How stigma gets under the skin: the role of stigma, self-stigma and self-esteem in subjective recovery from psychosis

Vass, Victoria; Sitko, Katarzyna; West, Sophie; Bentall, Richard P.

doi:10.1080/17522439.2017.1300184

Cited by 46 publications

(37 citation statements)

References 44 publications

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“…A negative association was found for PR-scale total scores with a diagnosis of comorbid PTSD (r = −0.13, p = 0.01) ( 26 ). PR-scale total scores were also found to be negatively associated with type of diagnosis (schizophrenia or bipolar disorder) ( r = −0.41, p < 0.01), indicating that having a non-affective psychotic disorder is related to lower PR-scale total scores as compared to an affective psychotic disorder ( 56 ).…”

Section: Resultsmentioning

confidence: 99%

“…Few studies reported on effects of socio-demographic and patient characteristics. Five studies investigated the relationship between age and PR-scale total scores ( 19 , 29 , 36 , 39 , 56 ), only one of which found a small (negative) association (r = −0.23, p < 0.05), indicating that older age was related to lower PR ( 19 ). One study investigated the relationship between gender and PR-scale total scores ( 56 ), and another investigated the relationship between education and PR-scale total scores ( 36 ); both found negligible differences.…”

Section: Resultsmentioning

confidence: 99%

“…Five studies investigated the relationship between age and PR-scale total scores ( 19 , 29 , 36 , 39 , 56 ), only one of which found a small (negative) association (r = −0.23, p < 0.05), indicating that older age was related to lower PR ( 19 ). One study investigated the relationship between gender and PR-scale total scores ( 56 ), and another investigated the relationship between education and PR-scale total scores ( 36 ); both found negligible differences. Other studies reported no significant differences in PR-scale total scores for years of illness ( 29 ), medication adherence ( 38 ), contact with recovered peers ( 43 ), or involuntary treatment ( 43 ).…”

Section: Resultsmentioning

confidence: 99%

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Personal Recovery in People With a Psychotic Disorder: A Systematic Review and Meta-Analysis of Associated Factors

et al. 2021

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Background: Personal recovery (PR) is a subjective, multidimensional concept, and quantitative research using PR as an outcome is rapidly increasing. This systematic review is intended to support the design of interventions that contribute to PR in psychotic disorders, by providing an overview of associated factors and their weighted importance to PR: clinical factors, social factors, and socio-demographic characteristics are included, and factors related to the concept of PR (organized into CHIME dimensions).Methods: A systematic literature search was conducted from inception to March 2020. Quantitative studies that had used a validated questionnaire assessing the concept of PR were included. Mean effect sizes for the relationship between PR-scale total scores and related factors were calculated using meta-analyses. Sources of heterogeneity were examined using meta-regression tests.Results: Forty-six studies, that used (a total of) eight PR measures, showed that in clinical factors, affective symptoms had a medium negative association with PR-scale total scores (r = −0.44, 95%CI −0.50 to −0.37), while positive, negative and general symptoms had small negative correlations. No association was found with neuro-cognition. Social factors (support, work and housing, and functioning) showed small positive correlations. Gender and age differences had barely been researched. Large associations were found for PR-scale total scores with the CHIME dimensions hope (r = 0.56, 95%CI 0.48–0.63), meaning in life (r = 0.48, 95%CI 0.38–0.58) and empowerment (r = 0.53, 95%CI 0.42–0.63); while medium associations were found with connectedness (r = 0.34, 95%CI 0.43–0.65) and identity (r = 0.43, 95%CI 0.35–0.50). Levels of heterogeneity were high, sources included: the variety of PR measures, variations in sample characteristics, publication bias, variations in outcome measures, and cultural differences.Discussion: Most interventions in mental healthcare aim to reduce symptoms and improve functioning. With regard to stimulating PR, these interventions may benefit from also focusing on enhancing hope, empowerment, and meaning in life. The strength of these findings is limited by the challenges of comparing separate CHIME dimensions with questionnaires assessing the concept of PR, and by the high levels of heterogeneity observed. Future research should focus on the interaction between elements of PR and clinical and social factors over time.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Personal Recovery in People With a Psychotic Disorder: A Systematic Review and Meta-Analysis of Associated Factors

et al. 2021

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“…The findings of different studies have shown that stigma is a significant barrier for individuals suffering from mental problems in asking for and seeking help. In fact, shame and a lack of self‐esteem in people with mental health issues are the well‐known outcomes of social stigma (Heath et al, 2018; Oliveira, Carvalho, & Esteves, 2016; Vass, Sitko, West, & Bentall, 2017). The outcomes of studies on stigma show that more than 50% of the individuals who might normally use mental health services reject this kind of help to avoid being labelled as “mentally ill” (Kessler et al, 2001; Narrow et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

Mental health stigma among Middle Eastern adolescents: A protocol for a systematic review

