Implicit and explicit self-stigma, psychological flexibility and outcomes in first episode psychosis

Section A reviews the literature from two areas: it looks first at empirical studies exploring self-stigma in psychosis and secondly at psychological flexibility in psychosis. In doing so, the review aims to consider the question as to whether the psychological flexibility model, as presented by Acceptance and Commitment Therapy, can help us to understand how and why self-stigma can have a detrimental impact on some individuals experiencing symptoms of psychosis.
Section B reports on a quantitative study of self-stigma, psychological flexibility, psychological well-being and quality of life in a First Episode Psychosis population.
Research suggests that individuals experiencing psychosis may self-stigmatise, whereby negative beliefs and stereotypes about mental health difficulties are internalised. This in turn has been found to impact negatively on a number of areas. The psychological flexibility model presented by Acceptance and Commitment Therapy may help us to understand this. This study aimed to explore self-stigma using both an explicit and implicit measure of self-stigma to see how these were related to psychological flexibility, quality of life and well-being.
Twenty-six participants experiencing first episode psychosis were recruited. They completed self-report questionnaires pertaining to quality of life, psychological well-being, psychological flexibility and explicit self-stigma. In addition, they completed a computer based reaction-time task designed to measure implicit self-stigma.
Significant relationships were found between explicit self-stigma and well-being, and between psychological flexibility, explicit self-stigma, quality of life and well-being. Explicit self-stigma was found to statistically mediate the relationship between flexibility and well-being. Implicit self-stigma was not related to any investigated variable.
The findings suggest psychological inflexibility may lead to greater self-stigma, which in turn decreases psychological well-being. This implied that interventions geared towards increasing flexibility may not only improve well-being, but may also help address issues of self-stigma.