Table 1 Selected characteristics and main findings of cross-sectional studies comparing ethnic minorities with majorities on stigma outcomes (N = 29)
Study | Country | Type of CMD | Racial groups | Recruitment | Outcomes | Results |
|---|---|---|---|---|---|---|
Adewuya, 2008 [31] | Nigeria | Various | Black (Nmaj = 1869) Other (Nmin = 92) | Community | • Self-report • SDS | • There were no ethnic differences in discrimination against people with mental illness (p = 0.14) |
Ahn 2015 [32] | North Korea | Various | Asian (Nmaj = 3055) Asian (Nmin = 545) | Other | • Self-report • PDD | • Asian majorities (M = 35.64) had higher perceived stigma than Asian minorities (M = 37) (p = 0.007) |
Anglin 2006 [18] | USA | Various | White (Nmaj = 913) Black (Nmin = 118) | Community | • Vignette • Study-constructed | • There was more stereotype (i.e. perceived dangerousness) against people with depression among Black group compared to White group (t = 2.14) (p < .05) • There was less prejudice (i.e. tendency to blame) against people with depression among Black group compared to White group (t = − 2.33) (p < .05) • There was less discrimination (i.e. tendency to endorse punishment) against people with depression among Black group compared to White group (t = − 3.91) (p < .001) |
Aznar-Lou 2016 [33] | Catalonia, Spain | Various | White (Nmaj = 1668) White (Nmin = 56) Black (Nmin = 58) Asian (Nmin = 7) Other (Nmin = 82) | Community | • Self-report • CAMI-23 | • Asian (M = 20.9), Other (M = 23.0) Black (M = 23.5) and White minority (M = 23.9) had less stereotypes (i.e. less favourable attitudes in authoritarianism) against those with CMDs) compared to White majority (M = 25.0) • Asian (M = 25.4) Other (M = 26.9) and Black (M = 27.0) groups had less stereotypes (i.e. favourable attitudes in benevolence) compared to white minority (M = 27.8) and majority (M = 27.7) • Asian (M = 34.3) Other (M = 36.2) Black (M = 36.4) had less stereotypes (i.e. favourable attitudes toward supporting those with CMDs) compared to White minority (M = 37.3) and majority (M = 37.5) • Asian group (M = 13.7) had more discrimination (i.e. least favourable attitudes towards those with CMDs) compared to Other (M = 15.3) Black (M = 15.5) White minority (M = 16.6) majority (M = 16.5) |
Brown 2010 [19] | USA | Various | White (Nmaj = 229) Black (Nmin = 220) | Community | • Self-report • ISMI • PDD | • There were no differences between Black (M = 31.3, SD = 4.1) and White (M = 31.0, SD = 4.8) groups in perceived stigma (p = .55) • There were no differences between Black (M = 65.9, SD = 11) and White (M = 65.0, SD = 11.4) groups in internalised stigma (p = .42) |
Caplan 2011 [22] | USA | Depression | Hispanic (Nmaj = 91) Hispanic (Nmin = 86) | Clinical | • Self-report • Study-constructed | • There was higher anticipated stigma among minority Hispanic group compared to the majority (p = 0,015) |
Cheng 2015 [15] | USA | Depression | White (Nmaj = 206) Asian (Nmin = 231) | Community | • Vignette • AQ | • There was more discrimination(i.e. desire for social distance) against a person with depression among Asian group (M = 3.16, SD = 1.06) compared to White (M = 2.80, SD = 1.18) p = 0.004 • There was more discrimination (i.e. less willingness to hire and rent) against a person with depression among Asian group (M = 5.54, SD = 1.64) compared to White (M = 6.00, SD = 1.82) p = 0.008 • There was more prejudice (i.e. blame) against a person with depression among Asian group (M = 4.18, SD = 1.63) compared to White (M = 3.73, SD = 1.78) p = 0.02 • There was more prejudice (i.e. anger) against a person with depression among Asian group (M = 3.26, SD = 1.90) compared to White (M = 2.58, SD = 1.72) p = 0.002 • There was more prejudice (i.e. fear of someone) against someone with depression among Asian group (M = 3.78, SD = 1.96) compared to White (M = 3.32, SD = 2.01) p = 0.54 |
