Unpacking stigma: Meta-analyses of correlates and moderators of personal stigma in psychosis

Personal stigma entails perceived, experienced and internalised stigmatisation. Mental Health stigma has been widely researched across a range of countries and a meta-analysis of their associations and moderators in psychosis is timely. Meta-analyses were conducted examining the correlates and moderators of personal stigma in terms of: (1) demographic variables (2) illness related variables (3) symptoms/negative outcomes, and (4) aspects of wellbeing. Associations were obtained from a total of 216 records. Several demographic factors including age, economic status, employment, and rural residence had small associations with aspects of personal stigma (r's = 0.12 to-0.13). Personal stigma aspects were inversely related to medication adherence (r's =-0.20,-0.21), and positively associated with insight and number of hospitalisations (r's = 0.09-0.19). Most symptoms were positively associated with personal stigma (r's = 0.10-0.43), whereas inverse relations with wellbeing variables were identified (r's =-0.13 to-0.54). Moderator effects emerged including that of cultural setting and sex, age and education level, highlighting the role of cultural and demographic factors in shaping personal stigma aspects in psychosis. The present study also highlights the importance of recognizing the negative effect of actual stigma and discrimination experiences; particularly its detrimental impact on self-image and its complex role in shaping the internalisation of societal stigma.

Automated summary

Personal stigma is influenced by perceived, experienced and internalised factors, and is associated with demographic factors, illness symptoms, medication adherence, insight, number of hospitalisations, and wellbeing. The study also identifies cultural and demographic factors as moderators, emphasizing their impact on shaping personal stigma in psychosis. Recognizing the detrimental effects of stigma and discrimination experiences is crucial in understanding their complex role in shaping societal stigma internalisation.