Self-Stigma and Its Relationship with Victimization, Psychotic Symptoms and Self-Esteem among People with Schizophrenia Spectrum Disorders

Ellen M. A. Horsselenberg*, Jooske T. van Busschbach, Andre Aleman, Gerdine H.M. Pijnenborg

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

7 Citations (Scopus)
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Abstract

Objective

Self-stigma is highly prevalent in schizophrenia and can be seen as an important factor leading to low self-esteem. It is however unclear how psychological factors and actual adverse events contribute to self-stigma. This study empirically examines how symptom severity and the experience of being victimized affect both self-stigma and self-esteem.

Methods

Persons with a schizophrenia spectrum disorder (N = 102) were assessed with a battery of self-rating questionnaires and interviews. Structural equation modelling (SEM) was subsequently applied to test the fit of three models: a model with symptoms and victimization as direct predictors of self-stigma and negative self-esteem, a model with an indirect effect for symptoms mediated by victimization and a third model with a direct effect for negative symptoms and an indirect effect for positive symptoms mediated by victimization.

Results

Results showed good model fit for the direct effects of both symptoms and victimization: both lead to an increase of self-stigma and subsequent negative self-esteem. Negative symptoms had a direct association with self-stigma, while the relationship between positive symptoms and self-stigma was mediated by victimization.

Conclusions

Our findings suggest that symptoms and victimization may contribute to self-stigma, leading to negative self- esteem in individuals with a schizophrenia spectrum disorder. Especially for patients with positive symptoms victimization seems to be an important factor in developing self- stigma. Given the burden of self- stigma on patients and the constraining effects on societal participation and service use, interventions targeting victimization as well as self- stigma are needed.

Original languageEnglish
Article numbere0149763
Number of pages13
JournalPLoS ONE
Volume11
Issue number10
DOIs
Publication statusPublished - 26-Oct-2016

Keywords

  • SEVERE MENTAL-ILLNESS
  • POSTTRAUMATIC-STRESS-DISORDER
  • INTERNALIZED STIGMA
  • CRIMINAL VICTIMIZATION
  • VIOLENT VICTIMIZATION
  • NEGATIVE SYMPTOMS
  • TRAUMA
  • SCALE
  • INDIVIDUALS
  • RELIABILITY

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