Internalized stigma in adults with early phase versus prolonged psychosis

Firmin, Ruth L.; Lysaker, Paul H.; Luther, Lauren; Yanos, Philip T.; Leonhardt, Bethany L.; Breier, Alan; Vohs, Jenifer L.

doi:10.1111/eip.12553

Cited by 24 publications

(19 citation statements)

References 55 publications

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“…In the present study, psychotic symptoms were strongly and positively associated with internalized stigma, as in other studies (Boyd et al, 2016;Firmin et al, 2019;Moriarty et al, 2012). Yanos et al (2008) also claimed that psychotic symptoms play a critical role as a cause, rather than a consequence, of diminished hope and self-esteem.…”

Section: Discussionsupporting

confidence: 87%

“…cross-sectional survey, discrimination, Indonesian, internalized stigma, psychotic symptom, schizophrenia Furthermore, the severity of psychotic symptoms has been shown to have a positive correlation with internalized stigma (Boyd, Hayward, Bassett, & Hoff, 2016;Firmin et al, 2019;Moriarty, Jolley, Callanan, & Garety, 2012). Yanos et al (2008) pointed out that psychotic symptoms and internalized stigma cause diminished hope and loss of self-esteem and lead to negative recovery outcomes for people diagnosed with severe mental illness.…”

Section: Introductionmentioning

confidence: 99%

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Factors associated with internalized stigma for Indonesian individuals diagnosed with schizophrenia in a community setting

Pribadi

Lin

Chen

et al. 2020

Psychiatric Ment Health Nurs

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Accessible summary What is known on the subject? Internalized stigma in people diagnosed with mental illness has several negative outcomes; however, it remains unclear in an Indonesian context. The human rights of people diagnosed with mental illness in Indonesia have been routinely violated because of the existing stigma against mental illness and deficiencies in the country's mental healthcare services. What the paper adds to existing knowledge? To the best of our knowledge, this is the first study to examine the level of internalized stigma and related factors among Indonesians diagnosed with schizophrenia. Almost one‐third of the subjects had moderate‐to‐severe levels of internalized stigma, among which discrimination was the strongest type. Specifically, younger and unemployed people with more psychotic symptoms had higher levels of internalized stigma. What are the implications for practice? The provision of adequate pharmacological and psychosocial treatments to help people manage their psychotic symptoms is extremely important to ameliorate stigma. Vocational rehabilitation and employment support for unemployed people may potentially reduce their internalized stigma and promote recovery. Abstract IntroductionThe human rights of people diagnosed with mental illness in Indonesia have been routinely violated because of societal stigma associated with mental illness and deficiencies in the country's mental healthcare services. Knowledge about internalized stigma among people diagnosed with schizophrenia in lower middle‐income Muslim countries is also scarce. AimTo identify the level of internalized stigma and related factors among people diagnosed with schizophrenia in Indonesia. MethodA cross‐sectional survey was conducted with a purposive sample of 300 people diagnosed with schizophrenia from an urban Indonesian psychiatric hospital. ResultsAlmost one‐third of the subjects had moderate‐to‐severe levels of internalized stigma, among which discrimination was the strongest type. Younger age, unemployment status and having psychotic symptoms significantly increased the risk of internalized stigma when analysed in a multivariable ordinal logistic regression. DiscussionThe present study firstly identified the high levels of internalized stigma among Indonesian individuals diagnosed with schizophrenia. Implications for practiceMental health nurses are suggested to provide early anti‐stigma illness management and family psychoeducation interventions to people diagnosed with schizophrenia and their family caregivers, helping them to develop an optimistic understanding about the concept of schizophrenia and mitigating the negative consequences of public and internalized stigma.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Factors associated with internalized stigma for Indonesian individuals diagnosed with schizophrenia in a community setting

Pribadi

Lin

Chen

et al. 2020

Psychiatric Ment Health Nurs

View full text Add to dashboard Cite

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“…In addition, people who have developed psychosis often experience significant social anxiety and shame about their disorder, and feelings of social marginalization that can contaminate their social interactions with others . Consequently, among people with a recent onset of psychosis, there is some evidence that experienced stigma is associated with a worse quality of life , greater levels of distressing symptoms such as depression and anxiety , and more impaired psychosocial functioning .…”

Section: Introductionmentioning

confidence: 99%

Clinical and demographic correlates of stigma in first‐episode psychosis: the impact of duration of untreated psychosis

