Perceived stigma from mental health service providers and its adverse impact on service engagement and recovery among people with mental illness.

The present study investigated how perceived stigma from mental health service providers would influence the mental health recovery of people with mental illness. Specifically, this study examined whether perceived stigma from service providers would adversely affect the clinical, functional, and personal recovery of people with mental illness by exacerbating the content and process of self-stigma and service disengagement. A total of 353 people with mental illness completed questionnaires about perceived stigma from service providers, self-stigma content and process, service disengagement, and clinical, functional, and personal recovery. The associations among these variables were analyzed using structural equation modeling and bootstrap analyses. Structural equation modeling showed that perceived stigma from service providers was related to higher levels of self-stigma content and process, which were, in turn, related to greater levels of service disengagement and then lower levels of clinical, functional, and personal recovery. Bootstrap analyses further showed that perceived stigma from service providers had significant indirect effects on clinical, functional, and personal recovery through self-stigma content and process and service disengagement. Our findings show that perceived stigma from service providers may adversely affect mental health recovery through intensifying self-stigma and heightening service disengagement. These findings highlight the importance of mitigating the stigma-related experiences of people with mental illness in order to facilitate their mental health recovery. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Longitudinal impact of experienced discrimination on mental health among people with mental disorders.

The present study examined the longitudinal impact of stigma on mental health among people with mental disorders. Specifically, this study tested whether higher levels of experienced discrimination would be longitudinally associated with lower levels of symptomatic remission, functional restoration, well-being, and life satisfaction and whether these associations would be mediated by higher levels of self-stigma content and process. A total of 202 people with mental disorders completed questionnaires at three time points (i.e., T1, T2, and T3) over two years. Path analyses showed that experienced discrimination at T1 was positively associated with self-stigma content and process at T2, which were, in turn, negatively associated with symptomatic remission, functional restoration, well-being, and life satisfaction at T3. Bootstrap analyses further revealed that experienced discrimination at T1 had indirect effects on symptomatic remission, functional restoration, well-being, and life satisfaction at T3 through self-stigma content and process at T2. This study shows that experienced discrimination may exacerbate self-stigma content and process and, in turn, impede recovery and wellness among people with mental disorders. Our findings highlight the importance of designing and implementing stigma and self-stigma reduction programs in order to enable people with mental disorders to attain mental illness recovery and positive mental health.

Longitudinal impact of self-stigma content and process on parental warmth and hostility among parents of children with autism spectrum disorder.

This study examined whether self-stigma content and process would prospectively influence parental warmth and hostility through increasing parenting stress among parents of children with autism spectrum disorder (ASD). On three occasions across two years, 441 Hong Kong parents of children with ASD provided questionnaire data. Path analyses showed that self-stigma content and process were associated with greater parenting stress, which was, in turn, associated with reduced parental warmth and increased parental hostility. Our findings reveal the longitudinal influences of self-stigma on parenting practices and demonstrate how these influences can be explained by parenting stress. Our findings also suggest the importance of supporting parents of children with ASD to mitigate self-stigma and associated parenting stress in improving their parenting practices.

Longitudinal impact of parents' discrimination experiences on children's internalizing and externalizing symptoms: A 2-year study of families of autistic children.

LAY ABSTRACT: Although many parents of autistic children are routinely discriminated against, the potential impact of this discrimination on their parenting processes and child-rearing outcomes has seldom been investigated. The present study addressed this gap in the literature by examining the longitudinal associations of parents' discrimination experiences with children's internalizing and externalizing symptoms among families of autistic children and testing whether these associations would be mediated by parental depression, harsh parenting, and coparenting conflict. On three occasions across 2 years (i.e. T1, T2, and T3), 441 parents of autistic children from Hong Kong, China, provided questionnaire data. Path analyses showed that parents' discrimination experiences at T1 had significant direct effects on parental depression, harsh parenting, and coparenting conflict at T2, which, in turn, had significant direct effects on children's internalizing and externalizing symptoms at T3. Bootstrap analyses further demonstrated that parents' discrimination experiences at T1 had significant indirect effects on children's internalizing and externalizing symptoms at T3 via parental depression, harsh parenting, and coparenting conflict at T2. Our findings have important theoretical contributions and significant practical implications. Theoretically, our findings elucidate how parents' discrimination experiences may longitudinally heighten children's internalizing and externalizing symptoms by adversely affecting parental well-being and parent-child and inter-parental relationships. Practically, our findings highlight the importance of designing and implementing community-based stigma reduction programs and family-based stigma coping interventions to reduce parents' discrimination experiences and associated adverse outcomes on well-being, parenting, marriage, and child development.

