Self-stigma as a barrier to recovery: a longitudinal study

Abstract

Stigma limits life opportunities of persons with mental illness. Self-stigma, the internalization of negative stereotypes, undermines empowerment and could hinder recovery. Here we examined self-stigma's effect on recovery among 222 disability pensioners with mental illness over 2 years, controlling for age, gender, symptoms and recovery at baseline measured by the Recovery Assessment Scale. More self-stigma at baseline was associated with a significant decrease in recovery after 1 year (not significant after 2 years). An increase of self-stigma from baseline to follow-up predicted less recovery 1 and 2 years later. Interventions that reduce self-stigma could therefore improve recovery.

Self-stigma in serious mental illness and autism spectrum disorder: Results from the REHABase national psychiatric rehabilitation cohort

“…A strong positive correlation was found between self-stigma and the early stages of personal recovery. This reflects the findings of several studies showing a negative association between self-stigma and personal recovery [10,17] (15 studies [19]). The associations between preserved insight into illness, elevated self-stigma, and the early stages of personal recovery in our sample consistently support many of the predictions of the "illnessidentity model" [6].…”

“…IS is highly prevalent in Europe (41.7% in SZ, 21.7% in mood disorders [1,2]) and the United States (36.1% out of 144 people with SMI [5]). According to the "illness identity model" [6], IS can have pervasive effects on recovery-related outcomes, including self-esteem, hopefulness, wellbeing, motivation to achieve personal life goals, social interaction, employment, and symptom severity [7][8][9][10]. Individuals with elevated self-stigma report more dysfunctional attitudes, social withdrawal, depressive symptoms, and increased suicidal ideation [6,11,12].…”

Stigma correlates in individuals with mental health conditions versus community members enrolled in a nationwide integrated arts‐based community rehabilitation program in Israel

“…The finding that people with MHCs who have high self‐stigma also reported a low sense of personal recovery (Hypothesis 1) is consistent with previous reports that self‐stigma undermines personal recovery, possibly by reducing self‐efficacy and hope, impairing social functioning and preventing goal attainment, thus constituting a barrier to rehabilitation (Clement et al, ; Corrigan et al, ; Drapalski et al, ). It is also consistent with the findings of an intervention study where a program for reducing self‐stigma improved personal recovery (Oexle et al, ).…”

“…Self‐stigma can lead to fear of rejection (Drapalski et al, ), which may lead to social network depletion and severe isolation, thereby further undermining their chances for rehabilitation (Link, Wells, Phelan, & Yang, ). By contrast, interventions for reducing self‐stigma may encourage a process of restoring a sense of meaning to life and promoting recovery (Ehrlich‐Ben Or et al, ; Oexle et al, ). Gender differences in self‐stigma are generally inconsistent (Livingston & Boyd, ), but some studies show gender differences in specific aspects of self‐stigma (Barney, Griffiths, Christensen, & Jorm, ; Mackenzie, Visperas, Ogrodniczuk, Oliffe, & Nurmi, ).…”

Digital technology in psychiatry: towards the implementation of a true person-centered care in psychiatry?

“…Digital tools may thus aid in pushing psychiatry towards a true person-centered care, where the service user is a central and active partner in his or her own treatment process. As patients will be empowered to be actively engaged in their treatment, this may also reduce self-stigma which has been shown to have malignant effects on outcome [9]. Digital tools may thus play a crucial role in gearing treatment more towards the specific needs of an individual, as such personalizing psychiatric health care.…”