Conner 2010 [35] | USA | Various | White (Nmaj = 229) Black (Nmin = 201) | Community | • Self-report • ISMI • PDD | • There was no differences in perceived stigma between Black (M = 2.61, SD = 0.28) and White (M = 2.59, SD = .29) groups t [246] = − 0.58 • There was more internalised stigma among Black (M = 2.18, SD = 0.30) compared to White (M = 2.10, SD = 0.30) group (t [246] = − 2.118, p = .035). |
Conner 2009 [18] | USA | Various | White (Nmaj = 51) Black (Nmin = 48) | Other | • Self-report • ISMI • PDD | • There was more perceived stigma among Black (M = 2.90, SD = 0.75) compared to White (M = 2.32, SD = 0.55) group (p < .001) • There was more internalised stigma among Black (M = 2.75, SD = 0.81) compared to White (M = 2.30, SD = 0.53) |
Copelj 2011 [36] | Australia | Depression | White (Nmaj = 54) Other (Nmin = 54) | Community | • Self-report • DSS | • There was more perceived stigma (i.e. perceived attitudes of others about depression) among Other group (M = 17.82, SD = 7.58) compared to White (M = 9.03, SD = 5.36) F = 32.95 • There was more stereotype (i.e. personal attitudes toward depression) about depression among Other group (M = 25.16, SD = 6.13) compared to White (M = 19.35, SD = 8.79) F = 10.78 |
Eisenberg 2009 [37] | USA | Various | White (Nmaj = 3780 Asian (Nmin = 579) Black (Nmin = 266) Hispanic (Nmin = 302) Combination (Nmin = 240) Other (Nmin = 290) | Students | • Self-report • PDD | • There was more perceived stigma for depression among Black (M = 2.77),Hispanic (M = 2.50) Asian (M = 2.50), Combination (M = 2.48) and Other (M = 2.54) groups compared to White (M = 2.38 • There was more stereotype (i.e. personal attitudes toward depression) about depression among Asian (M = 1.45) compared to Black (M = 0.93), Hispanic (M = 1.05), Combination (M = 0.91), Other (M = 1.10) groups compared to White (M = 0.95) |
Fogel 2005 [16] | USA | Depression | White (Nmaj = 66,817) Asian (Nmin = 1839) | Community | • Self-report • Study-constructed | • There was more anticipated stigma for depression related with depression among Asian (M = 2.45, SD = 1.22) compared to White (M = 2.10, SD = 1.25) F = 144.40, (p < 0.001) • There was more anticipated stigma for depression related with employer among Asian (M = 2.93, SD = 1.07) compared to White (M = 2.68, SD = 1.16) F = 85.55, (p < 0.001) • There was more anticipated stigma for depression related with family among Asian (M = 2.23, SD = 1.19) compared to White (M = 1.71, SD = 1.18) F = 360.38 (p < 0.001) |
Georg Hsu 2008 [17] | USA | Depression | White (Nmaj = 100) Asian (Nmin = 100) | Community | • Vignette • Study-constructed | • There was more stereotype (i.e. personal attitudes toward depression) about depression among Asian (M = 39.4) compared to White (M = 15.0) P = 0.000 |
Givens 2007 [21] | USA | Depression | White (Nmaj = 68,319) Black (Nmin = 3596) Asian (Nmin = 2794) Hispanic (Nmin = 3203) Other (Nmin = 841) | Community | • Self-report • Study-constructed | • There was more anticipated stigma for depression related with family among Asian (M = 71.7, SD = 1.24), Black (M = 68.5, SD = 1.24), Hispanic (M = 61.8, SD = 0.89) and Other (M = 60.4, SD = 0.96) groups compared to White (M = 63.1, SD = 1.00) • There was more anticipated stigma for depression related with family among Asian (M = 55.0, SD = 1.30), Black (M = 45.4, SD = 1.08), Hispanic (M = 42.8, SD = 0.91) and Other (M = 43.01, SD = 1.01) groups compared to White (M = 43.03, SD = 1.0) • There was more anticipated stigma for depression related with employer among Asian (M = 42.9, SD = 1.88), African (M = 26.8, SD = 0.92), • Hispanic (M = 28.1, SD = 0.96) and Other (M = 27.5, SD = 1.01) groups compared to White (M = 27.9, SD = 1.0) |
