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

Year 2025, Volume: 8 Issue: 2, 102 - 110, 13.07.2025

Tülay Yıldırım Üşenmez , Funda Kavak

https://doi.org/10.62425/esbder.1523091

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

  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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

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

Year 2025, Volume: 8 Issue: 2, 102 - 110, 13.07.2025

Tülay Yıldırım Üşenmez , Funda Kavak

https://doi.org/10.62425/esbder.1523091

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

Ethical Statement

Ethical Consideration Firstly, approval (APPROV NO: 2022/3726) from the Ethics Committee of a University and official permission from the hospital and CMHC were got. The purpose of the study was clarified to the people with mental illness, and they were notified that their data would be protected confidental and that they could leave the study at any time. Additionally, the study was carried out in the light of the Principles of Helsinki Declaration. The written consent was obtained from the people via informed voluntary consent form.

Supporting Institution

Çalışmayı destekleyen kurum bulunmamaktadır.

Thanks

Çalışmaya katılan tüm bireylere teşekkür ederiz.

References

  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
There are 30 citations in total.

Details

Primary Language English
Subjects Health Services and Systems (Other)
Journal Section Articles
Authors

Tülay Yıldırım Üşenmez 0000-0002-9979-9654

Funda Kavak 0000-0002-2159-0180

Publication Date July 13, 2025
Submission Date July 26, 2024
Acceptance Date May 22, 2025
Published in Issue Year 2025 Volume: 8 Issue: 2

Cite

APA Yıldırım Üşenmez, T., & Kavak, F. (2025). The Effect of Internalized Stigma on Psychological Resilience in People with Mental llness. Journal of Midwifery and Health Sciences, 8(2), 102-110. https://doi.org/10.62425/esbder.1523091
AMA Yıldırım Üşenmez T, Kavak F. The Effect of Internalized Stigma on Psychological Resilience in People with Mental llness. Journal of Midwifery and Health Sciences. July 2025;8(2):102-110. doi:10.62425/esbder.1523091
Chicago Yıldırım Üşenmez, Tülay, and Funda Kavak. “The Effect of Internalized Stigma on Psychological Resilience in People With Mental Llness”. Journal of Midwifery and Health Sciences 8, no. 2 (July 2025): 102-10. https://doi.org/10.62425/esbder.1523091.
EndNote Yıldırım Üşenmez T, Kavak F (July 1, 2025) The Effect of Internalized Stigma on Psychological Resilience in People with Mental llness. Journal of Midwifery and Health Sciences 8 2 102–110.
IEEE T. Yıldırım Üşenmez and F. Kavak, “The Effect of Internalized Stigma on Psychological Resilience in People with Mental llness”, Journal of Midwifery and Health Sciences, vol. 8, no. 2, pp. 102–110, 2025, doi: 10.62425/esbder.1523091.
ISNAD Yıldırım Üşenmez, Tülay - Kavak, Funda. “The Effect of Internalized Stigma on Psychological Resilience in People With Mental Llness”. Journal of Midwifery and Health Sciences 8/2 (July2025), 102-110. https://doi.org/10.62425/esbder.1523091.
JAMA Yıldırım Üşenmez T, Kavak F. The Effect of Internalized Stigma on Psychological Resilience in People with Mental llness. Journal of Midwifery and Health Sciences. 2025;8:102–110.
MLA Yıldırım Üşenmez, Tülay and Funda Kavak. “The Effect of Internalized Stigma on Psychological Resilience in People With Mental Llness”. Journal of Midwifery and Health Sciences, vol. 8, no. 2, 2025, pp. 102-10, doi:10.62425/esbder.1523091.
Vancouver Yıldırım Üşenmez T, Kavak F. The Effect of Internalized Stigma on Psychological Resilience in People with Mental llness. Journal of Midwifery and Health Sciences. 2025;8(2):102-10.
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