Insight in paranoia: The role of experiential avoidance and internalized stigma
Abstract
Evidence suggests that insight in psychosis has been related to treatment adherence, recovery and good prognosis, but also to depression, low self-esteem, and diminished quality of life. Thus, insight might not be advantageous under all circumstances. Internalized-stigma (i.e. self-acceptance of stigmatizing images of illness) and experiential avoidance (i.e. unwillingness to experience negative private events) have been proposed as moderating variables between insight, and psychological health variables and/or distress. We investigated the patterns of association of insight with satisfaction with life, self-esteem, depression, anxiety and psychotic psychopathology as moderated by self-stigmatizing beliefs and experiential avoidance, in a sample of 47 participants with persecutory beliefs and diagnosed with schizophrenia or other psychotic disorder. Moderation analyses confirm the importance of internalized-stigma and experiential avoidance. The presence of insight was associated with more depression when there were high levels of self-stigma. Whereas, the absence of insight was associated with a greater life satisfaction when there were high levels of experiential avoidance. To summarize, our results help understand the complex relationship between insight, psychological health variables and emotional distress, pointing to a differential pattern of moderation for negative and positive outcomes. We discuss the implications of these results for research and treatment of paranoia.
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The link between insight and depression is mediated by self-stigma.
“Replicating earlier research 75 , several groups have found that the link between insight and depression was mediated by self-stigma [82][83][84] .”
From Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments (2018) · cites this paper as [84]
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- Authors
- Valiente, C., Provencio, M., Espinosa, R., Duque, A., & Everts, F.
- Affiliations
- Universidad Complutense de Madrid (ES)
- Corresponding author
- Valiente, Carmen
- Venue
- Schizophrenia Research
- Publisher
- Elsevier BV
- Published
- 2015-05
- Volume
- 164
- Issue
- 1-3
- Pages
- 214-220
- ISSN
- 0920-9964 (ISSN-L)
- OpenAlex
- W2097032204
- Cited by
- 34
- References
- 52
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 3 · 2023: 1 · 2022: 5 · 2021: 4 · 2020: 8 · 2019: 2 · 2018: 3 · 2017: 3 · 2016: 1
- FWCI
- 1.89
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Schizophrenia Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- I+D+I Spanish Ministry of Education and Science (PSI2009-13472, PSI2012-31494)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
- Keywords
- insight, paranoia
- MeSH terms
- Adult, Depression, Female, Humans, Male, Paranoid Disorders, Psychiatric Status Rating Scales, Surveys and Questionnaires, Schizophrenia, Schizophrenic Psychology, Self Concept, Young Adult, Social Stigma
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