Stigma resistance is associated with advanced stages of personal recovery in serious mental illness patients enrolled in psychiatric rehabilitation

Abstract

Background Stigma resistance (SR) is defined as one's ability to deflect or challenge stigmatizing beliefs. SR is positively associated with patient's outcomes in serious mental illness (SMI). SR appears as a promising target for psychiatric rehabilitation as it might facilitate personal recovery. Objectives The objectives of the present study are: (i) to assess the frequency of SR in a multicentric non-selected psychiatric rehabilitation SMI sample; (ii) to investigate the correlates of high SR Methods A total of 693 outpatients with SMI were recruited from the French National Centers of Reference for Psychiatric Rehabilitation cohort (REHABase). Evaluation included standardized scales for clinical severity, quality of life, satisfaction with life, wellbeing, and personal recovery and a large cognitive battery. SR was measured using internalized stigma of mental illness – SR subscale. Results Elevated SR was associated with a preserved executive functioning, a lower insight into illness and all recovery-related outcomes in the univariate analyses. In the multivariate analysis adjusted by age, gender and self-stigma, elevated SR was best predicted by the later stages of personal recovery [rebuilding; p = 0.004, OR = 2.89 (1.36–4.88); growth; p = 0.005, OR = 2.79 (1.30–4.43)). No moderating effects of age and education were found. Conclusion The present study has indicated the importance of addressing SR in patients enrolled in psychiatric rehabilitation. Recovery-oriented psychoeducation, metacognitive therapies and family interventions might improve SR and protect against insight-related depression. The effectiveness of psychiatric rehabilitation on SR and the potential mediating effects of changes in SR on treatment outcomes should be further investigated in longitudinal studies.

Recovering Context in Psychiatry: What Contextual Analysis of Service Users' Narratives Can Teach About Recovery Support

“…Within our study, this desire, once contextualized is understood as a consequence of intolerance for troubled behavior. In line with previous recovery research, this genre confirms the significance of overcoming stigma ( 5 , 56 , 57 ) and regaining a sense of dignity ( 58 ) to develop a new, positive identity after being confronted with mental distress. A contextual approach, however, also showed the difficulty of this process for people that are deprived from the social and narrative resources to move beyond devaluating perceptions of mental distress.…”

Cognitive Functioning and Its Relationship with Self-Stigma in Men with HIV Who Have Sex with Men: The Mediating Role of Health-Related Quality of Life

“…Memory is one of the main dimensions highly correlated with executive functioning, which in turn, is closely related to stigma resistance. 72 Adequate executive functioning seems to promote adequate coping strategies, resilience, and those metacognitive abilities needed to fight against self-stigma as proposed in recent research. 72 This fact has been replicated in other studies such as that conducted by Grover et al, in which executive dysfunction was found to be significantly related to higher levels of self-stigma in people with schizophrenia.…”

“… 72 Adequate executive functioning seems to promote adequate coping strategies, resilience, and those metacognitive abilities needed to fight against self-stigma as proposed in recent research. 72 This fact has been replicated in other studies such as that conducted by Grover et al, in which executive dysfunction was found to be significantly related to higher levels of self-stigma in people with schizophrenia. 73 The conclusions obtained in these previous studies could explain the results of our work.…”

Seeds that bloom on stony ground – Concept paper of the future perspectives of the unexploited capacities of positive clinical psychology in Hungary

“…Furthermore, the controlling approach and the perception and treatment of the patient in an incompetent status remain in diff erent type of mental health care facilities. For example, if more attention is paid to strengths during rehabilitation, it will have an impact on the stigma associated with mental illness (Dubreucq et al, 2022) and, ultimately, on the severity of the symptoms of the illnesses. Sartorius' (1978) emblematic examination must be mentioned here which indicated that the clinical diagnosis on initial evaluation appeared to be a good predictor of subsequent symptomatology.…”

“…Sartorius' (1978) emblematic examination must be mentioned here which indicated that the clinical diagnosis on initial evaluation appeared to be a good predictor of subsequent symptomatology. A recent study showed (Dubreucq et al, 2022) that stigma resistance is associated with advanced stages of personal recovery in serious mental illness patients. Challenging stigma through activism was associated with fewer depressive symptoms (Marcussen et al, 2021).…”