Self-Stigma and Depression Among Community-Dwelling Adults With Physical Disabilities in China: The Chain Mediating Role of Social Participation and Self-Esteem

BackgroundWith the intensification of the aging population, the number of people with physical disabilities in China is gradually increasing. Physical disabilities have led to the formation of unique psychological characteristics among this group, seriously affecting their thoughts, behaviors, and quality of life. Therefore, this study explores the action paths and predictive values of self-stigma, social participation, self-esteem, and their influence on depression among community-dwelling people with physical disabilities in China based on the modified labeling theory. MethodsFrom April to September 2023, a cross-sectional study was conducted on 280 people with physical disabilities recruited from 8 counties and cities in Yanbian Prefecture, China. Various dimensional scales were used to measure depression, self-stigma, social participation, and self-esteem. SPSS 26.0 was employed for descriptive statistical analysis, and Amos 26.0 was used to construct a structural equation model and analyze the mediating effect. ResultsThe average score of depression was (43.08{+/-}9.28). Pearson analysis showed that self-stigma, social participation were significantly positively correlated with depression, while self-esteem was significantly negatively correlated with depression (all p<0.05). Path analysis results indicated that self - stigma could directly affect depression ({beta}=0.297,P<0.001), and also indirectly affect depression through social participation ({beta}=0.265, P<0.01), self-esteem ({beta}=0.106, P<0.01), and both social participation and self-esteem ({beta}=0.076, P<0.01), with effect sizes of 39.92%, 35.62%, 14.25%, and 10.22% respectively. ConclusionSocial participation and self-esteem play a chain-mediating role between self-stigma and depression among community-dwelling people with physical disabilities. This provides a reference for formulating social intervention plans to improve the mental health of people with physical disabilities.