title: Impact of cognitive therapy on internalised stigma in people with at-risk mental states.
abstract: BACKGROUND
  Internalised stigma in young people meeting criteria for at-risk mental states (ARMS) has been highlighted as an important issue, and it has been suggested that provision of cognitive therapy may increase such stigma.
  
  
  OBJECTIVE
  To investigate the effects of cognitive therapy on internalised stigma using a secondary analysis of data from the EDIE-2 trial.
  
  
  METHODS
  Participants meeting criteria for ARMS were recruited as part of a multisite randomised controlled trial of cognitive therapy for prevention and amelioration of psychosis. Participants were assessed at baseline and at 6, 12, 18 and 24 months using measures of psychotic experiences, symptoms and internalised stigma.
  
  
  RESULTS
  Negative appraisals of experiences were significantly reduced in the group assigned to cognitive therapy (estimated difference at 12 months was -1.36 (95% CI -2.69 to -0.02), P = 0.047). There was no difference in social acceptability of experiences (estimated difference at 12 months was 0.46, 95% CI -0.05 to 0.98, P = 0.079).
  
  
  CONCLUSIONS
  These findings suggest that, rather than increasing internalised stigma, cognitive therapy decreases negative appraisals of unusual experiences in young people at risk of psychosis; as such, it is a non-stigmatising intervention for this population.
authors.affiliation: School of Psychological Sciences, University of Manchester and Greater Manchester West Mental Health NHS Foundation Trust, Manchester, UK. tony.morrison@manchester.ac.uk
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Morrison
authors.forename: Max
authors.initials: M
authors.lastname: Birchwood
authors.forename: Melissa
authors.initials: M
authors.lastname: Pyle
authors.forename: Clare
authors.initials: C
authors.lastname: Flach
authors.forename: Suzanne L K
authors.initials: SL
authors.lastname: Stewart
authors.forename: Rory
authors.initials: R
authors.lastname: Byrne
authors.forename: Paul
authors.initials: P
authors.lastname: Patterson
authors.forename: Peter B
authors.initials: PB
authors.lastname: Jones
authors.forename: David
authors.initials: D
authors.lastname: Fowler
authors.forename: Andrew I
authors.initials: AI
authors.lastname: Gumley
authors.forename: Paul
authors.initials: P
authors.lastname: French
mesh_terms: D000293:Adolescent; D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care; D011618:Psychotic Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D012307:Risk Factors; D012649:Self Concept; D016037:Single-Blind Method; D057545:Social Stigma; D016896:Treatment Outcome