv Res. 2016;16:322.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Sanchez K, Eghaneyan BH, Killian MO, Cabassa L, Trivedi MH. Measurement, education and tracking in integrated care (METRIC): use of a culturally adapted education tool versus standard education to increase engagement in depression treatment among Hispanic patients: study protocol for a randomized control trial. Trials. 2017;18(1):363.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Association AP. Diagnostic and statistical manual of mental disorders: DSM-IV. Washington, DC: American Psychiatric Association; 1994.

    Google Scholar 

  37. Huang FY, Chung H, Kroenke K, Delucchi KL, Spitzer RL. Using the patient health questionnaire-9 to measure depression among racially and ethnically diverse primary care patients. J Gen Intern Med. 2006;21(6):547–52.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Merz EL, Malcarne VL, Roesch SC, Riley N, Sadler GR. A multigroup confirmatory factor analysis of the patient health questionnaire-9 among English- and Spanish-speaking Latinas. Cult Divers Ethn Minor Psychol. 2011;17(3):309–16.

    Article  Google Scholar 

  39. Killian MO, Sanchez K, Eghaneyan BH, Cabassa LJ, Trivedi MH. Profiles of depression in a treatment-seeking Hispanic population: psychometric properties of the patient health questionnaire-9. Int J Methods Psychiatr Res. 2020. https://doi.org/10.1002/mpr.1851.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092–7.

    Article  PubMed  Google Scholar 

  41. Mills SD, Fox RS, Malcarne VL, Roesch SC, Champagne BR, Sadler GR. The psychometric properties of the generalized anxiety disorder-7 scale in Hispanic Americans with English or Spanish language preference. Cult Divers Ethn Minor Psychol. 2014;20(3):463–8.

    Article  Google Scholar 

  42. Li CH. Confirmatory factor analysis with ordinal data: Comparing robust maximum likelihood and diagonally weighted least squares. Behav Res Methods. 2016;48(3):936–49.

    Article  PubMed  Google Scholar 

  43. Brown TA. Confirmatory factor analysis for applied research. Chicago: Guilford Publications; 2006.

    Google Scholar 

  44. Revelle W. Using R and the psych package to find ω 2013. http://personality-project.org/r/psych/HowTo/Rold-for-omega.pdf. Accessed 15 April 2021.

  45. McDonald RP. Test theory: a unified treatment. Mahwah: Lawrence Erlbaum Associates; 1999.

    Google Scholar 

  46. Cheng HL, Kwan KL, Sevig T. Racial and ethnic minority college students’ stigma associated with seeking psychological help: examining psychocultural correlates. J Couns Psychol. 2013;60(1):98–111.

    Article  PubMed  Google Scholar 

  47. Lopez V, Sanchez K, Killian MO, Eghaneyan BH. Depression screening and education: an examination of mental health literacy and stigma in a sample of Hispanic women. BMC Public Health. 2018;18(1):646.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Tancredi DJ, Slee CK, Jerant A, Franks P, Nettiksimmons J, Cipri C, et al. Targeted versus tailored multimedia patient engagement to enhance depression recognition and treatment in primary care: randomized controlled trial protocol for the AMEP2 study. BMC Health Serv Res. 2013. https://doi.org/10.1186/1472-6963-13-141.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Sanchez K, Killian MO, Eghaneyan BH, Cabassa LJ, Trivedi MH. Culturally adapted depression education and engagement in treatment among Hispanics in primary care: outcomes from a pilot feasibility study. BMC Fam Pract. 2019;20(1):140.

    Article  PubMed  PubMed Central  Google Scholar 

  50. O’Connor C, Vaughan S. Does selectively endorsing different approaches to treating mental illness affect lay beliefs about the cause and course of mental illness? Psychiatry Res. 2021;297:113726.

    Article  PubMed  Google Scholar 

  51. Stepler R, Brown A. Portrait of Hispanics in the United States. 2016. http://www.pewhispanic.org/2016/04/19/statistical-portrait-of-hispanics-in-the-united-states/. Accessed 1 March 2020.

  52. González HM, Vega WA, Williams DR, Tarraf W, West BT, Neighbors HW. Depression care in the United States: too little for too few. JAMA Psychiat. 2010;67(1):37–46.

    Google Scholar 

  53. Derr AS. Mental health service use among immigrants in the United States: a systematic review. Psychiatr Serv. 2016;67(3):265–74.

    Article  PubMed  Google Scholar 

  54. Jones AL, Mor MK, Haas GL, Gordon AJ, Cashy JP, Schaefer JH Jr, et al. The role of primary care experiences in obtaining treatment for depression. J Gen Intern Med. 2018;33(8):1366–73.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Luty J, Umoh O, Sessay M, Sarkhel A. Effectiveness of changing minds campaign factsheets in reducing stigmatised attitudes towards mental illness. Psychiatr Bull. 2007;31(10):377–81.

    Article  Google Scholar 

  56. Luty J, Rao H, Arokiadass SMR, Easow JM, Sarkhel A. The repentant sinner: methods to reduce stigmatised attitudes towards mental illness. Psychiatr Bull. 2008;32(9):327–32.

    Article  Google Scholar 

  57. Luty J, Umoh O, Nuamah F. Effect of brief motivational interviewing on stigmatised attitudes towards mental illness. Psychiatr Bull. 2009;33(6):212–4.

    Article  Google Scholar 

  58. Collado A, Zvolensky M, Lejuez C, MacPherson L. Mental health stigma in depressed Latinos over the course of therapy: results from a randomized controlled trial. J Clin Psychol. 2019;75(7):1179–87.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

DESEO was funded by a grant from the U.S. Department of Health and Human Services Center for Medicare and Medicaid Services (CMS), Center for Medicare and Medicaid Innovation, Grants to Support the Hispanic Health Services Research Grant Program (Grant No. 1H0CMS331363-01-00). METRIC was funded by a grant from the National Institute of Health (NIH) National Institute on Minority Health and Health Disparities (NIMHD, 1R15MD010220-01).

Author information

Authors and Affiliations

Authors

Contributions

All authors contributed to the study conception and design. BE assisted in the data collection and preparation and wrote the first draft of the manuscript. MK performed the data analyses. KS was the Principal Investigator of Project DESESO and METRIC and also contributed to drafting the manuscript. LJC provided consultation to the research team and review and editing to the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Brittany H. Eghaneyan.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 18 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Eghaneyan, B.H., Killian, M.O., Sanchez, K. et al. Psychometric Properties of Three Measures of Stigma Among Hispanics with Depression. J Immigrant Minority Health 23, 946–955 (2021). https://doi.org/10.1007/s10903-021-01234-3

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10903-021-01234-3

Keywords

Navigation