The relationship between internalized stigma, negative symptoms and social functioning in schizophrenia: The mediating role of self-efficacy
Abstract
The broad aim of the present study was to gain a greater understanding of the processes that contribute to negative symptoms and social functioning in schizophrenia. More specifically, a theoretical model was proposed predicting that self-efficacy would mediate the relationship between internalized stigma and both negative symptoms and social functioning in schizophrenia. Initial analyses revealed that all variables were correlated. Specifically, internalized stigma was strongly correlated with negative symptoms, social functioning and self-efficacy. Furthermore, self-efficacy was strongly related to negative symptoms and moderately associated with social functioning. Further analyses however did not support the mediational role of self-efficacy. The theoretical and clinical implications of the findings, together with recommendations for future research, are outlined.
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Self-perception factors such as self-esteem, self-efficacy and internalised stigma are associated with poor social functioning in psychosis.
“Self‐perception factors included self‐esteem (Lysaker et al. 2007), self‐efficacy (Chang et al. 2017) and internalised stigma (Hill and Startup 2013; Lysaker et al. 2007).”
From Social Functioning Interventions in Psychosis: A Systematic Review. (2025) · cites this paper as Hill and Startup 2013
Cites
Lysaker, P. H., Roe, D., & Yanos, P. T. (2006) · Schizophrenia Bulletin · doi:10.1093/schbul/sbl016 · Cited by 688 · see citing works
STARTUP, M., JACKSON, M. C., EVANS, K. E., & BENDIX, S. (2005) · Psychological Medicine · doi:10.1017/s0033291705005003 · Cited by 43 · see citing works
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Dubreucq, J., Plasse, J., & Franck, N. (2021) · Schizophrenia Bulletin · doi:10.1093/schbul/sbaa181 · Cited by 358 · see citing works
Predictors of Relapse and Functioning in First-Episode Psychosis: A Two-Year Follow-Up Study
Bergé, D., Mané, A., Salgado, P., Cortizo, R., Garnier, C., Gomez, L., Diez-Aja, C., Bulbena, A., & Pérez, V. (2016) · Psychiatric Services · doi:10.1176/appi.ps.201400316 · Cited by 96 · see citing works
Levels of stigma among community mental health staff in Guangzhou, China
Li, J., Li, J., Thornicroft, G., & Huang, Y. (2014) · BMC Psychiatry · doi:10.1186/s12888-014-0231-x · Cited by 92 · see citing works
Grover, S., Singh, A., & Mattoo, S. (2016) · Indian Journal of Psychiatry · doi:10.4103/0019-5545.192024 · Cited by 61 · see citing works
Cavelti, M., Rüsch, N., & Vauth, R. (2014) · Journal of Nervous & Mental Disease · doi:10.1097/nmd.0000000000000160 · Cited by 60 · see citing works
Arnold, C., Farhall, J., Villagonzalo, K.-A., Sharma, K., & Thomas, N. (2021) · Internet Interventions · doi:10.1016/j.invent.2021.100411 · Cited by 34 · see citing works
“This internalised stigma may result in diminished self-esteem and self-efficacy for individuals with mental illness such as psychosis (Corrigan et al., 2006; Hill and Startup, 2013; Karakaş et al., 2016).”
BackgroundSocial Functioning Interventions in Psychosis: A Systematic Review.
Vinu, M., & Georgiades, A. (2025) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.70090 · Cited by 9 · see citing works
- Authors
- Hill, K., & Startup, M.
- Affiliations
- University of Newcastle Australia (AU)
- Corresponding author
- Startup, Mike
- ORCID
- Hill, Kimberley
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2013-04
- Volume
- 206
- Issue
- 2-3
- Pages
- 151-157
- ISSN
- 0165-1781 (ISSN-L)
- OpenAlex
- W2022195535
- Cited by
- 97
- References
- 2
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 4 · 2023: 6 · 2022: 3 · 2021: 14 · 2020: 9 · 2019: 9 · 2018: 13 · 2017: 4 · 2016: 10 · 2015: 5 · 2014: 7 · 2013: 3
- FWCI
- 3.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatry Research (publishedVersion)
- PubMed (publishedVersion)
- NOVA (University of Newcastle Australia) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- schizophrenia, self-stigma, negative symptoms, social functioning, self-efficacy, mediation, stigma
- MeSH terms
- Adult, Female, Humans, Male, Middle Aged, Psychotic Disorders, Surveys and Questionnaires, Schizophrenia, Schizophrenic Psychology, Self Concept, Social Adjustment, Social Behavior, Stereotyping, Self Efficacy, Young Adult, Social Stigma, Anhedonia
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