(PS5-87) What will people think? Subjective social status and beliefs about treatments among Arabs in the Middle East

Abstract Text:

Background: The Arab population is a collectivistic community (Bassurah et al., 2022), where communal – or social – status plays a significant role in shaping self-concept and social relationships. This emphasis may also influence how community members address personal concerns, particularly when trying to seek or access mental health care - a highly stigmatized topic and process within the Arab community (Zolezzi et al., 2018). Exploring these beliefs is essential in informing culturally specific approaches towards destigmatization and increasing help-seeking behaviors among Arabs.

Methods: Participants (N = 72; 43.1% female) were recruited primarily from the TGM Research survey panel; some participants were also recruited from an online depression screening study (Leykin et al., 2012). Participants eligible for this analysis lived in one of the countries in the Arab world, spoke Arabic, screened positive for depression, and reported never having sought help for depression. Participants reported their subjective social status (SSS) via the MacArthur ladder (Adler et al., 2000) and completed several other measures, including a measure of attitudes about treatments for depression (Totah et al., 2005). MANOVA models were used to understand the influence of SSS on positive and, separately, negative beliefs about antidepressants and psychotherapy for depression, controlling for age, gender, depression level (PHQ-9; Kroenke et al., 1999), and social support (MSPSS; Zimet et al., 1988). Interactions between SSS and other variables were examined.

Results: Subjective social status moderated the relationships between age and negative attitudes about treatment (p = .025) and between social support and negative attitudes (p = .018). Specifically, older individuals with higher SSS were less concerned about side effects of medication (p = .011), and older participants with lower SSS were concerned about being misunderstood in therapy (p = .005). Individuals with higher SSS exhibited a strong inverse relationship between social support and the concern about having to take medications forever, whereas those with lower SSS showed no such relationship (p = .033). Individuals with lower SSS likewise had stereotypical beliefs about therapy but only with low social support, though no such relationship was evidenced among those with higher SSS (p = .046). Interestingly, no relationships were identified between subjective social status and positive beliefs about psychotherapy and medication (all ps ns).

Conclusion: The results suggest that communal standing may influence negative and stigmatizing beliefs regarding depression treatments but not necessarily positive beliefs. Thus, an effective psychoeducation strategy for Arab communities may involve both efforts to educate the community about the helpfulness of therapy and medications, as these types of beliefs appear to be resistant to social comparisons, while simultaneously offering corrective education regarding negative beliefs, thereby addressing community-level attitudes about depression treatments.