TY - JOUR
T1 - Stigma related to labels and symptoms in individuals at clinical high-risk for psychosis
AU - Yang, Lawrence H.
AU - Link, Bruce G.
AU - Ben-David, Shelly
AU - Gill, Kelly E.
AU - Girgis, Ragy R.
AU - Brucato, Gary
AU - Wonpat-Borja, Ahtoy J.
AU - Corcoran, Cheryl M.
N1 - Funding Information:
The preparation of this manuscript was supported in part by NIMH grant 1 R01 MH096027-01 , Brain and Behavior Research Foundation Young Investigator Award ( #17539 ), the Rollin M. Gerstacker Foundation , and the Calderone Prize , which have been awarded to Dr. Yang, and from NIMH ( K23 MH06627901A2 ) which has been awarded to Dr. Corcoran. The authors would like to thank Christopher Ceccolini and Binoy Shah for their help in formatting the manuscript, and Leigh Arndt for her help in the data collection.
Funding Information:
The preparation of the manuscript was supported in part by awards from the Brain and Behavior Research Foundation (# 17839 ), the Rollin M. Gerstacker Foundation , the Calderone Prize , and the National Institute of Mental Health (NIMH) ( R01 MH096027 ) awarded to Dr. Yang, and from NIMH ( K23 MH06627901A2 ) which has been awarded to Dr. Corcoran. The Brain and Behavior Foundation, the Gerstacker Foundation, the Calderone Foundation, and the NIMH had no further role in the conceptualization or writing of the report; and in the decision to submit the paper for publication.
Publisher Copyright:
© 2015 Elsevier B.V.
PY - 2015/10/1
Y1 - 2015/10/1
N2 - Background: Despite advances that the psychosis "clinical high-risk" (CHR) identification offers, risk of stigma exists. Awareness of and agreement with stereotypes has not yet been evaluated in CHR individuals. Furthermore, the relative stigma associated with symptoms, as opposed to the label of risk, is not known, which is critical because CHR identification may reduce symptom-related stigma. Methods: Thirty-eight CHR subjects were ascertained using standard measures from the Center of Prevention and Evaluation/New York State Psychiatric Institute/ Columbia University. Labeling-related measures adapted to the CHR group included "stereotype awareness and self-stigma" ("Stereotype awareness", "Stereotype Agreement", "Negative emotions [shame]"), and a parallel measure of "Negative emotions (shame)" for symptoms. These measures were examined in relation to symptoms of anxiety and depression, adjusting for core CHR symptoms (e.g. attenuated psychotic symptoms). Results: CHR participants endorsed awareness of mental illness stereotypes, but largely did not themselves agree with these stereotypes. Furthermore, CHR participants described more stigma associated with symptoms than they did with the risk-label itself. Shame related to symptoms was associated with depression, while shame related to the risk-label was associated with anxiety. Conclusion: Both stigma of the risk-label and of symptoms contribute to the experience of CHR individuals. Stereotype awareness was relatively high and labeling-related shame was associated with increased anxiety. Yet limited agreement with stereotypes indicated that labeling-related stigma had not fully permeated self-conceptions. Furthermore, symptom-related stigma appeared more salient overall and was linked with increased depression, suggesting that alleviating symptom-related shame via treating symptoms might provide major benefit.
AB - Background: Despite advances that the psychosis "clinical high-risk" (CHR) identification offers, risk of stigma exists. Awareness of and agreement with stereotypes has not yet been evaluated in CHR individuals. Furthermore, the relative stigma associated with symptoms, as opposed to the label of risk, is not known, which is critical because CHR identification may reduce symptom-related stigma. Methods: Thirty-eight CHR subjects were ascertained using standard measures from the Center of Prevention and Evaluation/New York State Psychiatric Institute/ Columbia University. Labeling-related measures adapted to the CHR group included "stereotype awareness and self-stigma" ("Stereotype awareness", "Stereotype Agreement", "Negative emotions [shame]"), and a parallel measure of "Negative emotions (shame)" for symptoms. These measures were examined in relation to symptoms of anxiety and depression, adjusting for core CHR symptoms (e.g. attenuated psychotic symptoms). Results: CHR participants endorsed awareness of mental illness stereotypes, but largely did not themselves agree with these stereotypes. Furthermore, CHR participants described more stigma associated with symptoms than they did with the risk-label itself. Shame related to symptoms was associated with depression, while shame related to the risk-label was associated with anxiety. Conclusion: Both stigma of the risk-label and of symptoms contribute to the experience of CHR individuals. Stereotype awareness was relatively high and labeling-related shame was associated with increased anxiety. Yet limited agreement with stereotypes indicated that labeling-related stigma had not fully permeated self-conceptions. Furthermore, symptom-related stigma appeared more salient overall and was linked with increased depression, suggesting that alleviating symptom-related shame via treating symptoms might provide major benefit.
KW - Adolescents
KW - At risk
KW - Clinical high risk state for psychosis
KW - Discrimination
KW - Early psychosis
KW - Prodrome
KW - Stigma
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U2 - 10.1016/j.schres.2015.08.004
DO - 10.1016/j.schres.2015.08.004
M3 - Article
C2 - 26314731
AN - SCOPUS:84942363596
VL - 168
SP - 9
EP - 15
JO - Schizophrenia Research
JF - Schizophrenia Research
SN - 0920-9964
IS - 1-2
M1 - 6492
ER -