Mediating effects of self-stigma and depression on the association between autistic symptoms and recovery in patients with schizophrenia-spectrum disorders: a cross-sectional study

Abstract

Background Several studies have indicated that self-stigma is associated with depressive symptoms and could be a barrier to recovery in patients with schizophrenia-spectrum disorders. More recently, an association between autistic symptoms and self-stigma was found in schizophrenia-spectrum patients. This study aimed to investigate the association between self-stigma, autistic and depressive symptoms, and recovery in patients with schizophrenia. Methods In total, 105 participants were evaluated using the Autism Spectrum Quotient, the Internalized Stigma of Mental Illness Scale, the Quick Inventory of Depressive Symptomatology, and the Recovery Assessment Scale to investigate autistic symptoms, self-stigma, depressive symptoms, and recovery, respectively. The relationship between self-stigma, autistic symptoms, depressive symptoms, and recovery was assessed using structural equation modeling analysis. Results Impaired attention switching, one symptom of autism, was found to positively affect stereotype endorsement, which negatively influenced recovery through depressive symptoms. Moreover, problems with communication skills negatively affected recovery through depressive symptoms. Concerning self-stigma, stereotype endorsement and perceived discrimination had a negative effect on recovery through depressive symptoms, whereas stigma resistance had a direct negative effect on recovery. Conclusions This study may provide meaningful insight into the psychological structure of recovery and could inform effective interventions for patients with schizophrenia-spectrum disorders. This was a cross-sectionally designed study; therefore, further longitudinal studies are needed to identify the causal relationships between self-stigma, autistic and depressive symptoms, and recovery.

The association of social support and hope with self‐stigma and perceived recovery among people with schizophrenia: The serial mediation effect

“…Scholars in Singapore have used a recovery scale based on recovery theory in a community setting and found that for individuals with schizophrenia, internalized stigma is negatively associated with personal recovery (Lim et al, 2020); that is, people who have a higher degree of self-stigma have worse personal recovery outcomes. A psychiatric survey from Japan showed consistent bivariate correlation analysis results for both adult inpatients and outpatients with schizophrenic spectrum disorders: self-stigma was strongly negatively correlated with recovery (Komatsu et al, 2021). Japanese scholars Komatsu et al (2021) also found, using a survey involving hospitalized and community-based patients with schizophrenia, that there was a moderate negative correlation between the degree of patients' self-stigma and the degree of recovery; that is, the higher the degree of self-stigma was, the lower the level of self-reported perceived recovery.…”

“…Scholars in Singapore have used a recovery scale based on recovery theory in a community setting and found that for individuals with schizophrenia, internalized stigma is negatively associated with personal recovery (Lim et al., 2020); that is, people who have a higher degree of self‐stigma have worse personal recovery outcomes. A psychiatric survey from Japan showed consistent bivariate correlation analysis results for both adult inpatients and outpatients with schizophrenic spectrum disorders: self‐stigma was strongly negatively correlated with recovery (Komatsu et al., 2021). Japanese scholars Komatsu et al.…”

“…Therefore, promoting personal recovery for individuals with schizophrenia is an important issue for mental health professionals worldwide. Japanese studies have investigated depressive symptoms, communication skills, and self‐stigma toward recovery (Komatsu et al., 2021), but only a few studies have concurrently explored the influence of self‐stigma, social support, and perceived hope on recovery. Thus, the aim of this study was to discuss the relationships among self‐stigma, social support, perceived hope, and perceived recovery.…”

Assessment and correlates of autistic symptoms in Schizophrenia Spectrum Disorders measured with the PANSS Autism Severity Score: A systematic review

“…Only one study assessed the relationship between autistic features measured with the PAUSS and internalized stigma, showing that more severe autistic symptoms are not correlated with worse internalized stigma, and could even have a protective effect on stigma resistance (59). On the contrary, the results of two studies conducted by another research group suggest that more severe autistic symptoms could be correlated to worse internalized stigma (87,88). However, in these studies the severity of autistic symptoms was not assessed through clinical observation or caregivers reports, but though self-rated assessment tools.…”

Association between Self-Stigma and Suicide Risk in Individuals with Schizophrenia: Moderating Effects of Self-Esteem and Perceived Support from Friends

“…Self-stigma is associated with increased risks of social anxiety, hopelessness, psychiatric symptoms, and low treatment adherence among individuals with mental illnesses [ 7 , 13 , 14 ]. Both cross-sectional [ 15 , 16 ] and longitudinal [ 17 , 18 ] studies have revealed a significant correlation between self-stigma and depressive symptoms among individuals with schizophrenia. Although studies have examined the association between self-stigma and depression, few have focused on the association between self-stigma and suicide risk among individuals with schizophrenia.…”