Hickie 2007 [34] | Australia | Depression | White (Nmaj = 38) Asian (Nmin = 184) | Students | • Self-report • Study-constructed | • There were no differences in discrimination against those with depression related with employer among Asian compared to White groups (p = 1.00) • There were no differences in discrimination against those with depression related with family (among Asian compared to White groups (p = 0.05) • There was more discrimination against those with depression related with friends among Asian compared to White groups (p = 0.04) • There was more discrimination against those with depression related with doctor/health professional among Asian compared to White groups (p = 0.001) • There was more stereotype (i.e. perception of those with depression as dangerous) among Asian compared to White groups (p = 0.000) • There was more prejudice (i.e. blame) against those with depression among Asian compared to White groups (p = 0.000) |
Jimenez 2012 [23] | USA | Various | White (Nmaj = 1257) (Black (Nmin = 536) Asian (Nmin = 112) Hispanic (Nmin = 303) | Other | • Self-report • Study-constructed | • There was more anticipated stigma for having any CMDs among Hispanic (40.3%) compared to Asian (25.9%), Black (12.9%) groups compared to White (15.3%) p = 0.000 |
Makowski 2017 [11] | Germany | Various | White (Nmaj = 1622) Other (Nmin = 364) | Community | • Self-report • Study-constructed | • Other group had more prejudice (i.e. perception of migrants with depression as scary) (M = 2.28; SE = 0.11) compared to White group (M = 1.82; SE = 0.04)F = 8.179; (p = 0.000) • Other group had more prejudice (i.e. perception of migrants with depression as having problems with comprehension) (M = 2.04, SE = 0.11) compared to White groups (M = 1.64, SE = 0.04) F = 5.796, (p = 0.003) • Other group had more prejudice (i.e. feeling more uncomfortable) (M = 2.50, SE = 0.13) against migrants with depression compared to White (M = 2.00; SE = 0.04) F = 9.339 (p = 0.000) • Other group had more stereotypes (i.e. perception of migrants with depression as feeling inadequate around others) (M = 2.47, SE = 0.07) compared to White (M = 2.31, SE = 0.02) F = 3.539 (p = 0.029) |
Menke 2009 [38] | USA | Depression | White (Nmaj = 744) Black (Nmin = 147) | Clinical | • Self-report • LSCS | • There was more perceived stigma for depression among Black group (M = 46.16; SD = 12.59) compared to White (M = 41.95; SD = 18.89) t = 3.35 (p = 0.000) |
Mokkarala 2016 [39] | USA | Various | White (Nmaj = 116) Asian (Nmin = 61) | Students | • Self-report • Study-constructed | • There were no significant differences in perceived stigma (shame) for having any CMDs between White (M = 1.90, SD = 0.67) and Asian groups (M = 2.04, SD = 0.57), t = 1.29 |
Nadeem 2007 [8] | USA | Depression | White (Nmaj = 886) Black (Nmin = 1497) Hispanic (Nmin = 5153) | Clinical | • Self-report • Study-constructed | • There was more stereotype (i.e. personal attitudes toward depression) about depression among Black (p = .037) and Hispanic (p = .30) groups compared to White. |
O’Mahen 2011 [40] | USA | Depression | White (Nmaj = 251) Black (Nmin = 281) | Other | • Self-report • LSCS | • There was more perceived stigma for depression among Black (M = 42.31, SD = 5.76) compared to White groups (M = 40.04, SD = 6.44) (p = 0.000) |
