The Effect of Internalized Stigma on Psychological Resilience in People with Mental llness

Abstract

Objective: The purpose of the present study was to evaluate the effect of internalized stigma on psychological resilience in people with mental illness. Methods: The present study was a cross-sectional type. A hundred-sixty five (165) people with mental illlness were included in the study. Descriptive Features Form, Internalized Stigma of Mental Illness Inventory (ISMI), and Brief Resilience Scale (BRS) were utilized to gather data. Results: There was a statistically negative strong relationship between ISMI and BRS (r=-0.803, p<.05). It was also identified that internalized stigma predicted psychological resilience by 64%. Conclusion: Decreasing the level of internalized stigma of people with mental illness may positively affect their psychological resilience.

Keywords

• Internalized stigma
• mental illness
• psychological resilience

References

1. Abay, A.R., & Çölgeçen, Y. (2018). Psychiatric social work- duties and responsibilities of social workers in preventive, therapeutic and rehabilitative mental health. OPUS–International Journal of Society Researches, 9(16),2147-2185. https://doi.org/10.26466/opus.484950
2. Alhadidi, M., Abdullah, K. L., Tang, L. Y., Danaee, M., & Al Hadid, L. A. R. (2021). Knowledge about schizophrenia, insight into illness, and internalized stigma and their associated factors among people diagnosed with schizophrenia in a long-term care facility. Perspectives in Psychiatric Care, 57(1), 225-234. https://doi.org/ 10.1111/ppc.12553
3. Alptekin, K., Üçok, A., Ayer, A., Ünal, A., Erol, A., Ensari, H., Atmaca, M., & Devrimci Özgüven, H. (2014). Treatment guidelines for patients with schizophrenia or psychotic disorder who are hospitalized in a psychiatry clinic. Bulletin of Clinical Psychopharmacology, 24(3), 276-288. https://openurl.ebsco.com/EPDB%3Agcd%3A5%3A15192629/detailv2?sid=ebsco%3Aplink%3Ascholar&id=ebsco%3Agcd%3A98628817&crl=c
4. Ayar, D., Karasu, F., & Sahpolat, M. (2021). The relationship between levels of solution-focused thinking and internalized stigma and social functionality in mental disorders. Perspectives in Psychiatric Care, 1–11. https://doi.org/10.1111/ppc.12944
5. Batinić, B., Lemonis, E., & Opačić, G. (2012). Efects of internalized stigma of mental disorder on quality of life and self-esteem in panic disorder patients. Acta Clinica Croatica, 51(Supplement 2), 41. https://hrcak.srce.hr/file/156544
6. Bishop, M., & Greeff, A. P. (2015). Resilience in families in which a member has been diagnosed with schizophrenia. Journal of Psychiatric and Mental Health Nursing, 22(7), 463-471. https://doi.org/10.1111/jpm.12230
7. Bozikas, V. P., Parlapani, E., Holeva, V., Skemperi, E., Bargiota, S. I., Kirla, D., ... & Garyfallos, G. (2016). Resilience in patients with recent diagnosis of a schizophrenia spectrum disorder. The Journal of Nervous and Mental Disease, 204(8),578-584. https://doi.org10.1097/NMD.0000000000000541
8. Coşkun, S., & Güven, N. C. (2012). Comparison of internalized stigma level of patients attending to a public and private psychiatric institution. J Psy Nurs, 3(3), 121-28. https://doi.org/ 10.5505/phd.2012.62681

