Emotional and stigma-related experiences relative to being told one is at risk for psychosis

Woodberry, Kristen A.; Powers, Kate; Bryant, Caitlin; Downing, Donna; Verdi, Mary; Elacqua, Katherine M.; Reuman, Audrey R.L.; Kennedy, Lyndon; Shapiro, Daniel I.; West, Michael O.; Huang, Debbie; Crump, Francesca M.; Grivel, Margaux M.; Blasco, Drew; Herrera, Shaynna; Corcoran, Cheryl; Seidman, Larry J.; Link, Bruce G.; McFarlane, William R.; Yang, Lawrence H.

doi:10.1016/j.schres.2021.09.017

Cited by 16 publications

(7 citation statements)

References 23 publications

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“…Stereotype awareness is an observation, whereas stereotype agreement and discrimination are internalized aspects of stigma that can be targeted through treatment. Helpful interventions may include providing feedback on one’s CHR status in a way that enhances the positive effects (e.g., relief, validation) of CHR labeling (Uttinger et al, 2018; Welsh & Tiffin, 2012), directly inquiring about the perceived impact of CHR labeling during feedback (Woodberry et al, 2021), and providing psychoeducation to increase understanding of the CHR condition (Herrera et al, 2021; McFarlane et al, 2012). Psychosocial interventions could also address stigma as a barrier to treatment engagement (Ben-David et al, 2019; Gronholm et al, 2017; He et al, 2020; Rusch et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

The association between mental health stigma and face emotion recognition in individuals at risk for psychosis.

Herrera¹,

Larsen²,

Crump³

et al. 2023

Stigma and Health

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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.

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Section: Discussionmentioning

confidence: 99%

The association between mental health stigma and face emotion recognition in individuals at risk for psychosis.

Herrera¹,

Larsen²,

Crump³

et al. 2023

Stigma and Health

Self Cite

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“…Systematic inquiry into psychotic-spectrum symptoms implicitly educates young patients that psychotic-spectrum experiences are not rare and that primary care providers are interested in hearing about these experiences. Careful triage and engagement can improve early detection of subthreshold symptoms that progress to threshold symptoms over time, improve the quality of care for non-psychotic mental health concerns, and directly address internalized stigma within mental health sessions and psychoeducation (32).…”

Section: Discussionmentioning

confidence: 99%

Screening for Early Emerging Mental Experiences (SEE ME): A Model to Improve Early Detection of Psychosis in Integrated Primary Care

2022

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Early intervention in serious mental health conditions relies on the accurate identification of adolescents and young adults at high risk or with very recent onset of psychosis. Current early detection strategies have had limited success, identifying only a fraction of these individuals within the recommended 3- to 6-month window. Broader public health strategies such as population screening are hampered by low base rates and poor self-report screen specificity. Screening for Early Emerging Mental Experiences (SEE ME) is a three-stage “SCREEN—TRIAGE—ENGAGE” model for the early detection of psychosis in integrated primary care adolescent and young adult patients during the period of peak onset. It builds on the KNOW THE SIGNS—FIND THE WORDS—MAKE THE CONNECTION framework outlined on psychosisscreening.org and developed with input from community collaborators. Systematic screening aims to expand the reach of early detection and reduce reliance on provider knowledge. Triage and engagement by trained mental health clinicians aims to improve the specificity of screen responses, enhance engagement in appropriate care, and reduce provider burden. Leveraging the low stigma of primary care, its reach to non-help-seeking adolescents and young adults, and the mental health training of clinicians within integrated care practices, SEE ME has potential to improve the benefit/risk ratio of early detection of psychosis by improving both the sensitivity and specificity of screening and clinical response. We review the rationale and design of this promising model.

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“…All participants are being provided with an information sheet explaining the objectives and procedure of the study as well as the confidentiality of the data collected. All participants are being asked in writing for their consent in accordance with the Declaration of Helsinki ( WMA, 2013 ) and Law 14/2007 on Biomedical Research.…”

Section: Ethics Statementmentioning

confidence: 99%

“…There are recent studies that relate the stigma associated with the diagnosis of UHR with a worse prognosis ( Colizzi et al, 2020 ) and stimulated negative stereotypes ( Woodberry et al, 2021 ). For this reason, alternative terms like pre-diagnosis stage’ (PDS), potential of developing a mental illness (PDMI), and disposition for developing a mental illness (DDMI) have been proposed that generate less discomfort among patients and families ( Polari et al, 2021a ).…”

Section: Introductionmentioning

confidence: 99%

Application of the unified protocol for the transdiagnostic treatment of comorbid emotional disorders in patients with ultra-high risk of developing psychosis: A randomized trial study protocol

et al. 2022

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BackgroundCognitive Behavioral Therapy is delivered in most of the early intervention services for psychosis in different countries around the world. This approach has been demonstrated to be effective in decreasing or at least delaying the onset of psychosis. However, none of them directly affect the comorbidity of these types of patients that is often the main cause of distress and dysfunctionality. The Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (UP) is a psychological intervention that combines cognitive-behavioral and third-generation techniques that address emotional dysregulation as an underlying mechanism that these disorders have in common. The application of this intervention could improve the comorbid emotional symptoms of these patients.Materials and methodsThe study is a randomized controlled trial in which one group receives immediate UP plus standard intervention and the other is placed on a waiting list to receive UP 7 months later, in addition to standard care in one of our early psychosis programs. The sample will be 42 patients with UHR for psychosis with comorbid emotional symptoms. The assessment is performed at baseline, at the end of treatment, and at 3-months’ follow-up, and includes: general psychopathology, anxiety and depression, positive and negative emotions, emotional dysregulation, personality, functionality, quality of life, cognitive distortions, insight, and satisfaction with the UP intervention.DiscussionThis will be the first study of the efficacy, acceptability, and viability of the UP in a sample of young adults with UHR. The results of this study may have clinical implications, contributing to improving the model of care for young people who consult for underlying psychotic, anxiety, and/or depressive symptoms that can lead to high distress and dysfunctionality.Clinical trial registration[https://clinicaltrials.gov/], identifier [NCT04929938].

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Emotional and stigma-related experiences relative to being told one is at risk for psychosis

Cited by 16 publications

References 23 publications

The association between mental health stigma and face emotion recognition in individuals at risk for psychosis.

The association between mental health stigma and face emotion recognition in individuals at risk for psychosis.

Screening for Early Emerging Mental Experiences (SEE ME): A Model to Improve Early Detection of Psychosis in Integrated Primary Care

Application of the unified protocol for the transdiagnostic treatment of comorbid emotional disorders in patients with ultra-high risk of developing psychosis: A randomized trial study protocol

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