Factors Affecting Stigma Resistance in Patients with Bipolar Disorder / 신경정신의학

OBJECTIVES: Stigma resistance is an individual capacity to fight the stigma of mental illness and is an issue of ongoing research regarding the stigma. The aim of this study was to evaluate predictors of stigma resistance in patients with bipolar disorder. METHODS: Demographic, clinical, and psychosocial data were collected from 102 bipolar patients in a university mental hospital. Stigma resistance was measured using a subscale of the Internalized Stigma of Mental Illness Scale. Patients completed self-reported questionnaires including items on self-esteem, hopelessness, social support, and social conflict. RESULTS: Stigma resistance showed positive association with functioning, self-esteem, and social support, and showed negative association with depressive symptoms, hopelessness, and social conflict. In multivariate analysis, stigma resistance was predicted by sex, education, and self-esteem. Self-esteem was the strongest predictive factor of stigma resistance. CONCLUSION: In accordance with previous studies, self-esteem was a central role of predicting stigma resistance. A program for improving self-esteem and its related psychosocial factors will be helpful to enhancing stigma resistance in bipolar patients.

A Study on the Reliability and Validity of the Korean Version of Internalized Stigma of Mental Illness Scale (K-ISMI) / 신경정신의학

OBJECTIVES: The Internalized Stigma of Mental Illness (ISMI) scale designed to measure the subjective experience of stigma with sub-scales measuring Alienation, Stereotype Endorsement, Perceived Discrimination, Stigma Resistance, and Social withdrawal. The purpose of this study was to examine the reliability and validity of the Korean version of ISMI. METHODS: The subjects were 194 schizophrenic patients and 205 peoples with depressive disorder. K-ISMI, CES-D (The Center for Epidemiologic Studies Depression Scale) and Self Esteem scale were performed. RESULTS: Results showed that the ISMI had high internal consistence and split-half reliabilities. The internal consistency coefficients (Cronbach alpha) of each subscale ranged from .83 to .93. The validity of the ISMI was investigated by principal axis factoring analysis, yielding 5 factors of alienation, perceived discrimination, negative stereotype, stigma resistance, devaluation and social withdrawal. 5 subscales explained 60.67% of total variance. Concurrent validity was supported by comparisons against scales measuring related constructs. As expected, the ISMI had positive correlations with CES-D, and it had negative correlation with self-esteem scale. Subsidiary analysis showed that schizophrenic patients showed higher internalized stigma than depressed patients. CONCLUSION: Overall, the findings support the utility of ISMI as a tool to evaluate internalized stigma of persons with mental illness. Interventions that can lessen internalized stigma may well hasten the recovery process in individuals with mental illness.