STIGMA, DEPRESSION AND SELF-EFFICACY: A MULTIPLE SCLEROSIS POPULATION STUDY

Background. Stigma is increasingly recognised as a significant factor contributing to depression in individuals with Multiple Sclerosis (MS). This study aimed to explore the extent to which stigma is associated with depression compared to other biopsychosocial factors and to examine the potential protective role of self-efficacy in this context.

Methods. Data were utilised from the Trajectories of Outcome in Neurological Conditions (TONiC) study, a large-scale UK-based study assessing quality of life in people with neurological conditions. A multinomial logistic regression was conducted on a training and validation sample (total n = 4,297) to identify the unique relative risk ratios for different predictors of depression. A Structural Equation Model (SEM) was also employed to analyse the associations between stigma, self-efficacy, and depression.

Results. The Multinomial Logistic Regression model demonstrated good predictive accuracy (72.6%) and fit the validation data well (CFI = 1.00, TLI = 0.99, RMSEA = .014). The variables contributing the greatest to mild and moderate-severe depression were the London Handicap Scale and the Stigma Scale for Chronic Illness. Self-Efficacy had a strong protective effect. The SEM analysis showed that stigma has a direct but relatively small-to-moderate effect on depression (β = .16, p < .001). Stigma significantly associated with lower self-efficacy (β = -.67, p < .001), which in turn had a strong negative association with depression (β = -.58, p < .001).

Discussion. These findings suggest that while stigma directly associates with depression in MS, its more significant role is through reducing self-efficacy, potentially exacerbating depressive symptoms. Interventions aimed at increasing self-efficacy could mitigate the negative association of stigma with mental health. The study underscores the importance of targeted anti-stigma campaigns and the development of self-efficacy interventions to improve the quality of life for individuals with MS.

Conclusion. This study highlights the unique contribution of stigma to depression in MS and the potential mediating role of self-efficacy. Future research should focus on longitudinal studies to understand the dynamics of stigma over time and develop effective self-efficacy interventions.