Psychological Components of Disease Stigma Across Illnesses: Associations with Cultural and Personal Factors

Understanding public stigma against patients (also known as disease stigma)—negative attitudes or discriminatory responses toward individuals with a disease—is essential for improving health outcomes and fostering inclusive communities. In this study, 279 participants rated their responses toward eight disease groups (e.g., HIV/AIDS, COVID-19, and depression). Using multiple factor analysis, we identified three components of disease stigma: exclusionary (e.g., avoidance and harmful evaluation), prosocial (e.g., sympathy and helping), and attribution (blame/responsibility). Confirmatory factor analysis supported this three-component structure. Repeated-measures ANOVAs revealed systematic differences across diseases: COVID-19 and schizophrenia elicited stronger exclusionary responses, depression evoked the strongest prosocial responses, and HIV/AIDS was associated with the highest attribution of blame. Linear mixed-effects models further indicated that perceived cultural tightness was positively associated with the attribution component, self-control was positively associated with the prosocial component, and higher self-esteem was linked to greater exclusionary responses. Furthermore, network analysis showed dense within-component clustering (e.g., trust—negative evaluation; sympathy—helping) and a peripheral positioning of attribution within the stigma network. These findings provide insights into the psychological components of disease stigma and its cultural and personal correlates, providing targets for component-specific stigma reduction strategies.