9. Doğan, T. (2015). Adaptation of the Brief Resilience Scale into Turkish: a validity and reliability study. The Journal of Happiness & Well-Being, 3, 93–102. https://www.tayfundogan.net/wpcontent/uploads/2016/09/K%C4%B1saPsikolojikSaglamlikOlcegi.pdf
10. Ersoy, M. A., & Varan, A. (2007). Reliability and validity of the Turkish version of the Internalized Stigma of Mental Illness Scale. Turkish Journal of Psychiatry, 18, 163–171. https://www.turkpsikiyatri.com/Data/UnpublishedArticles/ruhsalHastaliklarda.pdf
11. Hasan, A. A., & Musleh, M. (2017). Self‐stigma by people diagnosed with schizophrenia, depression and anxiety: cross‐sectional survey design. Perspect Psychiatr Care, 54(2), 142‐148. https://doi.org/10.1111/ppc.12213
12. Gomes, D. R. A. S., Zanetti, A. C. G., Miasso, A. I., Castro, F. F. S., & Vedana, K. G. G. (2021). Internalized stigma in people with mood disorders: predictors and associated factors. The Journal of Nervous and Mental Disease, 209(1), 54-58. https://doi.org/ 10.1097/NMD.0000000000001257
13. Kehyayan, V., Mahfoud, Z., Ghuloum, S., Marji, T., & Al-Amin, H. (2021). Internalized stigma in persons with mental illness in Qatar: a cross-sectional study. Frontiers in Public Health, 9, 685003. https://doi.org/10.3389/fpubh.2021.685003
14. Kök, H., & Demir, S. (2018). Internalized stigma, self-esteem and perceived social support among patients with schizophrenia and bipolar disorder. Çukurova Medical Journal, 43(1), 99-106. https://doi.org/10.17826/cumj.340622
15. Mejia-Lancheros, C., Lachaud, J., O'Campo, P., Wiens, K., Nisenbaum, R., Wang, R., Hwang, S. W., & Stergiopoulos, V. (2020). Trajectories and mental health‐related predictors of perceived discrimination and stigma among homeless adults with mental illness. PLoS One,15(2), e0229385. https://doi.org/10.1371/journal.pone.0229385
16. Mizuno, Y., Hofer, A., Frajo-Apor, B., Wartelsteiner, F., Kermmler, G., Pardeller, S., Suzuki, T., Mimura, M., Fleischhacker, W. W., & Uchida, H. (2018). Religiosity and psychological resilience in patients with schizophrenia and bipolar disorder: an international cross-sectional study. Acta Psychiatrica Scandinavica, 137,316-327.https://doi.org/10.1111/acps.12838
17. Nunes, K. G., & da Rocha, N. S. (2022). Resilience in severe mental disorders: correlations to clinical measures and quality of life in hospitalized patients with major depression, bipolar disorder, and schizophrenia. Quality of Life Research, 31(2), 507-516. https://doi.org/10.1007/s11136-021-02920-3
18. Öz, F., & Yılmaz Bahadır, E. (2009). A significant concept in protecting mental health: resilience. Hacettepe University Faculty of Health Sciences Nursing Journal, 82-89. https://dergipark.org.tr/en/download/article-file/88536
19. Pal, A., Sharan, P., & Chadda, R. K. (2017). Internalized stigma and its impact in Indian outpatients with bipolar disorder. Psychiatry Research, 258, 158-165. https://doi.org/10.1016/j.psychres.2017.09.087
20. Ran, M. S., Zhang, T. M., Wong, I. Y., Yang, X., Liu, C. C., Liu, B., … Chan, C.L.; CMHP Study Group. (2018). Internalized stigma in people with severe mental illness in rural China. International Journal of Social Psychiatry, 64, 9–16. https://doi.org/10.1177/0020764017743999
21. Post, F., Buchta, M., Kemmler, G., Pardeller, S., Frajo-Apor, B., & Hofer, A. (2021). Resilience predicts self-stigma and stigma resistance in stabilized patients with bipolar I disorder. Front. Psychiatry 12, 678807. https://doi:10.3389/fpsyt.2021.678807
22. Pribadi, T., Lin, EC-L, Chen, P. S., Lee, S. K., Fitryasari, R., & Chen, C. H. (2020). Factors associated with internalized stigma for indonesian individuals diagnosed with schizophrenia in a community setting. J Psychiatr Ment Health Nurs, 27,584–594. https://doi.org/10.1111/jpm.12611
23. Schulze, B., & Angermeyer, M. C. (2003). Subjective experiences of stigma. A focus group study of schizophrenic patients, their relatives and mental health professionals. Soc Sci Med, 56, 299–312. https://doi.org/10.1016/S0277-9536(02)00028-X
24. Sevinik, H., & Arslan FT. (2020). Determination of internalized stigma and social functioning level in schizophrenia patients, J Psy Nurs, 11(3), 173-180. https://doi.org/10.14744/phd.2020.50455
25. Sedić, B., Štrkalj Ivezić, S., Petrak, O., & Ilić, B. (2021). Differences in resilience, self-stigma and mental health recovery between patients with schizophrenia and depression. Psychiatria Danubina, 33(suppl 4), 518-528. https://hrcak.srce.hr/file/393841
26. Şenormancı, G., Güçlü, O., & Şenormancı, Ö. (2022). Resilience and associated factors in schizophrenia. Turkish Journal of Psychiatry, 33(1).https://doi.org/10.5080/u25738
27. Uygun, E., Köseoğlu, A., Küçükgöncü, S., & Erkoç, Ş. N. (2018). Psychological resilience and related factors in the ethymic bipolar patients. JCBPR, 7(3), 120−126. https://doi.org/10.5455/JCBPR.297336
28. Yeşil, B., & Han Almış, B. (2016). The differences of a mental health hospital from a training and research hospital in terms of stigmatization level. Firat University Journal of Health Science, 30, 125–129. https://web.archive.org/web/20180422052258id_/http://tip.fusabil.org/pdf/pdf_FUSABIL_1165.pdf
29. Yılmaz, E., & Okanlı, A. (2015). The effect of internalized stigma on the adherence to treatment in patients with schizophrenia. Archives of Psychiatric Nursing, 29(5), 297-301. https://doi.org/10.1016/j.apnu.2015.05.006
30. Zhang, T. M., Wong, I. Y. L., Yu, Y. H., Ni, S. G., He, X. S., Bacon-Shone, J., ... & Ran, M. S. (2019). An integrative model of internalized stigma and recovery-related outcomes among people diagnosed with schizophrenia in rural China. Social Psychiatry and Psychiatric Epidemiology, 54(8), 911-918. https://doi.org/10.1007/s00127-018-1646-3