Abstract
BackgroundIt is estimated that 8 million of the Chinese adult population had a diagnosis of schizophrenia. Stigma associated with mental illness, which is pervasive in the Chinese cultural context, impacts both persons with schizophrenia and their family caregivers. However, a review of the literature found a dearth of research that explored internalized stigma from the perspectives of both patients and their caregivers.MethodsWe integrated data from standardized scales and narratives from semi-structured interviews obtained from eight family-dyads. Interview narratives about stigma were analyzed using directed content analysis and compared with responses from Chinese versions of the Internalized Stigma of Mental Illness Scale and Affiliated Stigma Scale. Scores from the two scales and number of text fragments were compared to identify consistency of responses using the two methods. Profiles from three family-dyads were analyzed to highlight the interactive aspect of stigma in a dyadic relationship.ResultsOur analyses suggested that persons with schizophrenia and their caregivers both internalized negative valuation from their social networks and reduced engagement in the community. Participants with schizophrenia expressed a sense of shame and inferiority, spoke about being a burden to their family, and expressed self-disappointment as a result of having a psychiatric diagnosis. Caregivers expressed high level of emotional distress because of mental illness in the family. Family dyads varied in the extent that internalized stigma were experienced by patients and caregivers.ConclusionsFamily plays a central role in caring for persons with mental illness in China. Given the increasingly community-based nature of mental health services delivery, understanding internalized stigma as a family unit is important to guide the development of cultural-informed treatments. This pilot study provides a method that can be used to collect data that take into consideration the cultural nuances of Chinese societies.
Highlights
It is estimated that 8 million of the Chinese adult population had a diagnosis of schizophrenia
In parallel with self-stigma, affiliate stigma refers to the extent to which family caregivers internalize the prejudicial attitudes toward themselves, resulting in the use of negative affective, behavioral, and cognitive responses to cope with the spoiled identity as a close associate of someone with mental illness [5]
Pilot study, we examined stigma of mental illness from the perspectives of persons living with schizophrenia and their family caregivers in a suburban community in China
Summary
It is estimated that 8 million of the Chinese adult population had a diagnosis of schizophrenia. Stigma associated with mental illness, which is pervasive in the Chinese cultural context, impacts both persons with schizo‐ phrenia and their family caregivers. Self-stigma captures the adverse psychological processes that persons with mental illness experience because of negative stereotypes, prejudice, and discrimination they encounter in daily social interactions and upon the awareness that valuable societal resources such as employment, healthcare, and housing are denied or less accessible to them because of a psychiatric diagnosis. In parallel with self-stigma, affiliate stigma refers to the extent to which family caregivers internalize the prejudicial attitudes toward themselves, resulting in the use of negative affective, behavioral, and cognitive responses to cope with the spoiled identity as a close associate of someone with mental illness [5]
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