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Study Finds Stigma Significantly Impacts Youth at High Risk for Psychosis

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A recent study published in the journal Schizophrenia Research has brought to light the profound impact of stigma on young people at clinical high risk (CHR) for psychosis. The research, conducted by a team from Northwestern University and other institutions, highlights the severe levels of perceived and internalised stigma faced by these youth and its correlation with depressive symptoms.

The study involved 94 CHR youth and a control group of 45 young people without psychotic spectrum symptoms. The researchers evaluated internalised stigma (the extent to which the individuals themselves accept these views) and perceived devaluation (negative views from others). The findings were stark: CHR youth reported stigma significantly more frequently and at higher levels than the control group.

CHR participants showed an overwhelming endorsement of mental health-related stigma, with 80.85% acknowledging perceived devaluation compared to just 17.77% in the control group. Furthermore, CHR individuals scored substantially higher on both the perceived devaluation and internalised stigma scales, indicating a pervasive experience of stigma.

Interestingly, while positive psychotic symptoms (such as delusions and hallucinations) are central to defining CHR syndrome, they showed no significant relationship with stigma measures. Instead, depressive symptoms were closely linked to perceived devaluation stigma. Higher levels of perceived devaluation were associated with increased depressive symptomatology, suggesting a bidirectional relationship where stigma exacerbates depression and vice versa.

This association underscores the importance of addressing depressive symptoms and stigma simultaneously in interventions for CHR youth. The study’s findings suggest that perceived devaluation has greater clinical significance than internalised stigma, which could guide future stigma reduction strategies.

The implications of these findings extend beyond the individual to broader societal and community levels. The researchers emphasise the need for targeted anti-stigma interventions, particularly those that can be implemented in schools and community settings where young people are most vulnerable to negative stereotypes about mental health.

Effective anti-stigma programmes often include social contact with individuals who have experienced mental health issues, combined with psychoeducation. These approaches have shown success in reducing stigma towards people with psychotic disorders and could be adapted for CHR youth.

Despite the significant findings, the study has its limitations. Being cross-sectional, it cannot establish causality or the directionality of the relationship between stigma and symptomatology. Longitudinal studies are necessary to better understand these dynamics and develop effective prevention and intervention strategies.

Moreover, the study’s sample was relatively homogenous regarding socio-economic status, with a high proportion of participants from racialised minorities. Future research should explore how stigma interacts with other forms of discrimination and stereotypes, including race and socio-economic status, to provide a more comprehensive understanding.

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