Self-compassion mitigates the cognitive, affective, and social impact of courtesy stigma on parents of autistic children.

PURPOSE: Due to the courtesy stigma of autism spectrum disorder, many parents of autistic children are devaluated and discriminated against by the public. Despite the high prevalence of this courtesy stigma, very few studies have examined its negative effects on parents of autistic children and explored the factors that may protect the parents from these negative effects. The present study utilized a 2-year, two-wave prospective longitudinal design to examine the associations of courtesy stigma with adverse cognitive (self-stigma), affective (depressive and anxiety symptoms), and social (parent-child and inter-parental conflicts) consequences for parents of autistic children and to test whether these associations would be moderated and mitigated by self-compassion. METHODS: A total of 381 parents of autistic children completed questionnaires about courtesy stigma, self-compassion, self-stigma, depressive and anxiety symptoms, and parent-child and inter-parental conflicts at time 1 (T1) and time 2 (T2). RESULTS: Courtesy stigma interacted with self-compassion at T1 in predicting self-stigma, depressive and anxiety symptoms, and parent-child and inter-parental conflicts at T2. Specifically, the associations of courtesy stigma with the adverse psychological consequences were weaker for parents with high self-compassion than for those with low self-compassion. CONCLUSION: Our results demonstrate the prospective associations of courtesy stigma with adverse cognitive, affective, and social consequences for parents of autistic children, as well as the protective effects of self-compassion against such associations. These results highlight the importance of increasing parents' self-compassion to help them cope with courtesy stigma and improve their psychological well-being.

The impact of stigma on engaged living and life satisfaction among people with mental illness in Hong Kong.

PURPOSE: The present study aimed to investigate how the interpersonal (experienced discrimination) and intrapersonal (anticipated stigma and internalized stigma) manifestations of psychiatric stigma may affect engaged living and life satisfaction among people with mental illness. In this study, we developed and evaluated a conceptual model to clarify how experienced discrimination may lead to anticipated stigma and internalized stigma and thereby impede engaged living and reduce life satisfaction. METHODS: A total of 205 Hong Kong Chinese people with mental illness completed standardized questionnaire measures of experienced discrimination, anticipated stigma, internalized stigma, engaged living, and life satisfaction. The associations among these variables were analyzed using path analyses and bootstrap analyses. RESULTS: Path analyses showed that experienced discrimination was related to higher levels of anticipated stigma and internalized stigma, which were, in turn, linked to lesser engaged living and consequently lower life satisfaction. Bootstrap analyses further revealed that experienced discrimination had significant indirect effects on life satisfaction via anticipated stigma and engaged living and via internalized stigma and engaged living. CONCLUSIONS: Theoretically, our study uncovers how the interpersonal and intrapersonal manifestations of psychiatric stigma may adversely affect engaged living and life satisfaction among people with mental illness. Practically, our study points to the importance of developing and implementing stigma-related interventions at societal and individual levels in order to enable people with mental illness to live fulfilling and satisfying lives.

The impact of perceived and internalised stigma on clinical and functional recovery among people with mental illness.

