A Comparison of Social Exclusion Towards People with Depression or Chronic Back Pain

Br J Pain. 2023 Jun;17(3):267-280. doi: 10.1177/20494637221148337. Epub 2023 Jan 7.

Abstract

Objectives: Research comparing mental and physical health stigma is scarce. The aim of this study was to compare social exclusion towards hypothetical males and females with depression or chronic back pain. Furthermore, the study investigated whether social exclusion is associated with participant's empathy and personality traits, while controlling for their sex, age and personal exposure to mental/physical chronic health conditions.

Design: This study employed a cross-sectional questionnaire design.

Methods: Participants (N = 253) completed an online vignette-based questionnaire and were randomly allocated to either a depression or chronic back pain study condition. Measures of social exclusion through respondents' willingness to interact with hypothetical individuals, empathy and the Big Five personality traits were completed.

Results: Willingness to interact scores did not significantly differ depending on the diagnosis or sex of the hypothetical person in the vignette. For depression, higher levels of conscientiousness significantly predicted less willingness to interact. Whilst being a female participant and having higher empathy significantly predicted greater willingness to interact. For chronic back pain, higher empathy significantly predicted greater willingness to interact, with no significant predictors found from the Big Five personality traits.

Conclusion: Findings indicate that females and males with depression or chronic back pain face similar levels of social exclusion, with empathy being a core variable driving social exclusion behaviours. These findings enhance our understanding of potential variables driving social exclusion, in-turn informing campaign development to reduce public stigma towards depression and chronic back pain.

Keywords: chronic back pain; depression; empathy; public stigma; social exclusion.