Stigma Resistance and the Mental Illness Self-View

Objective: Stigma resistance (SR) has recently emerged as a prominent aspect of research on recovery from schizophrenia, partly because studies have suggested that the development of stigma-resisting beliefs may help individuals lead a fulfilling life and recover from their mental illness. The present study assessed the relationship between personal SR ability and prediction variables such as self-stigma, self-esteem, self-reflection, coping styles, and psychotic symptomatology. Method: We performed an exploratory cross-sectional study of 170 community-dwelling patients with schizophrenia. Self-stigma, self-esteem, self-reflection, coping skills, and SR were assessed through self-report. Psychotic symptom severity was rated by the interviewers. Factors showing significant association in univariate analyses were included in a stepwise backward regression model. Results: Stepwise regressions revealed that acceptance of stereotypes of mental illness, self-esteem, self-reflection, and only 2 adaptive coping strategies (positive reinterpretation and religious coping) were significant predictors of SR. The prediction model accounted for 27.1% of the variance in the SR subscale score in our sample. Conclusions: Greater reflective capacity, greater self-esteem, greater preferences for positive reinterpretation and religious coping, and fewer endorsements of the stereotypes of mental illness may be key factors that relate to higher levels of SR. These factors are potentially modifiable in tailored interventions, and such modification may produce considerable improvements in the SR of the investigated population. This study has implications for psychosocial rehabilitation and emerging views of recovery from mental illness.

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Correlates and moderators of stigma resistance among people with severe mental illness

Psychiatry Research ◽

10.1016/j.psychres.2018.09.040 ◽

2018 ◽

Vol 270 ◽

pp. 198-204 ◽

Cited By ~ 5

Author(s):

Lauren K. O'Connor ◽

Philip T. Yanos ◽

Ruth L. Firmin

Keyword(s):

Mental Illness ◽

Severe Mental Illness ◽

Stigma Resistance

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Stigma Resistance and Its Associated Factors among People with Bipolar Disorder at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia

Depression Research and Treatment ◽

10.1155/2020/7917965 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Nigus Alemnew Engidaw ◽

Eyosiyas Yeshialem Asefa ◽

Zelalem Belayneh ◽

Abate Dargie Wubetu

Keyword(s):

Bipolar Disorder ◽

Mental Illness ◽

Associated Factors ◽

Addis Ababa ◽

Community Support ◽

Self Esteem ◽

Internalized Stigma ◽

Specialized Hospital ◽

Stigma Resistance ◽

Bipolar Patients

Background. Stigma resistance is the capacity to cope and remain unaffected by mental illness stigmatization. In bipolar patients, having low stigma resistance may result in a higher internalized stigma, low self-esteem, and poor treatment outcome. In Ethiopia, the prevalence of stigma resistance among bipolar patients is not well known. Therefore, this study is aimed at assessing the prevalence of stigma resistance and its associated factors among bipolar patients at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia. Method. An institutional-based cross-sectional study was conducted from May 8th to June 14th, 2016, at Amanuel Mental Specialized Hospital. The study participants were selected using a systematic random sampling technique. The stigma resistance subscale of the internalized stigma of mental illness was used to measure stigma resistance. Bivariable and multivariable logistic regression was computed to identify factors associated with stigma resistance. Accordingly, variables with P values of less than 0.05 were considered as statistically significant predictors of stigma resistance with a 95% confidence interval. Results. In this study, 418 participants completed the interview with a response rate of 98.8%. The prevalence of low stigma resistance was 56.9% (95%CI=51.9‐61.6%). Being unemployed (AOR=1.65; 95%CI=1.35‐1.87), high internalized stigma (AOR=3.04; 95%CI=1.83‐5.05) and low self-esteem (AOR=2.13; 95%CI=1.72‐6.76) were significantly associated with low stigma resistance. Conclusions and Recommendation. More than half of the bipolar patients attending the Amanuel Mental Specialized Hospital had low stigma resistance. Therefore, stigma reduction programs have focused on improving self-esteem and reducing internalized stigma to increase their stigma resistance. Mental health information dissemination regarding community support and reengagement of people with bipolar disorder is highly recommended.