Papadopoulos 2002 [41] | UK | Various | White (Nmaj = 79) Other (Nmin = 91) | Community | • Self-report • CAMI-23 | • There was more discrimination (i.e. desire for more social distance) towards those with CMDs among Other group compared to White (p < .001) • There was more stereotype about those with CMDs among Other group compared to White (p < .001) |
Picco 2016 [42] | Singapore | Various | Asian (Nmaj = 150) Asian (Nmin = 130) | Clinical | • Self-report • ISMI | • There was more internalised stigma (i.e. alienation, social withdrawal) among the minority Asian group compared to the majority (p = 0.615); IN (p = 0.161) |
Rao 2007 [43] | USA | Various | White (Nmaj = 158) Black (Nmin = 71) Asian (Nmin = 28) Hispanic (Nmin = 100) | Students | • Vignette • AQ | • There was more stereotype (i.e. perceiving people with CMDs and dangerous) among Black (M = 14)(p < .001) and Asian (M = 11) groups compared to White (M = 12) and Hispanic (M = 9) (p < .001) • There was more discrimination (i.e. desire for segregation) against those with CMDs among African (M = 13) (p < .001), Asian (M = 13) groups compared to White (M = 11) and Hispanic (M = 10) (p < .005) |
Rüsh 2012 [44] | UK | Various | White (Nmaj = 2990) Comb (Nmin = 429) | Community | • Self-report • CAMI-23 | • There was more prejudice and discrimination (i.e. desire for segregation) against people with CMDs among Black (p < 0.001) and Asian groups compared to White (p < 0.001) • There was less tolerance and support for people with CMDs among Black (p < 0.001) and Asian groups compared to White (p = < 0.005) • There was more discrimination against those with CMDs among African (p < 0.001) and Asian groups compared to White (p < 0.001) |
Schafer 2011 [45] | UK | Various | White (Nmaj = 209) Black (Nmin = 63) | Students | • Self-report • CAMI-23 | • There was more stereotype (i.e. negative attitudes) against those with any CMDs among Black (M = 2.27) compared to White groups (M = 1.93) t = − 4.563 (p = 0 < 001) |
Shamblaw 2015 [46] | Canada | Depression | White (Nmaj = 200) Asian (Nmin = 276) | Students | • Self-report • DAQ • SDS | • There was more stereotype against those with depression among Asian (M = 115.71, SD = 24.74) compared to White (M = 105.72, SD = 27.08), t = 4.07 (p < 0.001) • There was more discrimination (i.e. desire for social distance) among Asian (M = 37.30, SD = 9.21) compared to White groups (M = 40.26, SD = 9.40), t = 3.34, (p = 0.001) |
Subramaniam 2017 [23] | Singapore | Various | Asian (Nmaj = 1034) Asian (Nmin = 977) Asian (Nmin = 963) Other (Nmin = 32) | Community | • Self-report • DSS | • There was more discrimination (i.e. desire for social distance) against those with CMDs among majority Asian group (M = 12.00, SE = 0.09) compared to minority Asian groups (M = 10.89, SE = 0.09), (M = 11.52, SE = 0.11) and Other (M = 11.71, SE = 0.45) (p < .001) • There was more perceived stigma (i.e. perception of those with CMDs as weak not sick) among minority Asian groups (M = 10.95, SE = 0.06), (M = 10.74, SE = 0.08) compared to the majority (M = 10.07, SE = 0.06) (p < .001) • There was more perceived stigma (i.e. perception of those with CMDs as dangerous and unpredictable) among minority Asian groups (M = 11.60, SE = 0.09),(M = 11.75, SE = 0.11) compared to the majority (M = 11.61, SE = 0.08) (p = 0.66) |
Wang 2013 [47] | USA | Various | White (Nmaj = 467) Black (Nmin = 221) Hispanic (Nmin = 57) Other (Nmin = 65) | Students | • Vignette • SDS | • There was more discrimination (i.e. desire for social distance) against those with any CMDs among Black (M = 24.28, SD = 5.04), Other (M = 23.60, SD = 6.23) and Hispanic (M = 23.17, SD = 4.87) compared to White (M = 22.41, SD = 5.07), F = 6.32 (p = 0.000) |