Modeling self-agency among people with schizophrenia: empirical evidence for consumer-based recovery

Abstract

Background: Self-agency--the awareness of one's own capacity to make decisions and to engage in deliberate action - is often interfered with or lost during the course of severe mental illness. Most existing literature on self-agency is either of experimental or qualitative nature, and empirical evidence is scanty.

Sampling and methods: This paper draws on a subset of empirical data from a larger recovery study that involved 204 people with schizophrenia in the community. Structural equation models are built to contrast the models with and without the contribution of self-agency.

Results: The self-agency factor loads significantly on variables from five major areas of recovery (hope, empowerment, resilience, self-responsibility and self-mastery). Structural equation models show that the incorporation of this self-agency construct has vastly improved the modeling of the adverse effect of stigma on the quality of life of these subjects. The model with self-agency fitted the criteria better, and explained more total variance (increased from 56 to 80%) for the quality of life of these subjects.

Conclusions: Cross-sectional empirical findings appear to support the claim that self-agency is an important construct that cuts through many dimensions of recovery. Initial discussions are made on the nature and function of self-agency, and its relations with recovery concepts and components.