title: Association of stigma resistance with emotion regulation - functional magnetic resonance imaging and neuropsychological findings.
abstract: BACKGROUND
  [corrected] Personal characteristics contribute to whether negative attitudes in society are internalized as deteriorating self-stigma. Studies in healthy subjects suggest that resilience is associated with the regulation of amygdala activation by the medial prefrontal cortex (mPFC), but little is known about the factors that contribute to individual stigma resistance in psychiatric patients.
  
  
  METHODS
  We assessed stigma (by measuring association strengths between social inferiority and schizophrenia by an implicit association test) in 20 patients with schizophrenia and in 16 age- and sex-matched healthy control subjects. The brain activation strengths were measured by functional magnetic resonance imaging during evaluation of schizophrenia-related statements and of control statements.
  
  
  RESULTS
  Association strengths between social inferiority and schizophrenia were inversely related to the strength of the activation of the rostro-ventral mPFC. This inverse correlation survived adjustment for global functioning, depression symptom scores, and insight. Activation of the rostro-ventral mPFC was negatively correlated with activation of the amygdala. The association strengths between social inferiority and schizophrenia correlated with the compromised performance in a Stroop task, which is a measure of cognitive regulation.
  
  
  CONCLUSIONS
  Our findings suggest that individual stigma resistance is associated with emotion regulation. These findings may help to understand better stigma resistance and thereby aid the development of patient interventions that add to the public anti-stigma work in reducing devastating effects of stigma.
authors.affiliation: Department of Psychiatry, University of Helsinki and Helsinki University Central Hospital, Finland; Brain Research Unit, O.V. Lounasmaa Laboratory and Advanced Magnetic Imaging Centre, Aalto University, Finland. Electronic address: raijtu@neuro.hut.fi.
authors.forename: Tuukka T
authors.initials: TT
authors.lastname: Raij
authors.affiliation: Department of Psychiatry, University of Turku; Harjavalta Hospital, Satakunta Hospital district, Finland.
authors.forename: Jyrki
authors.initials: J
authors.lastname: Korkeila
authors.affiliation: Department of Psychiatry, University of Helsinki and Helsinki University Central Hospital, Finland; National institute for health and welfare, department of mental health and substance abuse services, Helsinki, Finland.
authors.forename: Kaisla
authors.initials: K
authors.lastname: Joutsenniemi
authors.affiliation: Department of Psychiatry, University of Helsinki and Helsinki University Central Hospital, Finland; National institute for health and welfare, department of mental health and substance abuse services, Helsinki, Finland.
authors.forename: Samuli I
authors.initials: SI
authors.lastname: Saarni
authors.affiliation: Institute of Behavioural Sciences, University of Helsinki, Finland.
authors.forename: Tapani J J
authors.initials: TJ
authors.lastname: Riekki
mesh_terms: D000328:Adult; D001244:Association; D001921:Brain / Q000503:physiopathology*; D004644:Emotions / Q000502:physiology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D055500:Resilience, Psychological; D012559:Schizophrenia / Q000503:physiopathology*; D012565:Schizophrenic Psychology; D057545:Social Stigma; D055815:Young Adult