Mueser

DeTore

Kredlow

et al. 2019

Acta Psychiatr Scand

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Clinical and demographic correlates of stigma in first-episode psychosis: the impact of duration of untreated psychosis Mueser KT, DeTore NR, Kredlow MA, Bourgeois ML, Penn DL, Hintz K. Clinical and demographic correlates of stigma in first-episode psychosis: the impact of duration of untreated psychosis.Objective: To evaluate the relationships between perceived stigma and duration of untreated psychosis (DUP), demographic characteristics, and clinical and psychosocial functioning in persons with a first episode of psychosis (FEP). Method: A total of 399 participants with FEP presenting for treatment at 34 sites in 21 states throughout the United States were evaluated using standardized instruments to assess diagnosis, symptoms, psychosocial functioning, perceived stigma, wellbeing, and subjective recovery. Results: Perceived stigma was correlated with a range of demographic and clinical variables, including DUP, symptoms, psychosocial functioning, and subjective experience. After controlling for symptom severity, perceived stigma was related to longer DUP, schizoaffective disorder diagnosis, more severe depression, and lower wellbeing and recovery. The associations between stigma and depression, wellbeing, and recovery were stronger in individuals with long than short DUP, suggesting the effects of stigma on psychological functioning may be cumulative over the period of untreated psychosis. Conclusion: The findings suggest that independent of symptom severity, perceived stigma may contribute to delay in seeking treatment for FEP, and this delay may amplify the deleterious effects of stigma on psychological functioning. The results point to the importance of reducing DUP and validating interventions targeting the psychological effects of stigma in people with FEP. Significant outcomes• Higher levels of perceived stigma were significantly associated with a longer duration of untreated psychosis when controlling for psychiatric symptoms.• Perceived stigma was significantly related to more severe symptoms, worse psychosocial functioning, and lower subjective wellbeing and sense of recovery.• When overall symptom severity was statistically controlled, perceived stigma was related to worse depression, and lower wellbeing and recovery. Limitations• Only one (abbreviated) measure of perceived stigma was used, and self-stigma was not directly assessed.

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“…Improving social competence and social skills during treatment could make social interactions more enjoyable enhancing, therefore, the motivation to engage in social behavior [2,11,54]. Selfstigma is associated with impaired cognitive and social functioning, more severe positive and negative symptoms and increased social anxiety [55][56][57][58][59][60][61][62]. Reduced defeatist beliefs and self-stigma might contribute to the treatment effects on negative symptoms and social functioning [2,11,54].…”

Section: Discussionmentioning

confidence: 99%

Improving social function with real-world social-cognitive remediation in schizophrenia: Results from the RemedRugby quasi-experimental trial

Dubreucq

Gabayet²,

Ycart

et al. 2020

Eur. Psychiatr.

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Background. Functional capacity (FC) has been identified as a key outcome to improve real-world functioning in schizophrenia. FC is influenced by cognitive impairments, negative symptoms, self-stigma and reduced physical activity (PA). Psychosocial interventions targeting FC are still under-developed. Methods. we conducted a quasi-experimental study evaluating the effects of an exercise-enriched integrated social cognitive remediation (SCR) intervention (RemedRugby [RR]) compared with an active control group practicing Touch Rugby (TR). To our knowledge, this is the first trial to date evaluating the effectiveness of such a program provided in a real-life environment. Results. Eighty-seven people with schizophrenia were included and allocated to either the RR group (n = 57) or the TR group (n = 30) according to the routine clinical practice of the recruiting center. Outcomes were evaluated at baseline and post-treatment in both groups and after 6 months of follow-up in the RR group using standardized scales for symptom severity, social functioning, self-stigma, and a large cognitive battery. After treatment we observed moderate to large improvements in social function (Personal and Social Performance Scale [PSP], p < 0.001, d = 1.255), symptom severity (Positive and Negative Syndrome Scale [PANSS] negative, p < 0.001, d = 0.827; PANSS GP, p < 0.001, d = 0.991; PANSS positive, p = 0.009, d = 0.594), verbal abstraction (p = 0.008, d = 0.554), aggression bias (p = 0.008, d = 0.627), and self-stigma (stereotype endorsement, p = 0.019, d = 0.495; discrimination experiences, p = 0.047; d = 0.389) that were specific to the RR group and were not observed in participants playing only TR. Effects were persistent over time and even larger between post-treatment and follow-up. Conclusions. Exercise-enriched integrated SCR appears promising to improve real-life functioning in schizophrenia. Future research should investigate the potential effects of this intervention on neuroplasticity and physical fitness.

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Internalized stigma in adults with early phase versus prolonged psychosis

Abstract: Findings suggest that internalized stigma is an important variable to incorporate into models of early psychosis. Furthermore, internalized stigma may be a possible treatment target among those with early phase psychosis.

Cited by 24 publications

References 55 publications

Factors associated with internalized stigma for Indonesian individuals diagnosed with schizophrenia in a community setting

Factors associated with internalized stigma for Indonesian individuals diagnosed with schizophrenia in a community setting

Clinical and demographic correlates of stigma in first‐episode psychosis: the impact of duration of untreated psychosis

Improving social function with real-world social-cognitive remediation in schizophrenia: Results from the RemedRugby quasi-experimental trial

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