Longitudinal course of self-labeling, stigma stress and well-being among young people at risk of psychosis

Stigma related to labels and symptoms in individuals at clinical high-risk for psychosis

“…While prior studies (Rüsch, 2014a; 2014e) have demonstrated negative overall effects of stigma on broadly-defined psychological well-being in CHR persons, our study is the first to characterize ”labeling” vs. “symptom” stigma. Because stigma from these two sources might act differently, differentiating their effects upon anxiety and depression may facilitate intervention.…”

“…Clinicians might address an individual’s sense of shame, and help develop selective disclosure strategies regarding whom to tell about their label and what to say. Building upon youths’ inclination to disagree with stereotypes might provide a source of resilience to reduce shame (Rüsch, 2014e) and bolster positive emotions (i.e., understanding) associated with CHR identification (McGorry, 2002). …”

“…Recent cross-sectional (Rüsch, 2014a) and longitudinal (Rüsch, 2014e) studies of early identified youth at high risk of psychosis, ultra-high risk of psychosis, or risk of bipolar disorder have demonstrated negative effects of stigma and self-labeling on “stigma stress” and psychological well-being. We build on these promising studies, which employed single-item assessment, by characterizing both stigma associated with the label of risk and stigmatizing reactions to symptomatic behaviors; e.g., feeling “different” due to unusual perceptual experiences.…”

Early detection of psychosis: helpful or stigmatizing experience? A qualitative study

“…Studies focusing on the subjective perspective of patients with schizophrenia have reached the same conclusion . ARMS individuals who are experiencing low levels of stigma‐associated stress have been shown to have a better prognosis regarding their well‐being . Potential misinterpretation of ARMS as being equivalent to schizophrenia may increase the vulnerability to internalized stigma.…”

Ethical and Epidemiological Dimensions of Labeling Psychosis Risk

“…More specifically, studies of young people with attenuated psychotic symptoms, or with a history of hypomanic symptoms (consistent with an increased risk for bipolar disorder), have focused on the relationship between self-labeling as mentally ill and stigma stress, defined as perceived harm of mental health stigma in excess of perceived resources to cope with it. These studies found that, after adjusting for age, gender, symptoms, and functioning, self-labeling as mentally ill was associated with greater stigma stress and reduced well-being [27, 28], more suicidal ideation (mediated by social isolation) [29], and higher rates of developing schizophrenia [30], although self-labeling also was associated with more positive attitudes toward treatment [31]. Thus, these studies suggest that self-labeling as mentally ill is harmful overall for youths at risk for mental illness, although they do not provide any data as to the specific effects of clinicians’ use of diagnostic labels.…”