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Stigma Resistance and Well-Being in the Context of the Mental Illness Identity

Journal of Health and Social Behavior ◽

10.1177/0022146520976624 ◽

2021 ◽

pp. 002214652097662

Author(s):

Kristen Marcussen ◽

Mary Gallagher ◽

Christian Ritter

Keyword(s):

Mental Illness ◽

Depressive Symptoms ◽

Mental Health Center ◽

Well Being ◽

Self Esteem ◽

Self And Other ◽

Perceptual Control ◽

Stigma Resistance ◽

The Difference ◽

The Relationship

We use a perceptual control model of identity to examine the relationship between stigmatized appraisals (from self and other) and well-being among individuals with serious mental illness. We also examine the role of stigma resistance strategies in the identity process. Using in-depth interviews with active clients of a community mental health center (N = 156), we find that deflection, or distancing oneself from mental illness, is associated with greater self-esteem and fewer depressive symptoms. Challenging others through education is associated with higher self-esteem, and challenging stigma through activism is associated with fewer depressive symptoms. Activism also moderates the relationship between identity discrepancy (the difference between appraisals from self and other) and well-being; however, the extent to which activism is helpful or harmful depends on whether appraisals from others are more or less stigmatizing than self-views. We discuss the implications of these findings for identity and stigma research.

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Stigma Resistance and Its Associated Factors among Patients with Mood Disorder at St. Paul’s Hospital and Millennium Medical College, Addis Ababa, Ethiopia, 2019

Psychiatry Journal ◽

10.1155/2020/7429567 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Elias Tesfaye ◽

Chalachew Kassaw ◽

Liyew Agenagnew

Keyword(s):

Mental Illness ◽

Mood Disorder ◽

Linear Regression Analysis ◽

Educational Status ◽

Self Esteem ◽

Internalized Stigma ◽

Duration Of Treatment ◽

Resistance Level ◽

Stigma Resistance ◽

Stigma Of Mental Illness

Background. Stigma resistance is described as the capacity to counteract or remain unaffected by the stigma of mental illness. Patients who have high stigma resistance have shown good treatment outcome, so working on this issue is crucial since little is known about the stigma resistance level among patients with mood disorders. Objectives. To determine the magnitude and determinant factors of stigma resistance among patients with mood disorder attending at St. Paul’s Hospital. Methods. A cross-sectional study design was conducted on 238 study samples, and systematic random sampling was used to get the study participants. Internalized Stigma of Mental Illness Scale was used to measure stigma resistance. Data was entered using EpiData 3.1 and exported to the Statistical Package for Social Science 22.0 for analysis. Linear regression analysis (P<0.05) was used to identify a significant association between the outcome and predictor variable. Results. Out of 238 study samples, 235 patients took part with a 99% response rate. The overall percentage of stigma resistance was 49.5%. Low educational status (B=−1.465, 95% CI (-2.796, -0.134), P≤0.031), disability (B=−0.064, 95% CI (-0.102, -0.026), P≤0.001), nonadherence due to stigma (B=−1.365, 95% CI (-2.151, -0.580), P≤0.001), duration of treatment (B=0.091, 95% CI (0.042, 0.141), P≤0.001), internalized stigma (B=−2.948, 95% CI (-3.642, -2.254), P≤0.001), and self-esteem (B=1.859, 95% CI (0.812, 2.906), P≤0.001) were significantly associated with stigma resistance. Conclusion. This study found that only half of the patients had stigma resistance. Low educational status, high self-stigma, low self-esteem, disability, and short duration of treatment were negatively associated with stigma resistance, so working on those modifiable identified factors with focal stakeholders will be crucial to promote the stigma resistance level of patients with mood disorder.

