Internalized stigma in the 'high-risk' for psychosis designation and effects on symptoms and functioning

 
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Presentation First Author: 
Lawrence H. Yang
Abstract: 

Aim: Despite the benefits of a 'high-risk for psychosis (HRP) diagnosis in the early detection of psychosis, a risk of stigma exists among the >65% of subjects identified who may not progress to psychosis. Psychosis risk may activate stereotypes associated with 'schizophrenia, thus initiating psychological symptoms, treatment nonadherence, and social exclusion. We hypothesize, in one of the first studies of stigma in this group, that stigma will be associated with difficulties in symptoms and functioning. Methods: Forty (n=40) HRP subjects were recruited from 2010-2014 from Columbia Universitys Center of Prevention and Evaluation. Cases were identified using the Structured Interview for Prodromal Syndromes. Internalized stigma measures included Stereotype Awareness, Stereotype Agreement, and Stigma engulfment (when stigma becomes fully internalized). Functioning and symptomatology were measured by: 1) Social Adjustment Scale ; 2) Social Functioning Scales ; 3) Social Anxiety Scale; 4) Beck Depression Inventory. Results: Patients were ethnically diverse, 62.5% were male, with mean 21.8 (3.3) years. Subjects completed 13.1 (2.0) years of schooling. 72.5% were employed. Subjects endorsed some internalized stigma, such as agreeing with negative stereotypes including dangerousness to others (65% agreed) and trouble taking care of oneself (77.5% agreed). 87.5% of subjects reported feeling different from others due to labeling. When examining symptoms and functioning, only the most severe form of internalized stigma, stigma engulfment was significantly correlated with social adjustment, social anhedonia, depression, and social anxiety. Conclusions: Modifying internalized stigma before it reaches more severe stages may ameliorate difficulties in functioning and symptomatology.

Conference Name: 
Presentation Date: 
January, 2015
Additional Authors: 
Bruce G. Link - Ahtoy J. WonPat-Borja - Shelly B. David - Kelly Gill - Cheryl M. Corcoran
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