Stigma related to labels and symptoms in individuals at clinical high-risk for psychosis
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Background Despite advances that the psychosis "clinical high-risk" (CHR) identification offers, risk of stigma exists. Awareness of and agreement with stereotypes has not yet been evaluated in CHR individuals. Furthermore, the relative stigma associated with symptoms, as opposed to the label of risk, is not known, which is critical because CHR identification may reduce symptom-related stigma.Methods Thirty-eight CHR subjects were ascertained using standard measures from the Center of Prevention and Evaluation/New York State Psychiatric Institute/ Columbia University. Labeling-related measures adapted to the CHR group included "stereotype awareness and self-stigma" ("Stereotype awareness", "Stereotype Agreement", "Negative emotions [shame]"), and a parallel measure of "Negative emotions (shame)" for symptoms. These measures were examined in relation to symptoms of anxiety and depression, adjusting for core CHR symptoms (e.g. attenuated psychotic symptoms).Results CHR participants endorsed awareness of mental illness stereotypes, but largely did not themselves agree with these stereotypes. Furthermore, CHR participants described more stigma associated with symptoms than they did with the risk-label itself. Shame related to symptoms was associated with depression, while shame related to the risk-label was associated with anxiety.Conclusion Both stigma of the risk-label and of symptoms contribute to the experience of CHR individuals. Stereotype awareness was relatively high and labeling-related shame was associated with increased anxiety. Yet limited agreement with stereotypes indicated that labeling-related stigma had not fully permeated self-conceptions. Furthermore, symptom-related stigma appeared more salient overall and was linked with increased depression, suggesting that alleviating symptom-related shame via treating symptoms might provide major benefit.
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Acceptability of help-seeking may be undermined by close friends, family, colleagues and health professionals, further limiting sources of support.
“Acceptability of help-seeking may also be undermined by close friends, family, colleagues and health professionals which further limit sources of support. (6)”
From The impact of digital interventions on help-seeking behaviour for mental health problems: a systematic literature review (2022) · cites this paper as [6]
The Discussion (section 4.1; page unavailable) describes anticipated rejection and shame about others discovering a person’s clinical-high-risk status. The Methods (section 2.3; page unavailable) assess interpersonal stigma and perceived support. Neither passage says that friends, family, colleagues or health professionals undermine the acceptability of help-seeking or thereby limit sources of support. (LLM, conf=0.78)
Experimental — accuracy not yet measuredStigma is caused by the service user's experience of symptoms rather than induced by the clinician's designation.
“caused by the service user's experience of symptoms rather than induced by the clinician's designation 265”
From Preventive psychiatry: a blueprint for improving the mental health of young people (2021) · cites this paper as [265]
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- Authors
- Yang, L. H., Link, B. G., Ben-David, S., Gill, K. E., Girgis, R. R., Brucato, G., Wonpat-Borja, A. J., & Corcoran, C. M.
- Affiliations
- Columbia University Irving Medical Center (US)
- University of California, Riverside (US)
- Catholic University of America (US)
- New York State Psychiatric Institute (US)
- Columbia University (US)
- Corresponding author
- Yang, Lawrence H.
- Venue
- Schizophrenia Research
- Publisher
- Elsevier BV
- Published
- 2015-10
- Volume
- 168
- Issue
- 1-2
- Pages
- 9-15
- ISSN
- 0920-9964 (ISSN-L)
- PMC
- PMC4751087
- OpenAlex
- W2095846026
- Cited by
- 95
- References
- 43
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 12 · 2023: 8 · 2022: 8 · 2021: 13 · 2020: 6 · 2019: 11 · 2018: 10 · 2017: 6 · 2016: 8 · 2015: 2 · 2012: 1
- FWCI
- 7.03
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Schizophrenia Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- NIMH (1 R01 MH096027-01, K23 MH06627901A2)
- Brain and Behavior Research Foundation Young Investigator Award (#17539)
- Rollin M. Gerstacker Foundation
- Calderone Prize
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
- Keywords
- clinical high risk for psychosis
- MeSH terms
- Adolescent, Awareness, Child, Female, Humans, Male, Psychiatric Status Rating Scales, Psychotic Disorders, Self Concept, Stereotyping, Risk Assessment, Young Adult, Social Stigma, Prodromal Symptoms
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