Self-stigma as a barrier to recovery: a longitudinal study

Abstract

Stigma limits life opportunities of persons with mental illness. Self-stigma, the internalization of negative stereotypes, undermines empowerment and could hinder recovery. Here we examined self-stigma’s effect on recovery among 222 disability pensioners with mental illness over 2 years, controlling for age, gender, symptoms and recovery at baseline measured by the Recovery Assessment Scale. More self-stigma at baseline was associated with a significant decrease in recovery after 1 year (not significant after 2 years). An increase of self-stigma from baseline to follow-up predicted less recovery 1 and 2 years later. Interventions that reduce self-stigma could therefore improve recovery.

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References

  1. 1.

    Rüsch N, Angermeyer MC, Corrigan PW (2005) Mental illness stigma: concepts, consequences, and initiatives to reduce stigma. Eur Psychiatry 20:529–539

    Article  PubMed  Google Scholar 

  2. 2.

    Corrigan PW, Bink AB, Schmidt A, Jones N, Rüsch N (2016) What is the impact of self-stigma? Loss of self-respect and the ‘why try’ effect. J Ment Health 25:10–15

    Article  PubMed  Google Scholar 

  3. 3.

    Bellack AS, Drapalski A (2012) Issues and developments on the consumer recovery construct. World Psychiatry 11:156–160

    Article  PubMed  PubMed Central  Google Scholar 

  4. 4.

    Muñoz M, Sanz M, Pérez-Santos E, Quiroga M de LÁ (2011) Proposal of a socio-cognitive-behavioral structural equation model of internalized stigma in people with severe and persistent mental illness. Psychiatry Res 186:402–408

    Article  PubMed  Google Scholar 

  5. 5.

    Drapalski AL, Lucksted A, Perrin PB, Aakre JM, Brown CH, DeForge BR, Boyd JE (2013) A model of internalized stigma and its effects on people with mental illness. Psychiatr Serv Wash DC 64:264–9.

    Article  Google Scholar 

  6. 6.

    Dimitropoulos G, McCallum L, Colasanto M, Freeman VE, Gadalla T (2016) The effects of stigma on recovery attitudes in people with anorexia nervosa in intensive treatment. J Nerv Ment Dis 204:370–380

    Article  PubMed  Google Scholar 

  7. 7.

    Livingston JD, Boyd JE (2010) Correlates and consequences of internalized stigma for people living with mental illness: a systematic review and meta-analysis. Soc Sci Med 71:2150–2161

    Article  PubMed  Google Scholar 

  8. 8.

    Vass V, Morrison AP, Law H, Dudley J, Taylor P, Bennett KM, Bentall RP (2015) How stigma impacts on people with psychosis: the mediating effect of self-esteem and hopelessness on subjective recovery and psychotic experiences. Psychiatry Res 230:487–495

    Article  PubMed  Google Scholar 

  9. 9.

    Mittal D, Sullivan G, Chekuri L, Allee E, Corrigan PW (2012) Empirical studies of self-stigma reduction strategies: a critical review of the literature. Psychiatr Serv 63:974–981

    Article  PubMed  Google Scholar 

  10. 10.

    Evans-Lacko S, Brohan E, Mojtabai R, Thornicroft G (2012) Association between public views of mental illness and self-stigma among individuals with mental illness in 14 European countries. Psychol Med 42:1741–1752

    CAS  Article  PubMed  Google Scholar 

  11. 11.

    Viering S, Bärtsch B, Obermann C, Rüsch N, Rössler W, Kawohl W (2013) The effectiveness of individual placement and support for people with mental illness new on social benefits: a study protocol. BMC Psychiatry 13:195

    Article  PubMed  PubMed Central  Google Scholar 

  12. 12.

    Oexle N, Rüsch N, Viering S, Wyss C, Seifritz E, Xu Z Kawohl W (2017) Self-stigma and suicidality: a longitudinal study. Eur Arch Psychiatry Clin Neurosci. doi:10.1007/s00406-016-0698-1. (published online)

    Google Scholar 

  13. 13.

    Corrigan PW, Salzer M, Ralph RO, Sangster Y, Keck L (2004) Examining the factor structure of the recovery assessment scale. Schizophr Bull 30:1035

    Article  PubMed  Google Scholar 

  14. 14.

    Ritsher JB, Otilingam PG, Grajales M (2003) Internalized stigma of mental illness: psychometric properties of a new measure. Psychiatry Res 121:31–49

    Article  PubMed  Google Scholar 

  15. 15.

    Derogatis LR (1977) SCL-90-R, administration, scoring and procdures manual for the R(evised) version. John Hopkins University, School of Medicine, Baltimore

    Google Scholar 

  16. 16.

    Tsang HWH, Ching SC, Tang KH, Lam HT, Law PYY, Wan CN (2016) Therapeutic intervention for internalized stigma of severe mental illness: a systematic review and meta-analysis. Schizophr Res 173:45–53

    Article  PubMed  Google Scholar 

  17. 17.

    Corrigan PW, Larson JE, Michaels PJ, Buchholz BA, Rossi RD, Fontecchio MJ, Castro D, Gause M, Krzyżanowski R, Rüsch N (2015) Diminishing the self-stigma of mental illness by coming out proud. Psychiatry Res 229:148–154

    Article  PubMed  Google Scholar 

  18. 18.

    Thornicroft G, Mehta N, Clement S, Evans-Lacko S, Doherty M, Rose D, Koschorke Mirja, Shidhaye R, O’Reilly C, Henderson C (2016) Evidence for effective interventions to reduce mental-health-related stigma and discrimination. Lancet 387(10023):1123–1132

    Article  PubMed  Google Scholar 

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Acknowledgements

We are grateful to all participants.

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Correspondence to Nathalie Oexle.

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Ethical approval

The study was approved by the ethics committee of the canton of Zurich (reference number: KEK-ZH-NR: 2010 − 0311/0).

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Oexle, N., Müller, M., Kawohl, W. et al. Self-stigma as a barrier to recovery: a longitudinal study. Eur Arch Psychiatry Clin Neurosci 268, 209–212 (2018). https://doi.org/10.1007/s00406-017-0773-2

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Keywords

  • Mental illness
  • Self-stigma
  • Recovery