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Comparing Affiliate Stigma Between Family Caregivers of People With Different Severe Mental Illness in Taiwan

Chang, Chih-Cheng MD, MS*†‡; Yen, Cheng-Fang MD, PhD§∥; Jang, Fong-Lin MD*; Su, Jian-An MD, MS¶**††; Lin, Chung-Ying MS, PhD‡‡

The Journal of Nervous and Mental Disease: July 2017 - Volume 205 - Issue 7 - p 542–549
doi: 10.1097/NMD.0000000000000671
Original Articles

The family caregivers of people with mental illness may internalize the public stereotypes into the affiliate stigma (i.e., the self-stigma of family members). This study aimed to compare the affiliate stigma across schizophrenia, bipolar disorder, and major depressive disorder, and to investigate potential factors associated with affiliate stigma. Each caregiver of family members with schizophrenia (n = 215), bipolar disorder (n = 85), and major depressive disorder (n = 159) completed the Affiliate Stigma Scale, Rosenberg Self-Esteem Scale, Caregiver Burden Inventory, Taiwanese Depression Questionnaire, and Beck Anxiety Inventory. After controlling for potential confounders, the hierarchical regression models showed that caregivers of a family member with schizophrenia had a higher level of affiliate stigma than those of bipolar disorder (β = −0.109; p < 0.05) and major depressive disorder (β = −0.230; p < 0.001). Self-esteem, developmental burden, and emotional burden were significant factors for affiliate stigma. The affiliate stigma of caregivers is associated with their self-esteem, caregiver burden, and by the diagnosis.

*Department of Psychiatry, Chi Mei Medical Center, Tainan, Taiwan; †Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; ‡Department of Senior Citizen Service Management, College of Recreation and Health Management, Chia Nan University of Pharmacy and Science, Tainan; §Department of Psychiatry, School of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University; ∥Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung; ¶Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi; **Graduate Institute of Clinical Medical Sciences, Chang Gung University; ††Department of Nursing, Chang Gung Institute of Technology, Taoyuan, Taiwan; and ‡‡Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China.

Send reprint requests to Chung-Ying Lin, MS, PhD, OT/L, Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Hong Kong. E-mail:

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