Psychological inflexibility as a mediator of the relationship between depressive symptom severity and public stigma in depression

Psychological flexibility refers to attending to the present moment and accepting internal experiences in order to effectively adapt behavior in the pursuit of valued goals. Previous research has linked mental health stigma to lower levels of psychological flexibility (i.e., psychological inflexibility or experiential avoidance), resulting in negative attitudes toward those affected by mental health problems. In the current study, 570 individuals participated in an online survey in which they completed measures of depressive symptom severity, psychological inflexibility, and different types of public mental health stigma. Results showed that psychological inflexibility statistically mediated the relationship between depression symptomatology and public stigma toward others with depression, but not the relationship between depression symptomatology and stigma about others receiving treatment for depression. In other words, one's own depressive symptoms increased the likelihood of holding stigmatizing attitudes toward others with depression, and this process worked through increased levels of psychological inflexibility. In contrast, the relationship between people's increased depressive symptoms and stigmatizing attitudes about others receiving mental health treatment was not dependent on their psychological inflexibility level. The findings are discussed within an emerging contextual behavioral science model of stigma.