title: Empirical Studies of Self-Stigma Reduction Strategies: A Critical Review of the Literature.
abstract: OBJECTIVE
  The purpose of this article was to comprehensively review published literature about strategies to reduce self-stigma among people with mental illness. Recommendations and implications for research also are discussed.
  
  
  METHODS
  The electronic databases of Ovid, PubMed, and PsycINFO were searched for peer-reviewed articles published between January 2000 and August 2011 by using the key words “self-stigma,” “internalized stigma,” “perceived stigma,” and “stigma intervention.” The search was further narrowed to studies that described a detailed intervention and that used self-stigma as a primary or secondary outcome, tested the intervention among individuals with a psychiatric illness, and analyzed data quantitatively with acceptable statistical tools.
  
  
  RESULTS
  Fourteen articles met inclusion criteria, and eight reported significant improvement in self-stigma outcomes. Participants predominantly had schizophrenia and related disorders or depression. Six self-stigma reduction strategies were identified. Psychoeducation was the most frequently tested intervention. Self-stigma definitions, measurements, and conceptual frameworks varied considerably across these studies. Several studies lacked a theoretical framework for their intervention. Six different scales were used to measure self-stigma.
  
  
  CONCLUSIONS
  Two prominent approaches for self-stigma reduction emerged from our review: one, interventions that attempt to alter the stigmatizing beliefs and attitudes of the individual; and two, interventions that enhance skills for coping with self-stigma through improvements in self-esteem, empowerment, and help-seeking behavior. The second approach seems to have gained traction among stigma experts. Targeting high-risk groups to preempt self-stigma appears to be a promising area for future research.
authors.affiliation: Department of Psychiatry, Central Arkansas Veterans Healthcare System, Building 58 (152/NLR), 2200 Fort Roots Dr., Little Rock, AR 72114, USA. dinesh.mittal@va.gov
authors.forename: Dinesh
authors.initials: D
authors.lastname: Mittal
authors.forename: Greer
authors.initials: G
authors.lastname: Sullivan
authors.forename: Lakshminarayana
authors.initials: L
authors.lastname: Chekuri
authors.forename: Elise
authors.initials: E
authors.lastname: Allee
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Corrigan
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001294:Attitude to Health; D003866:Depressive Disorder / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D028642:Persons with Psychiatric Disorders / Q000523:psychology*; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D012559:Schizophrenia; D012565:Schizophrenic Psychology; D012649:Self Concept; D013240:Stereotyping; D055815:Young Adult