title: Predictors of Self-Stigma in Schizophrenia: New Insights Using Mobile Technologies.
abstract: Self-stigma has significant negative impact on the recovery of individuals with severe mental illness, but its varying course is not well understood. Individual levels of self-stigma may vary over time and fluctuate in response to both external/contextual (i.e., location, activity, social company) and internal (i.e., psychiatric symptoms, mood) factors. The aim of this study was to examine the relationship between self-stigmatizing beliefs and these factors, as they occur in the daily life of individuals with schizophrenia.
  
  
  
  Mobile technologies were used to longitudinally track momentary levels of self-stigma, psychotic symptoms, negative affect, positive affect, activity, and immediate social and physical environment in twenty-four individuals with schizophrenia, multiple times daily, over a one-week period.
  
  
  
  Multilevel modeling showed that participants' current activity was associated with changes in self-stigma (χ2= 10.53,p<0.05), but immediate location and social company were not. Time-lagged analyses found that increases in negative affect (β=0.11,p<0.01) and psychotic symptom severity (β=0.16,p<0.01) predicted increases in the intensity of self-stigmatizing beliefs. Psychotic symptoms were found to be both an antecedent and a consequence (β=0.08,p<0.01) of increased self-stigma.
  
  
  
  Our findings support a framework for understanding self-stigma as an experience that changes based on alterations in internal states and external circumstances. Mobile technologies are an effective methodology to study self-stigma and have potential to be used to deliver clinical interventions.
authors: Thresholds-Dartmouth Research Center, Chicago, Illinois, USA ; Dartmouth Psychiatric Research Center, Department of Psychiatry, The Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.
authors: Dror
authors: D
authors: Ben-Zeev
authors: Rochelle
authors: R
authors: Frounfelker
authors: Scott B
authors: SB
authors: Morris
authors: Patrick W
authors: PW
authors: Corrigan
keywords: ecological momentary assessment (EMA); mHealth; mobile technologies; schizophrenia; stigma