The Association Between Mental Health Stigma and Face Emotion Recognition in Individuals at Risk for Psychosis

Shaynna N. Herrera, Emmett M. Larsen, Joseph S. Deluca, Francesca M. Crump, Margaux Grivel, Drew Blasco, Caitlin Bryant, Daniel I. Shapiro, Donna Downing, Ragy R. Girgis, Gary Brucato, Debbie Huang, Yael Kufert, Mary Verdi, Michelle L. West, Larry J. Seidman, Bruce G. Link, William R. McFarlane, Kristen A. Woodberry, Lawrence H. YangCheryl M. Corcoran

Research output: Contribution to journalArticlepeer-review


Self-stigma has been associated with reduced accuracy of face emotion recognition in individuals at clinical high risk for psychosis (CHR). Stigma may also relate to slowing of performance during cognitive tasks for which a negative stereotype is relevant. This study aimed to investigate the association of mental illness stigma with face emotion recognition among CHR individuals. Participants were 143 CHR individuals identified using the Structured Interview for Psychosis-Risk Syndromes (SIPSs). Face emotion recognition was assessed using the Penn emotion recognition task (ER-40). Stigma was assessed using discrimination, stereotype awareness, and stereotype agreement subscales of the Mental Health Attitudes Interview for CHR. We tested associations of ER-40 accuracy and response times with these stigma variables, including the role of clinical and demographic factors. Racial/ethnic minoritized participants had higher attenuated positive symptoms than nonminoritized participants. Longer ER-40 response times were correlated with greater stereotype agreement (r =.17, p =.045) and discrimination (r =.22, p =.012). A regression model predicting ER-40 response times revealed an interaction of stereotype agreement with minoritized status (p =.008), with slower response times for minoritized participants as stereotype agreement increased. Greater disorganized symptoms and male gender also predicted longer response times. ER-40 accuracy was not associated with stigma. Overall, minoritized CHR individuals with greater internalized stigma took longer to identify face emotions. Future research is needed to assess whether slower response times are specific to social cues, and if internalized stigma interferes with performance in real-world social situations. Reducing stigma may be an important target for interventions that aim to improve social skills.

Original languageEnglish (US)
Pages (from-to)31-39
Number of pages9
JournalStigma and Health
Issue number1
StatePublished - Apr 21 2022


  • discrimination
  • prodrome
  • race
  • social cognition
  • stereotype

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health
  • Clinical Psychology
  • Social Psychology
  • Health Policy


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