The impact of stigma on emotional distress and recovery from psychosis: The mediatory role of internalised shame and self-esteem

Abstract

Internalised shame and self-esteem have both been proposed to play an integral role in the relationship between stigma and its negative psychological sequelae in people who experience psychosis, but there has been little quantitative exploration to examine their roles further. The aim of this study was to examine the relationship of stigma (experienced and perceived) with emotional distress and recovery in psychosis, and to examine internalised shame and self-esteem as potential mediators. A total of 79 participants were included for the purposes of this study. Participants were administered a battery of assessment measures examining experienced and perceived stigma, internalised shame, self-esteem, depression, hopelessness, and personal recovery. Results illustrated that stigma (experienced and perceived) was significantly associated with internalised shame, low self-esteem, depression, hopelessness and poor personal recovery. Stigma (experienced and perceived) and its relationship with depression, hopelessness and personal recovery was mediated by both internalised shame and low self-esteem. In conclusion, stigma can have significant negative emotional consequences and impede recovery in people with psychosis. This may indicate that stigma needs to be addressed therapeutically for people with psychosis with a particular emphasis on addressing internalised shame and low self-esteem.

Adaptation and preliminary psychometric properties of three self-stigma outcome measures for people living with dementia

“…The link between the appraisal of stigma as harmful (perceived harm subscale of the SSS) and social rejection and isolation was supported in the current study. However, the absence of a correlation between perceived harm and internalised shame was not predicted as previous mental health literature has found that internalised shame plays an integral role in shaping stigma experiences (40,48). In addition, the SSS total and the ability to cope subscales did not show correlations with internalised shame.…”

Adaptation and preliminary psychometric properties of three self-stigma outcome measures for people living with dementia

“…The link between the appraisal of stigma as harmful (perceived harm subscale of the SSS) and social rejection and isolation was supported in the current study. However, the absence of a correlation between perceived harm and internalized shame was not predicted as previous mental health literature has found that internalized shame plays an integral role in shaping stigma experiences (42,50). The SSS may not adequately measure the stigma stress appraisal process for people living with dementia.…”

Is sport an untapped resource for recovery from first episode psychosis? A narrative review and call to action

“…Although it is important to cater to the individual, adherence can be maximized through a combination of group and individual work (Ward, White, & Druss, 2015). In a recent qualitative exploration of the effects and determinants of exercise participation in people with FEP, Firth, Carney, Jerome, et al (2016) found both autonomy (eg, choosing the activity) and social support (eg, having an exercise buddy) to be critical factors in engaging participants; in contrast, anxiety and lack of motivation were key barriers.…”

“…In that way, sport is more powerful than politics” (Bailey, , p. 85). The reach of sport is especially important in regards to FEP recovery when the previously discussed stigmatising properties of psychotic illness are considered (eg, Wood, Byrne, Burke, Enache, & Morrison, ). Beyond its potential to be a uniting force, sport also offers many health benefits.…”