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M220. SELF-STIGMA, RESILIENCE, AND RECOVERY ATTITUDES AS PREDICTORS OF FUNCTIONING IN PEOPLE WITH SERIOUS MENTAL ILLNESSES

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa030.532 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S219-S220

Author(s):

Sarah E Dihmes ◽

Anthony Ahmed ◽

Sherry Tucker ◽

Alex Mabe ◽

Peter Buckley

Keyword(s):

Social Support ◽

Mental Illness ◽

Goodness Of Fit ◽

Social Withdrawal ◽

Coping Styles ◽

Internalized Stigma ◽

Community Functioning ◽

Stigma Resistance ◽

Path Models ◽

The Impact

Abstract Background Studies increasingly show an association between internalized stigma and increased symptoms, and poorer social and occupational functioning. Fewer studies have informed about protective traits, attitudes, and factors that may attenuate the impact of internalized stigma on psychopathology and psychosocial functioning. The current study used path analysis to examine putative intervening roles for resilience, coping, and recovery attitudes consistent with hope, empowerment, strengths, and self-direction on the effect of internalized stigma on psychopathology and function. Methods Participants were individuals diagnosed with either schizophrenia or schizoaffective disorder (N=84). All participants had completed training and certification as peer support specialists and included 49 individuals currently employed and 35 currently unemployed. Using mailed surveys, participants were administered the Life Stressors Inventory, Internalized Stigma of Mental Illness, the Connors Davidson Resilience Scale, Maryland Assessment of Recovery in Serious Mental Illness, the Brief Symptom Inventory, Brief COPE, Social Functioning Scale, and the Social Support Questionnaire. Path analytic models were estimated using Mplus5. Three path models were estimate designating psychopathology, social support, and community function as dependent variables. Goodness of Fit indices including the Comparative Fit Index (CFI), Tucker Lewis Index (TLI), the Root Mean Square Error of Approximation (RMSEA), and the Standardized Root Mean Squared Residual were used to evaluate the fit of the models to the data. Results There were associations between five subdomains of the ISMI—Alienation (r=0.47, p<0.001), Stereotype Endorsement (r=0.29, p<0.001), Discriminatory Experiences (r=0.40, p<0.001), Social Withdrawal (r=0.47, p<0.001), and Stigma Resistance(r=-0.28, p<0.01) and the severity of psychopathology. There was a significant association between internalized stigma and overall functioning (r=0.46, p<0.001). In addition, the five subdomains of the ISMI—Alienation (r=-0.53, p<0.001), Stereotype Endorsement (r=-0.40, p<0.001), Discriminatory Experiences (r=-0.39, p<0.001), Social Withdrawal (r=-0.40, p<0.001), and Stigma Resistance(r=0.35, p<0.001) were associated with ratings of the satisfaction with social support. Associations with reported amount of social support ranged from r=0.25 for Stigma Resistance to r= -0.39 for Alienation. The final path models for the severity of psychopathology (CFI/TLI = 0.955/0.933, RMSEA=0.091, SRMR =0.049), social support (CFI/TLI = 0.957/0.935, RMSEA=0.085, SRMR =0.072), and community functioning (CFI/TLI = 0.928/0.901, RMSEA=0.087, SRMR =0.09) produced adequate goodness-of-fit estimates. In all three models, the use of maladaptive coping but not the use of adaptive coping mediated the effect of internalized stigma on the dependent variable. Recovery attitudes did not significantly predict psychopathology when resilience was included in the model, suggesting possibly collinear constructs. Discussion The study demonstrates that coping styles, recovery, and resilience attitudes are associated with functional outcomes in people with schizophrenia spectrum disorders. However, the impact of internalized stigma on psychopathology, social, and community functioning may be mediated the use of maladaptive coping styles and attitudes consistent with resilience and adaptability.

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The Stigma Resistance Scale: A multi-sample validation of a new instrument to assess mental illness stigma resistance

Psychiatry Research ◽

10.1016/j.psychres.2017.09.063 ◽

2017 ◽

Vol 258 ◽

pp. 37-43 ◽

Cited By ~ 6

Author(s):

Ruth L. Firmin ◽

Paul H. Lysaker ◽

John H. McGrew ◽

Kyle S. Minor ◽

Lauren Luther ◽

...

Keyword(s):

Mental Illness ◽

Mental Illness Stigma ◽

New Instrument ◽

Stigma Resistance

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Internalized Stigma and Stigma Resistance Among Patients with Mental Illness in Han Chinese Population

Psychiatric Quarterly ◽

10.1007/s11126-014-9315-5 ◽

2014 ◽

Vol 86 (2) ◽

pp. 181-197 ◽

Cited By ~ 27

Author(s):

Yin-Ju Lien ◽

Yu-Chen Kao ◽

Yia-Ping Liu ◽

Hsin-An Chang ◽

Nian-Sheng Tzeng ◽

...

