Measuring self-stigma of mental illness in China and its implications for recovery.
ABSTRACT This study translated and validated the Chinese Version of the Self-stigma of Mental Illness Scale (CSSMIS), which may be used to measure self-stigma of mental health consumers in China. We also examined its correlation with self-esteem, self-efficacy and psychosocial treatment compliance. A cross-sectional observational study was implemented. Some 51 males and 57 females who suffered from severe mental illness were recruited from psychiatric settings in Hong Kong. They were required to complete the Chinese Version of the Self-stigma of Mental Illness Scale, the Rosenberg Self-esteem Scale and the Self-efficacy Scale. Their level of compliance during psychosocial treatment and their demographic information were recorded by their case managers. Exploratory factor analysis revealed two homologous factors for the four subscales of the CSSMIS. Factor 1 was related to the negative beliefs and consequences of having mental disorders, whereas Factor 2 was related to positive beliefs. The perceived stigma subscale and the three self-stigma subscales were strongly inter-correlated. Significant correlations were also found between almost all subscales of the CSSMIS and the remaining scales. The psychometric properties of the CSSMIS are statistically acceptable. The results also suggest that stigma played a detrimental role in undermining self-esteem, self-efficacy and psychosocial treatment compliance. Implications for recovery of mental health consumers are discussed.
- SourceAvailable from: Amy Elizabeth SickelAdvances in Mental Health. 12/2014; 12(3):202-215.
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ABSTRACT: Background. Up to 75% of patients suffering from schizophrenia do not take their antipsychotic medication in the way it is prescribed. Nonadherence has been shown to be associated with poorer therapy outcomes, higher hospitalization rates, and increased costs for health care systems. One important contributing factor to negative attitudes toward medication adherence may be self-stigmatization. Methods. 23 inpatients with a schizophrenia spectrum disorder, all receiving antipsychotic treatment, were assessed for attitude toward medication adherence (using the Rating of Medication Influences [ROMI] scale), subjective well-being under medication (using the Subjective Well-Being under Neuroleptics Scale), and self-stigmatization (using the Internalized Stigma of Mental Illness Inventory). Multiple linear regression analyses were used to predict attitude toward medication adherence from demographic and clinical data and level of self-stigmatization. Results. Patients' gender and their level of self-stigmatization explained 29% of the variance in total attitude toward medication. Inclusion of the self-stigmatization subscore for alienation resulted in an increase of explained variance to 36%. Follow-up analyses of the ROMI pro-adherence subscale scores revealed no correlations with any assessed variables. In contrast, 70% of the variance in the ROMI nonadherence subscale scores was explained by greater alienation, higher number of experienced side effects, less subjective well-being under medication, and female gender. Conclusions. Our findings imply that reducing the extent of self-stigmatization, especially the feeling of being alienated from society, could improve a negative attitude toward medication adherence in psychosis patients. Cognitive-behavioral therapy offers a variety of therapeutic strategies that could support patients in developing a more positive self-image and in more readily accepting antipsychotic medication as a tool for reaching personal life goals. (Journal of Psychiatric Practice 2014;20:405-410).Journal of Psychiatric Practice 09/2014; 20(5):405-410. · 1.35 Impact Factor
- Advances in Mental Health 01/2014; 12(3):202-215.