Toward Understanding the Insight Paradox: Internalized Stigma Moderates the Association Between Insight and Social Functioning, Hope, and Self-esteem Among People with Schizophrenia Spectrum Disorders
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Research has paradoxically linked awareness of illness to both better function outcomes and lesser hope and self-esteem. One possible explanation for these findings is that acceptance of having schizophrenia may impact outcomes differently depending on the meanings the person attaches to this acceptance, particularly whether he or she accepts stigmatizing beliefs about mental illness. To explore this possibility we performed a cluster analysis of 75 persons with schizophrenia spectrum disorders based on single measures of insight using the Positive and Negative Syndrome Scale, internalized stigma using the Internalized Stigma of Mental Illness Scale, and compared groups on concurrent assessments of hope and self-esteem. Three groups were produced by the cluster analyses: low in sight/mild stigma (n = 23), high insight/minimal stigma (n = 25), and high insight/moderate stigma (n = 27). As predicted, analysis of variance-comparing groups revealed that the high insight/moderate stigma group had significantly the lowest levels of hope on the Beck Hopelessness Scale and self-esteem using the Multidimensional Self-esteem Inventory. As predicted, the high insight/minimal stigma group also had significantly less impaired social function than the other groups. Implications for assisting persons to come to cope with awareness of illness and stigma are discussed.
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Good clinical insight may produce distress and compromise well-being (the insight paradox).
“In what may be referred to as the”
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 [75]
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Self-citation
- Authors
- Lysaker, P. H., Roe, D., & Yanos, P. T.
- Affiliations
- Richard L. Roudebush VA Medical Center (US)
- University of Medicine and Dentistry of New Jersey (US)
- Rutgers, The State University of New Jersey (US)
- Corresponding author
- Lysaker, P. H.
- Venue
- Schizophrenia Bulletin
- Publisher
- Oxford University Press (OUP)
- Published
- 2006-12-07
- Volume
- 33
- Issue
- 1
- Pages
- 192-199
- ISSN
- 0586-7614 (ISSN-L)
- 1745-1701
- PMC
- PMC2012366
- OpenAlex
- W2162981648
- Cited by
- 688
- References
- 57
- Citations by year
- 2026: 24 · 2025: 22 · 2024: 39 · 2023: 35 · 2022: 18 · 2021: 37 · 2020: 46 · 2019: 41 · 2018: 51 · 2017: 43 · 2016: 53 · 2015: 36 · 2014: 45 · 2013: 43 · 2012: 47
- FWCI
- 11.50
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Schizophrenia Bulletin (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (K23MH066973)
- 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
- insight, self-stigma
- MeSH terms
- Adaptation, Psychological, Adult, Awareness, Culture, Female, Humans, Internal-External Control, Male, Middle Aged, Motivation, Personality Inventory, Prejudice, Psychiatric Status Rating Scales, Schizophrenia, Schizophrenic Psychology, Self Concept, Sick Role, Social Adjustment, Outcome Assessment, Health Care
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