Keyword(s):

Mental Illness ◽

Chinese Population ◽

Han Chinese ◽

Internalized Stigma ◽

Han Chinese Population ◽

Stigma Resistance

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Reducing Self-Stigma in People with Severe Mental Illness Participating in a Regular Football League: An Exploratory Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16193599 ◽

2019 ◽

Vol 16 (19) ◽

pp. 3599

Author(s):

Álvaro Moraleda ◽

Diego Galán-Casado ◽

Adolfo J. Cangas

Keyword(s):

Mental Health ◽

Mental Illness ◽

Exploratory Study ◽

Internalized Stigma ◽

The Past ◽

Mental Health Patients ◽

Stigma Resistance ◽

Stigma Of Mental Illness ◽

The City ◽

Do So

For the past 15 years, a regular indoor football competition has been taking place in Madrid (Spain) with 15 teams from different mental health services in the city, in which teams face off weekly as part of a competition lasting nine months of the year. We are not aware of whether a similar competition experience is offered in other cities. The purpose of the present study was to evaluate whether participating in this league, called Ligasame, has an influence on participants’ self-stigma. To do so, the Internalized Stigma of Mental Illness scale (ISMI) was adapted into Spanish and applied to 108 mental health patients, 40% of which participated in Ligasame, and the remainder of which did not. The results obtained reflect significant differences between those participating in Ligasame and those that did not in terms of two specific dimensions related to self-stigma (stereotype endorsement and stigma resistance) and total score. On the other hand, no significant differences were found in terms of other variables, such as patients’ prior diagnosis, age or belonging to different resources/associations. In this article, we discuss the importance of these results in relation to reducing self-stigma through participation in a regular yearly mental health football league.

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Stigma resistance is associated with advanced stages of personal recovery in serious mental illness patients enrolled in psychiatric rehabilitation

Psychological Medicine ◽

10.1017/s0033291720004055 ◽

2020 ◽

pp. 1-11

Author(s):

J. Dubreucq ◽

J. Plasse ◽

F. Gabayet ◽

M. Faraldo ◽

O. Blanc ◽

...

Keyword(s):

Mental Illness ◽

Serious Mental Illness ◽

Satisfaction With Life ◽

Psychiatric Rehabilitation ◽

Clinical Severity ◽

Personal Recovery ◽

Promising Target ◽

Stigma Resistance ◽

Stigma Of Mental Illness ◽

Advanced Stages

Abstract Background Stigma resistance (SR) is defined as one's ability to deflect or challenge stigmatizing beliefs. SR is positively associated with patient's outcomes in serious mental illness (SMI). SR appears as a promising target for psychiatric rehabilitation as it might facilitate personal recovery. Objectives The objectives of the present study are: (i) to assess the frequency of SR in a multicentric non-selected psychiatric rehabilitation SMI sample; (ii) to investigate the correlates of high SR Methods A total of 693 outpatients with SMI were recruited from the French National Centers of Reference for Psychiatric Rehabilitation cohort (REHABase). Evaluation included standardized scales for clinical severity, quality of life, satisfaction with life, wellbeing, and personal recovery and a large cognitive battery. SR was measured using internalized stigma of mental illness – SR subscale. Results Elevated SR was associated with a preserved executive functioning, a lower insight into illness and all recovery-related outcomes in the univariate analyses. In the multivariate analysis adjusted by age, gender and self-stigma, elevated SR was best predicted by the later stages of personal recovery [rebuilding; p = 0.004, OR = 2.89 (1.36–4.88); growth; p = 0.005, OR = 2.79 (1.30–4.43)). No moderating effects of age and education were found. Conclusion The present study has indicated the importance of addressing SR in patients enrolled in psychiatric rehabilitation. Recovery-oriented psychoeducation, metacognitive therapies and family interventions might improve SR and protect against insight-related depression. The effectiveness of psychiatric rehabilitation on SR and the potential mediating effects of changes in SR on treatment outcomes should be further investigated in longitudinal studies.

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