The Development of an Empirical Model of Mental Health Stigma in Adolescents.

Background: Research on mental health stigma in adolescents is hampered by a lack of empirical investigation into the theoretical conceptualisation of stigma, as well as by the lack of validated stigma measures. This research aims to develop a model of public stigma toward depression in adolescents and to use this model to empirically examine whether stigma is composed of three separate dimensions (Stereotypes, Prejudice and Discrimination), as is theoretically proposed.

Method: Adolescents completed self-report measures assessing their stigmatising responses toward a fictional peer with depression. An exploratory factor analysis (EFA; N=332) was carried out on 58-items, which proposed to measure aspects of stigma. A confirmatory factor analysis (CFA; N=236) was then carried out to evaluate the validity of the observed stigma model. Finally, higher-order CFAs were conducted in order to assess whether the observed model supported the tripartite conceptualisation of stigma.

Results: The EFA returned a seven-factor model of stigma. These factors were designated as Dangerousness, Warmth & Competency, Responsibility, Negative Attributes, Prejudice, Classroom Discrimination and Friendship Discrimination. The CFA supported the goodness-of-fit of this seven-factor model. The higher-order CFAs indicated that these seven factors represented the latent constructs of, Stereotypes, Prejudice and Discrimination, which in turn represented Stigma.

Conclusions: Overall, results support the tripartite conceptualisation of stigma and suggest that measurements of mental health stigma in adolescents should include assessments of all three dimensions. These results also highlight the importance of establishing valid and reliable measures for assessing stigma in adolescents.