Spontaneous labelling and stigma associated with clinical characteristics of peers 'at-risk' for psychosis

Early Interv Psychiatry. 2014 Aug;8(3):247-52. doi: 10.1111/eip.12047. Epub 2013 Apr 18.

Abstract

Aim: The public health benefits of utilizing an 'at-risk for psychosis' designation are tempered by concerns about stigma. It is therefore of interest to examine whether symptoms associated with this designation might spontaneously induce labels associated with a psychotic disorder, other non-psychotic disorders or non-psychiatric labels. This pilot study explored the labels associated with characteristics of 'high risk for psychosis' and the corresponding stigma level.

Methods: A vignette describing an identical character, followed by a series of questions about stigmatizing attitudes towards the vignette character, was administered in the present investigation.

Results: The results indicated that even though most young people (59%) did not spontaneously label the vignette character with psychotic-like diagnostic labels, the single most frequent label provided was 'paranoid/a'. When such labelling, that is, strongly tied to psychosis, occurred, respondents exhibited stronger stigmatizing attributions of fear compared to those indicating non-psychiatric labels (e.g. 'weird').

Conclusions: These results suggest that the majority of respondents did not endorse diagnostic labels spontaneously, thus signaling that stigma in the majority of cases would not naturalistically be elicited. However, a segment of respondents evidenced stigma simply from behavioural changes manifested by individuals exhibiting signs of psychosis, independent of diagnosis. Implications for reducing any stigma associated with an 'at-risk for psychosis' designation are discussed.

Keywords: at risk for psychosis; labelling; stigma; ultra-high-risk.

MeSH terms

  • Adolescent
  • Adult
  • Attitude to Health*
  • Female
  • Humans
  • Male
  • Mental Disorders / psychology
  • Peer Group*
  • Pilot Projects
  • Prodromal Symptoms
  • Psychotic Disorders / diagnosis
  • Psychotic Disorders / psychology*
  • Social Stigma*
  • Young Adult