title: Change in self-stigma among persons with schizophrenia enrolled in rehabilitation: associations with self-esteem and positive and emotional discomfort symptoms.
abstract: Self-stigma is a barrier to the recovery of persons with schizophrenia. Little is known about whether participation in rehabilitation is naturalistically linked to declines in self-stigma, and if so, what is correlated with changes in self-stigma. The current study examined in a quasi-experimental design the rate of change of self-stigma and whether changes were correlated with self-esteem, positive symptoms, and emotional distress for persons enrolled in rehabilitation. Symptoms were measured using the Positive and Negative Syndrome Scale (Kay, Fizsbein, & Opler, 1987), self-esteem was measured with the Multidimensional Self-Esteem Inventory (Lysaker, Ringer, & Davis, 2008), and self-stigma was assessed using the Internalized Stigma of Mental Illness Scale (Ritsher, Otilingam, & Grajales, 2003). Seventy persons with schizophrenia who worked at least one month in a vocational rehabilitation program were assessed on all measures at baseline and five months later. Results indicated a 25% decrease in self-stigma for 38% of the sample; these individuals tended to have less emotional distress both at baseline and follow-up, and had higher levels of self-esteem at follow-up. No differences in positive symptoms were found for groups whose stigma did or did not decrease. Results suggest that decreases in self-stigma may be correlated with increased self-esteem, while higher levels of emotional distress may be a barrier to stigma reduction.
authors.affiliation: Roudebush VA Medical Center.
authors.forename: Paul H
authors.identifier: 0000-0002-6617-9387
authors.initials: PH
authors.lastname: Lysaker
authors.affiliation: Department of Community Mental Health, Faculty of Social Welfare and Health Science, University of Haifa.
authors.forename: David
authors.identifier: 0000-0002-6197-0989
authors.initials: D
authors.lastname: Roe
authors.affiliation: Roudebush VA Medical Center.
authors.forename: Jamie
authors.initials: J
authors.lastname: Ringer
authors.affiliation: School of Psychological Science, University of Indianapolis.
authors.forename: Emily M
authors.initials: EM
authors.lastname: Gilmore
authors.affiliation: Psychology Department, John Jay College of Criminal Justice, City University of New York.
authors.forename: Philip T
authors.initials: PT
authors.lastname: Yanos
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012050:Rehabilitation, Vocational / Q000523:psychology*; D012559:Schizophrenia / Q000534:rehabilitation*; D012565:Schizophrenic Psychology; D012649:Self Concept; D057545:Social Stigma; D016896:Treatment Outcome