The present study aimed to develop and validate a conceptual model linking public and internalised stigma to recovery attitudes, processes and outcomes among people with mental illness. Specifically, we sought to examine whether perceptions of public stigma (i.e., perceived stigma) would affect experiences of internalised stigma (i.e., self-stigma) and thereby influence recovery attitudes (i.e., recovery orientation), recovery processes (i.e., service engagement) and recovery outcomes (i.e., clinical recovery and functional recovery). A total of 205 people with mental illness from Hong Kong, China, completed questionnaire measures on perceived stigma, self-stigma, recovery orientation, service engagement, clinical recovery and functional recovery. The associations among these variables were analysed using path analyses and bootstrap analyses. Path analyses showed that perceived stigma was related to greater self-stigma, which was, in turn, linked to lower recovery orientation and then lesser service engagement and ultimately poorer clinical recovery and functional recovery. Bootstrap analyses further demonstrated that perceived stigma had significant indirect effects on recovery orientation via self-stigma, on service engagement via self-stigma and recovery orientation and on clinical recovery and functional recovery via self-stigma, recovery orientation and service engagement. Theoretically, our findings reveal how public and internalised stigma may adversely affect recovery attitudes, processes and outcomes among people with mental illness. Practically, our findings point to the vital and urgent need to develop effective interventions to mitigate stigma and self-stigma at community and individual levels in order to reduce the deleterious impact of stigma on recovery.

Longitudinal impact of public stigma and courtesy stigma on parents of children with autism spectrum disorder: The moderating role of trait mindfulness.

BACKGROUND: Although the public and courtesy stigma of autism spectrum disorder (ASD) are prevalent, there are very few studies examining their adverse psychological effects on parents of children with ASD or exploring plausible factors that can alleviate these adverse effects. The present study addressed these literature gaps by investigating the longitudinal linkages of public and courtesy stigma to detrimental cognitive (i.e., self-stigma content and process) and affective (i.e., perceived stress and symptoms of depression and anxiety) consequences for parents of children with ASD and testing if these linkages would be moderated by trait mindfulness. METHODS: At two time points separated by 12 months, 372 Hong Kong parents of children with ASD provided questionnaire data on public and courtesy stigma, mindfulness, self-stigma content and process, perceived stress, and symptoms of depression and anxiety. RESULTS: Hierarchical regressions showed that public and courtesy stigma interacted significantly with mindfulness at baseline in predicting self-stigma content and process, perceived stress, and symptoms of depression and anxiety at follow-up. Moreover, simple slope analyses showed that the linkages of public and courtesy stigma to the five detrimental psychological consequences were weaker in parents with high mindfulness than in those with low mindfulness. CONCLUSIONS: Our findings highlight the longitudinal linkages of public and courtesy stigma to detrimental cognitive and affective consequences for parents of children with ASD, and reveal the plausible protective effects of mindfulness against such linkages. These findings suggest the potential utility of increasing mindfulness in parents of children with ASD in coping with community stigma and improving mental health.

The Impact of Compassion from Others and Self-compassion on Psychological Distress, Flourishing, and Meaning in Life Among University Students.

Objectives: Research shows that compassion from others and from the self may enable university students to face, overcome, and bounce back from adversity and generate a greater sense of thriving and meaning in life. However, the underlying processes are largely unknown. The present study aimed to examine the associations of compassion with psychological distress, flourishing, and meaning in life among university students and explore the mechanisms underlying these associations. Methods: A total of 536 Hong Kong university students completed questionnaires measuring their experiences of compassion from others, self-compassion, resilience, psychological distress, flourishing, and meaning in life. Results: Serial mediation analyses showed that compassion from others was associated positively with self-compassion, which was, in turn, linked to greater resilience and consequently lower levels of psychological distress and higher levels of flourishing and meaning in life. Conclusions: Our findings reveal the associations of compassion from others and self-compassion with the well-being and life meaning of university students. The findings highlight the importance of being open and receptive to love and kindness from others. The findings also point to the importance of developing a caring attitude toward oneself.

