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Letters   |    
Stigma, Race, and Culture: In Reply
Jo Anne Sirey, Ph.D.
Psychiatric Services 2014; doi: 10.1176/appi.ps.650708
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Copyright © 2014 by the American Psychiatric Association


In Reply: We appreciate the thoughtful comments made by Dr. McKenzie in response to our article. Indeed, there is much to be learned about the individual and social factors associated with anticipated stigma among older adults across racial and ethnic groups. Anticipated stigma may be associated with static individual characteristics, vary according to clinical state, and be influenced by social supports or functioning. We also expect that anticipated stigma will be found to be associated with other negative attitudes toward mental health care and influenced by prior experiences with the mental health system. In addition, we know from our own early work that stigma affects older adults’ participation in mental health services differently than it affects younger adults (1) and that it is a factor predicting antidepressant adherence (2), even after mental health service is initiated. We look forward to future research reports of analyses where the complexity of anticipated stigma can be explored among older adults.

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Sirey  JA;  Bruce  ML;  Alexopoulos  GS  et al:  Perceived stigma as a predictor of treatment discontinuation in young and older outpatients with depression.  American Journal of Psychiatry 158:479–481, 2001
[CrossRef] | [PubMed]
Sirey  JA;  Bruce  ML;  Alexopoulos  GS  et al:  Stigma as a barrier to recovery: perceived stigma and patient-rated severity of illness as predictors of antidepressant drug adherence.  Psychiatric Services 52:1615–1620, 2001
[CrossRef] | [PubMed]
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