Internalized stigma among psychiatric outpatients: Associations with quality of life, functioning, hope and self-esteem

Abstract

This study aimed to: (i) determine the prevalence, socio-demographic and clinical correlates of internalized stigma and (ii) explore the association between internalized stigma and quality of life, general functioning, hope and self-esteem, among a multi-ethnic Asian population of patients with mental disorders. This cross-sectional, survey recruited adult patients (n=280) who were seeking treatment at outpatient and affiliated clinics of the only tertiary psychiatric hospital in Singapore. Internalized stigma was measured using the Internalized Stigma of Mental Illness scale. 43.6% experienced moderate to high internalized stigma. After making adjustments in multiple logistic regression analysis, results revealed there were no significant socio-demographic or clinical correlates relating to internalized stigma. Individual logistic regression models found a negative relationship between quality of life, self-esteem, general functioning and internalized stigma whereby lower scores were associated with higher internalized stigma. In the final regression model, which included all psychosocial variables together, self-esteem was the only variable significantly and negatively associated with internalized stigma. The results of this study contribute to our understanding of the role internalized stigma plays in patients with mental illness, and the impact it can have on psychosocial aspects of their lives.

Psychopathological profile and antipsychotic treatment may be linked to internalised stigma in schizophrenia – a cross-sectional study

“…The severity of illness and loss of general functioning have been previously linked to self-stigma in schizophrenia. These findings were confirmed in a recent systematic review by Boyd et al [26,36]. In the present study, several indicators of symptom severity predicted greater internalised stigma.…”

Strategies to reduce stigma related to visible chronic skin diseases: a systematic review

“…Irrespective of the type of stigma, consequences for affected people are severe. Stigmatization impairs health‐related quality of life, diminishes life satisfaction and may cause depressive symptoms up to severe mental illness . Negative consequences have been confirmed for patients of numerous medical fields such as mental health, obesity and HIV/AIDS .…”

“…Stigmatization impairs health-related quality of life, diminishes life satisfaction and may cause depressive symptoms up to severe mental illness. [8][9][10] Negative consequences have been confirmed for patients of numerous medical fields such as mental health, obesity and HIV/AIDS. [10][11][12][13] Building upon this, researchers have developed theoretical approaches and models explaining the emergence of stigma and designed interventions to combat it in society.…”

Psychological inflexibility and stigma: A meta-analytic review

“…Luoma, Kohlenberg, Hayes, Bunting, and Rye (2008) define self-stigma broadly as "shame, evaluative thoughts, and fear of enacted stigma that results from an individual's identification with a stigmatized group that serves as a barrier to the pursuit of valued life goals" (p.150). Self-stigma is known to be linked to a number of negative outcomes such as isolating behaviors (e.g., Drapalski et al, 2013), poorer overall functioning, and lower quality of life (Picco et al, 2016).…”