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Two studies examined how perceiving a stigma and barriers to care for psychological treatment moderate the relationships between stressors and psychological symptoms. One study utilized a sample of college students and the other a sample of U.S. Army soldiers. Factor analytic results from the two samples supported stigma and barriers to care being separate constructs. In the student sample, perceived stigma interacted with subjective stress to predict depression, such that the relationship between stress and depression was stronger when perceived stigma was high. In the military sample, barriers to care interacted with work overload to predict depression, such that the relationship between overload and depression was stronger when perceived barriers to care were high. Results reveal the importance of examining both stigma and barriers to care as moderators of the stressor-strain relationship, and reinforce the need to develop interventions to address stigma and remove barriers to care.
Stigma and barriers to care are two major concerns for individuals experiencing psychological difficulties (Britt, 2000; Cooper, Corrigan, & Watson, 2003; Hoge et al., 2004). In the present paper we test the hypothesis that perceiving stigma and barriers to care regarding psychological treatment may be especially important for individuals experiencing high levels of stress in different areas of their lives. When individuals are under high stress, perceiving a stigma and barriers regarding treatment may be especially predictive of mental health symptoms.
Corrigan and Perm (1999) have defined stigma as a negative and erroneous attitude about a person, akin to a prejudice or negative stereotype. Public stigma reflects the negative attitudes that the general public has toward people with mental illness, inviting discrimination, fear, and pessimism (Link, 1987; Link, Cullen, Frank, & Wozniak, 1987; Purvis, Brandt, Rouse, Vera, & Range, 1988; Skinner, Berry, Griffith, & Byers, 1995). Self stigma is the internalization of how the general public portrays people with mental illness, and the belief in that portrayal (Corrigan & Watson, 2002; Link, Cullen, Struening, Shrout, & Dohrenwend, 1989; Link & Phelan, 2001). Furthermore, contact with the public often intensifies the self-stigmatizing beliefs that people with severe mental illnesses hold.
Possessing self-stigmatizing beliefs about mental illness should have negative consequences for people who already have psychological problems, and one such consequence involves a loss in self-esteem. It is...