Self-Esteem and Stigma Among Persons With Schizophrenia: Implications for Mental Health

Department of Social Work, California State University, Long Beach, CA 90840-0902, USA.
Care Management Journals 02/2005; 6(3):139-44. DOI: 10.1891/cmaj.6.3.139
Source: PubMed


The purpose of the study was to examine the relationship between perceived stigma and self-esteem among adults with schizophrenia. The sample was drawn from three outpatient public mental health clinics in Southern California in September to November 2002. The following selection criteria were used to identify 31 respondents: (1) a diagnosis of schizophrenia and (2) stable symptoms. Self-esteem was measured using the Rosenberg Self-Esteem Scale. Stigma was measured using the Devaluation-Discrimination Measure. The strongest areas of stigma reported by those surveyed were related to hospitalization. The self-esteem of the respondents was moderately high. A Pearson's r correlation indicated that there was a significant, moderately strong correlation, with a higher level of perceived stigma associated with a lower level of self-esteem. Findings suggest that using a strengths-based approach and a recovery case management model is recommended to decrease stigma and promote self-esteem among persons with schizophrenia.

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    • "Among parents of Japanese middle and high school students, mean stigma scores before and after watching the educational program on schizophrenia were identical (32.8 ± 4.4), and our analysis comparing the distributions indicated that the pre- and post- program distributions were not significantly different (Wilcoxon signed-rank test P-value = 0.176). The scores of pre- and post-program stigma found in the present study were similar to the stigma score reported by Berge et al. (32.86 ± 6.22) [19], suggesting that the result of this study measured by Link’s Devaluation-Discrimination Scale is a typical result with little fluctuation among the general population. "
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    ABSTRACT: The stigma of schizophrenia constitutes a major barrier to early detection and treatment of this illness. Anti-stigma education has been welcomed to reduce stigma among the general public. This study examined the factors associated with the effectiveness of a web-based educational program designed to reduce the stigma associated with schizophrenia. Using Link's Devaluation-Discrimination Scale to measure stigma, the effect of the program was measured by the difference in pre- and post-program tests. In the present study, we focused on program participants whose stigma towards schizophrenia had considerably improved (a reduction of three points or more between pre- and post-program tests) or considerably worsened (an increase of three points or more). The study participants were 1,058 parents of middle or high school students across Japan, including 508 whose stigma had significantly decreased after the program and 550 whose stigma had significantly increased. We used multiple logistic regression analysis to predict a considerable reduction in stigma (by three or more points) using independent variables measured before exposure to the program. In these models, we assessed the effects of demographic characteristics of the participants and four measures of knowledge and views on schizophrenia (basic knowledge, Link's Devaluation-Discrimination Scale, ability to distinguish schizophrenia from other conditions, and social distance). Participants' employment status, occupation, basic knowledge of schizophrenia, pre-program Link's Devaluation-Discrimination Scale score, and social distance were significant factors associated with a considerable decrease in the stigma attached to schizophrenia following the educational program. Specifically, full-time and part-time employees were more likely to experience reduced stigma than parents who were self-employed, unemployed, or had other employment status. Considerable decreases in stigma were more likely among parents working in transportation and communication or as homemakers than among other occupational groups. In addition, parents with higher pre-program levels of stigma, lower basic knowledge, or lower social distance were more likely to have reduced levels of stigma. Based on the regression analysis results presented here, several possible methods of reducing stigma were suggested, including increasing personal contact with people with schizophrenia and the improvement of law and insurance systems in primary and secondary industries.
    Full-text · Article · Mar 2014 · BMC Public Health
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    • "Among parents of junior and senior high school students in Japan, the mean score for the Devaluation-Discrimination Measure was 32.74 ± 5.66, which is similar to the score reported by Berge et al. (32.86 ± 6.22) [5]. "
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    ABSTRACT: Stigma toward schizophrenia is a substantial barrier to accessing care and adhering to treatment. Provisions to combat stigma are important, but in Japan and other developed countries there are few such provisions in place that target parents of adolescents. The attitudes of parents are important to address as first schizophrenic episodes typically occur in adolescence. In overall efforts to develop an education program and provisions against stigma, here we examined the relationship between stigma toward schizophrenia and demographic characteristics of parents of junior and senior high school students in Japan. The specific hypothesis tested was that contact and communication with a person with schizophrenia would be important to reducing stigma. A questionnaire inquiring about respondent characteristics and which included a survey on stigma toward schizophrenia was completed by 2690 parents. The demographic characteristics significantly associated with the Devaluation- Discrimination Measure were family income, occupation, presence of a neighbor with schizophrenia, and participation in welfare activities for people with mental illness (p < 0.05). The mean ± SD score was 32.74 ± 5.66 out of a maximum of 48 points on the Link Devaluation-Discrimination Measure. Stigma toward schizophrenia among parents of junior and senior high school students was in fact significantly stronger among members of the general public who had had contact with individuals with schizophrenia. In addition, stigma was associated with family income.
    Full-text · Article · Dec 2011 · BMC Research Notes
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    • "However, the Japanese version of the DDM, a four-point Likert-type response scale (i.e., strongly agree, agree, disagree , and strongly disagree) was used. Because Link recommended that the two middle response categories be eliminated to simply it for the respondents, some studies changed the original six-point original scale to a four-point scale and have confirmed adequate internal consistency (Kurihara et al. 2000; Berge and Ranney 2005). The Japanese version also has adequate internal consistency and strong concurrent validity (Shimotsu et al. 2006). "
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    ABSTRACT: Mothers with mental illness have positive self-recognition of maternal role (PM), and it is important for parenting. The purpose of this study was to determine the psychosocial factors related to the PM. We recruited a total of 74 women diagnosed as having schizophrenia or mood disorders according to the DSM-IV-TR and who had minor children. Participant completed devaluation-discrimination measure, The social support questionnaire, self-efficacy for community life scale (SECL), parenting stress-short form scale (PS-SF), and Acceptance of maternal role scale. To identify factors predicting the PM, we utilized hierarchical regression analysis. The variables in all blocks explained 53% of the variance in the PM. In the final model, 'hard' living conditions (β = -0.31, P < 0.05), SECL (β = 0.34, P < 0.01) and PS-SF (β = -0.45, P < 0.01) were significant predictors of the PM. Our result indicates that psychosocial approach could enhance the PM.
    Full-text · Article · Oct 2011 · Community Mental Health Journal
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