Mohammadzadeh¹,

Awang

Mirzaei

2020

Psychiatric Ment Health Nurs

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Accessible Summary What is known on the subject? Four out of every five people with mental health disorders face stigma. Mental health and, consequently, mental health stigma are very common among youth living in the Middle East countries. Several studies have investigated mental health among adolescents in the Middle East, but studies on stigma are very scattered. There is no systematic review on stigma among adolescents with mental disorders across all the Middle East countries despite the common historical roots, similar cultural backgrounds, and recent widespread problems in the area. What this paper adds to existing knowledge? This paper will aim to review and analyse the studies on stigma among adolescents with mental disorders in the Middle East countries, from different aspects such as the age rang, kind of stigma and risk factors of stigma. The study will cover studies on all kinds of stigma among Middle Eastern adolescents up to 18 years old published between 2000 and 2019. The study terms are generally focused on four categories: (a) kinds of Stigma, (b) Mental health problems, (c) Age range and (d) Region of study population. What are the implications for practice? Increasing understanding and awareness of different angles of mental health stigma among adolescents may be helpful for better coping with this challenge. Understanding the nature of stigma may give adolescents the ability of ignoring it and avoid starting self‐stigma and/or stopping to seek help. Abstract IntroductionAlthough many epidemiological and interventional investigations regarding improving mental health among youth in the Middle East have been performed, there is no systematic review specifically analysing the studies on stigma among adolescents with mental disorders (A‐MDs) across all Middle East countries despite their common historical roots, similar cultural backgrounds, and recent widespread problems in the area. PurposeWe will aim to systematically review and analyse the English language studies on stigma among A‐MDs in the Middle East published between 2000 and 2019. MethodThe Web of Knowledge, Science Direct, PsycINFO and MEDLINE are electronic databases that will be included in this study. Furthermore, the bibliography lists of eligible articles will be manually searched for additional included articles. Descriptive statistics will be represented by mean score and standard deviation for continuous data and number/percentage for categorical data. DiscussionThis study may act as a resource for future studies attempting to assess and/or reduce stigma among children and adolescents with mental health issues specifically in the Middle East. ImplicationsIt is important for healthcare providers, including nursing professional, to improve their knowledge and vision towards stigma in their community. The outcomes of this study can be a shortcut reaching this information.

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“…However, assisting primary care providers to better understand the psychosocial (as well as the mental and physical health) needs of their patients with psychotic disorders may help in improving treatment and service referral pathways (Jones et al, 2015). Second, misunderstanding of the reasons associated with higher rates of service use could unintentionally fuel public, professional and internalized stigma of psychosis (Grandon et al, 2019;Vass et al, 2017;Wood et al, 2014). For example, if GPs do not consider loneliness as a possible reason for frequent health service use, this could reinforce stigmatizing attitudes (e.g., that people with psychosis are "weak-not sick", see Reavley et al, 2014) and result in clients not being referred for psychosocial treatment (Sullivan et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Loneliness and its association with health service utilization in people with a psychotic disorder

Badcock

Prinzio

Waterreus

et al. 2020

Schizophrenia Research

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Background: Loneliness is common in people with psychotic disorders and associated with reduced health and well-being. The relationship between loneliness in psychosis and health service use is unclear. This study examined whether loneliness predicts increased health care utilization in this population, independently of sociodemographics, health and functioning. Methods: We used cross-sectional data from the Second Australian National Survey of Psychosis. Loneliness was assessed using a single-item question, rated on a 4-point scale (not lonely; lonely occasionally; some friends but lonely for company; socially isolated and lonely). Health service use (past 12-months) was measured by the number of general practitioner (GP), emergency department (ED) and outpatient visits, inpatient admissions, and home visits by mental health professionals. Frequent hospital users comprised those in the top 15% of users of at least two services. Results: Negative binomial regression analysis showed that loneliness was associated with an increased number of GP visits, ED visits and inpatient admissions, only. Socially isolated and lonely survey participants were more than twice as likely (OR = 2.6) of being 'frequent users' compared to non-lonely responders. Following stringent adjustment for covariates, loneliness remained significantly associated with being a 'frequent user' and showed a non-significant trend to an increased number of GP visits and inpatient admissions. Conclusions: Loneliness is a complex social and personal problem for people with psychosis, related to greater use of some health services. Better strategies for identifying and responding to loneliness in this population have the potential to increase well-being and contain health service utilization costs.

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How stigma gets under the skin: the role of stigma, self-stigma and self-esteem in subjective recovery from psychosis

Cited by 46 publications

References 44 publications

Personal Recovery in People With a Psychotic Disorder: A Systematic Review and Meta-Analysis of Associated Factors

Personal Recovery in People With a Psychotic Disorder: A Systematic Review and Meta-Analysis of Associated Factors

Mental health stigma among Middle Eastern adolescents: A protocol for a systematic review

Loneliness and its association with health service utilization in people with a psychotic disorder

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