Internalized stigma, emotional dysfunction and unusual experiences in young people at risk of psychosis

Aims: To investigate the relationship between internalized stigma, depression, social anxiety and unusual experiences in young people considered to be at risk of developing psychosis.

Methods: A total of 288 participants meeting criteria for an at-risk mental state were recruited as part of a multisite randomized controlled trial of cognitive behavioural therapy for people meeting criteria for an at risk mental state (ARMS). The sample was assessed at baseline and 6 months using measures of at risk mental states, internalized stigma, depression and social anxiety.

Results: The Personal Beliefs about Experiences Questionnaire was validated for use with an ARMS sample. Correlational analyses at baseline indicated significant relationships between internalized stigma and: (i) depression; (ii) social anxiety; (iii) distress associated with unusual psychological experiences; and (iv) suicidal thinking. Regression analysis indicates negative appraisals of unusual experiences contributed significantly to depression scores at 6-month follow up when controlling for baseline depression and unusual psychological experiences.

Conclusions: These findings suggest that internalized stigma may contribute to the development and maintenance of depression in young people at risk of psychosis.