Effects of stigmatizing media coverage on stigma measures, self-esteem, and affectivity in persons with depression – an experimental controlled trial

Abstract

Abstract Background Stigmatization of people with mental illness is still a significant problem even in Western society. Media is an important vector for public messaging that may lead to stigma (and potentially counteract it). There is an ongoing debate about the impact of news with potentially stigmatizing content on people with depression. This experimental study aimed at investigating the direct effects media reporting could have on people with depression, namely, higher levels of stigma attitudes and negative affect, as well as lower levels of self-esteem and positive affect. Methods Experimental study; target sample size n = 180 patients; eligibility criteria: clinical diagnosis of depressive episode or dysthymia, aged 18–70 years, sufficient cognitive abilities and German language skills; exclusion criteria: acute psychotic, manic or hypomanic episode, addiction symptoms, or suicidal ideation; parallel assignment to one of three arms (each n = 60): watching a short film about a negative event relating to depression (experimental group), about a negative event without relation to depression (control group 1), or about a neutral event relating to depression (control group 2); primary outcomes: degrees of stigma attitudes (stereotype awareness, stereotype agreement, self-concurrence, and self-stigmatization); secondary outcomes: degrees of self-esteem, positive and negative affect; statistical analyses: general linear models with repeated-measures; one-way ANOVAs of the change in scores, followed by Bonferroni-adjusted pairwise comparisons; IBM SPSS Statistics 24.0. Results Significant group × time interactions in stereotype agreement (medium effect: η = 0.10) and negative affect (large effect: η = 0.26); the level of stereotype agreement increased significantly more in the experimental group than in control groups 1 and 2. The level of negative affect increased significantly more in the experimental group and in control group 1 than in control group 2. All other interaction effects were non-significant. Conclusion The present study allows statements about the direct effects of potentially stigmatizing media reporting on carriers of the stigmatized attribute, i.e., depression: Even single film presentations of familiar events that contain potentially stigmatizing content have an impact on stereotype agreement and negative affect. The impact of long-term exposure and change in other stigma-measures require a deeper understanding of stigma-processes. Potential explanations and implications for practice and future research are discussed. Trial registration Deutsche Register Klinischer Studien, Trial registration: DRKS00011855. Registered 23 June 2017, retrospectively registered; for details see Additional file 1.

Keywords

• Stigma
• Self-stigma
• Depression
• Media