An integrative model of internalized stigma and recovery-related outcomes among people diagnosed with schizophrenia in rural China

• Published in: Social Psychiatry and Psychiatric Epidemiology Vol. 54; no. 8; pp. 911 - 918
• Main Authors: Zhang, Tian-Ming, Wong, Irene Yin-Ling, Yu, Yue-Hui, Ni, Shi-Guang, He, Xue-Song, Bacon-Shone, John, Gong, Ke, Huang, Chao-Hua, Hu, Yan, Tang, Ming-Min, Cao, Wan, Chan, Cecilia Lai-Wan, Ran, Mao-Sheng
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 12.08.2019; Springer; Springer Nature B.V
• Subjects: Analysis; Economic conditions; Epidemiology; Low income groups; Marital status; Medicine; Medicine & Public Health; Mental disorders; Original Paper; Patient outcomes; Psychiatry; Recovery; Rural communities; Schizophrenia; Social aspects; Social factors; Social integration; Social interaction; Social support; Stigma; Symptoms; Internalized stigma; People diagnosed with schizophrenia; Rural China; Recovery
• ISSN: 0933-7954; 1433-9285
• DOI: 10.1007/s00127-018-1646-3

Purpose Internalized stigma, an adverse psychological process, severely impedes the lives of people diagnosed with schizophrenia and restricts them from social integration and recovery. The aim of this study was to empirically evaluate an integrative model of relationship between internalized stigma and patients’ recovery-related outcomes among people diagnosed with schizophrenia in a rural Chinese community. Method A total of 232 people diagnosed with schizophrenia in Xinjin, Chengdu, participated in this study and completed measures of internalized stigma, social interaction, perceived social support, social functioning, and symptoms. The internalized stigma of mental illness scale (ISMI) was used to measure the internalized stigma. Path analysis was used to test the association between internalized stigma and recovery-related outcomes. Results There were no significant differences in mean scores of ISMI by gender, age (18–64 years and ≥ 65 years), education, marital status, or economic capacity. Internalized stigma was negatively associated with perceived social support and social interaction. Furthermore, higher level of internalized stigma was associated with impaired social functioning, and a lower level of social functioning was significantly associated with more severe symptoms. Conclusion Internalized stigma is associated with poor social interaction and weakened perceived social support in people diagnosed with schizophrenia, and is linked negatively to outcomes in their recovery. It is essential to tailor interventions related to reducing internalized stigma within a Chinese context and evaluate the effectiveness of anti-stigma intervention on recovery for people diagnosed with schizophrenia.