Perceptions of stigma in youth at clinical high risk for psychosis and depressive symptomatology

Luz Maria Alliende; Gregory P Strauss; Lawrence H Yang; Vijay Anand Mittal

doi:10.1016/j.schres.2024.04.023

Perceptions of stigma in youth at clinical high risk for psychosis and depressive symptomatology

Schizophr Res. 2024 May 15:269:79-85. doi: 10.1016/j.schres.2024.04.023. Online ahead of print.

Authors

Luz Maria Alliende¹, Gregory P Strauss², Lawrence H Yang³, Vijay Anand Mittal⁴

Affiliations

¹ Department of Psychology, Northwestern University, Evanston, IL, USA. Electronic address: alliende@u.northwestern.edu.
² Department of Psychology, University of Georgia, Athens, GA, USA.
³ Department of Social and Behavioral Sciences, School of Global Public Health, New York University, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, USA.
⁴ Department of Psychology, Northwestern University, Evanston, IL, USA.

PMID: 38754312
DOI: 10.1016/j.schres.2024.04.023

Abstract

It is unclear what types of stigma youth at clinical high risk for psychosis (CHR) experience, and the relationship between them and symptomatology. 94 CHR youth, and a control group of 45 youth with no psychosis spectrum symptoms (NP) were rated for perceived devaluation (i.e. negative views from others) and internalized mental health stigma (i.e. the extent to which they would agree with said views) as well as positive and mood symptomatology. CHR youth reported stigma more frequently than the NP group (χ²(1) = 53.55, p < .001) and at higher levels (perceived devaluation: t (137) = 8.54, p < .001; internalized stigma: t (137) = 7.48, p < .001). Surprisingly, in the CHR group, positive symptoms held no significant relationship to stigma measures. However, ratings of perceived devaluation stigma were associated with depressive symptomatology (β = 0.27, t = 2.68, p = .0087) and depression scores were conversely associated with perceived devaluation stigma (β = 0.30, t = 2.05, p = .043). These findings speak to the relationship between depressive symptomatology and perceived devaluation stigma in CHR youth. Perceived devaluation stigma showed greater clinical significance and could have different mechanisms than internalized stigma in CHR youth. It is also noteworthy that while positive symptoms play a central role in defining the CHR syndrome, they seem less relevant to the experience of stigma than mood symptoms. These findings highlight the importance of interventions aimed at ameliorating youth's exposure to negative views about mental health as those managing depressive symptomatology.

Keywords: Clinical high risk for psychosis; Depression; Internalized stigma; Perceived devaluation stigma; Positive symptoms; Stigma.