Association of Stigma, Self-Esteem, and Symptoms with Concurrent and Prospective Assessment of Social Anxiety in Schizophrenia

Abstract

Rationale Often overlooked clinically, social anxiety is common in schizophrenia and may represent a barrier to quality of life and social function. Little is known, however, about the possible roots of social anxiety in schizophrenia or their relationship to social anxiety over time. Methods To explore this issue, we examined the relationship between self-esteem, self-stigma, positive and negative symptoms, emotional discomfort and affect recognition with concurrent and prospective assessments of social anxiety using the Multidimensional Anxiety Questionnaire in a sample of seventy-eight persons meeting criteria for schizophrenia or schizoaffective disorder. Results Univariate correlations revealed that self-esteem, self-stigma, negative symptoms and emotional discomfort were significantly related to social anxiety assessed concurrently and five months later. Multiple regressions revealed negative symptoms and discrimination experiences in particular were found to predict social anxiety prospectively even when initial levels of social anxiety were controlled for statistically. Conclusions Negative symptoms and self-stigma may be consistently related to social anxiety across time.

Personal stigma in schizophrenia spectrum disorders: a systematic review of prevalence rates, correlates, impact and interventions

“…On the other hand, positive symptoms, depression and general psychopathology were mostly found to correlate significantly with personal stigma. However, no illness‐related variable was unequivocally correlated with personal stigma, except for social anxiety, which was only assessed in two studies, one on perceived stigma and one on self‐stigma . These results are in line with another study that was excluded from our review due to the heterogeneity of its sample .…”

“…As in chronic samples, patients in the first episode showed increased perceived stigma when they had social anxiety . This does not differ from the results concerning the relationship of self‐stigma and social anxiety in a sample of elderly patients with multiple illness episodes (mean age=64.7, SD=8.7) . Likewise, the results of the second sample of patients with first‐episode psychosis concerned prevalence rates and the relationship between positive symptoms and perceived stigma , and they did not differ from results regarding patients in later disease stages .…”

The course of negative symptoms over the first five years of treatment: Data from an early intervention program for psychosis

“…Social withdrawal, which is a prominent aspect of the motivation component of negative symptoms, may partially reflect anxiety (Birchwood, 2003;Chudleigh et al, 2011;Lysaker et al, 2010;Penn et al, 1994), whereas diminished expressiveness appears unrelated to anxiety (Cohen et al, 2012;Huppert and Smith, 2001;Kelley et al, 1999). There is also evidence that the motivational component has more implications for everyday functioning than diminished expression Green et al, 2012;Rocca et al, 2014;Sayers et al, 1996;Strauss et al, 2013), although these findings may be confounded by the prominence of observed functioning in the assessment of negative symptoms related to motivation (Leifker et al, 2009;Ventura et al, 2009).…”

Coping humour impact on social anxiety in schizophrenic patients

“…В груп-пе больных шизофренией социальная тревожность связана преимуществен-но с реакциями избегания при чувстве стыда . По данным зарубежных исследо-ваний именно чувство стыда, возникаю-щее в связи со стигматизацией при за-болевании, является определяющим для социальной тревожности у больных ши-зофренией, в отличие от социальной тревожности у здоровых людей (Lysaker, 2010;Birchwood, 2006) .…”