Differential Impact of Experienced and Anticipated Discrimination on Sleep and Health Among Sexual Minorities.

For many lesbian, gay, and bisexual (LGB) individuals, stigma may represent a psychosocial stressor that can disrupt sleep and impair health. The present study tested a stigma model of sleep health to examine whether experienced and anticipated discrimination, as well as associated primal threat, would affect sleep quality and, in turn, physical and mental health among LGB individuals. A total of 401 LGB individuals (201 women and 200 men; mean age = 27.48 years) from Hong Kong, China, provided cross-sectional questionnaire data on experienced and anticipated discrimination, primal threat, sleep disturbance, and self-rated physical and mental health. Path analyses showed that experienced and anticipated discrimination were associated with higher primal threat, which was, in turn, associated with greater sleep disturbance and then poorer physical and mental health. Bootstrap analyses further revealed that experienced and anticipated discrimination had significant indirect effects on sleep disturbance via primal threat and on physical and mental health via primal threat and sleep disturbance. In addition, multi-group analyses demonstrated that the mediation model held across women and men and across lesbian/gay and bisexual individuals. Theoretically, our findings highlighted the importance of considering the differential effects of experienced and anticipated discrimination, as well as the contributive role of primal threat, on the sleep quality and health status of LGB individuals. Practically, our findings pointed to the necessity of developing community-based stigma reduction programs and individual-oriented stigma coping interventions in order to facilitate LGB individuals to reduce discrimination-related primal threat and thereby improve sleep and health.

The impact of psychological flexibility on sexual identity stress and well-being among lesbian, gay, and bisexual individuals.

Sexual identity stress may damage the well-being of lesbian, gay, and bisexual (LGB) individuals, but limited research has examined the potential protective factors in this context. The present study addressed this research gap by testing a psychological flexibility model of sexual identity development and positive mental health among LGB individuals. We hypothesized that psychological flexibility would be associated with greater engaged living (i.e., valued living and life fulfillment), which would, in turn, be linked to lower sexual identity stress (i.e., identity uncertainty, acceptance concern, internalized homonegativity, sexuality concealment, and difficult process of identity development) and then better well-being (i.e., emotional, psychological, and social well-being). A total of 401 LGB individuals completed questionnaire measures of psychological flexibility, engaged living, sexual identity stress, and well-being. Structural equation modeling showed that psychological flexibility was related to greater engaged living, which was, in turn, related to lower sexual identity stress and then better well-being. Bootstrap analyses further revealed that psychological flexibility had significant indirect effects on sexual identity stress via engaged living and on well-being via engaged living and sexual identity stress. In addition, multigroup analyses demonstrated that the mediation model held across women and men and across lesbian/gay and bisexual individuals. Theoretically, this study elucidated how psychological flexibility could enable LGB individuals to reduce sexual identity stress and improve well-being through living a valuable and fulfilling life. Practically, this study pointed to the utility of psychological flexibility training in facilitating LGB individuals to develop a positive sexual identity and enhance positive mental health. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The impact of mindfulness on self-stigma and affective symptoms among sexual minorities.

BACKGROUND: Research shows that mindfulness may enable sexual minorities to resist stigma and reduce distress. Less is known, however, about the underlying processes. The present study addressed this gap in the literature by examining how mindfulness would mitigate self-stigma and, in turn, alleviate affective symptoms among lesbian, gay, and bisexual (LGB) individuals. METHODS: A total of 401 LGB individuals from Hong Kong, China, provided cross-sectional questionnaire data on mindfulness, positive reappraisal, negative rumination, self-stigma content, self-stigma process, disempowerment, depressive symptoms, and anxiety symptoms. Structural equation modeling and Bootstrap analyses were conducted to analyze the relations among the variables. RESULTS: Structural equation modeling showed that mindfulness was associated with increased positive reappraisal and reduced negative rumination, which were, in turn, associated with lower levels of self-stigma content and process, respectively. Moreover, lower levels of self-stigma content and process were associated with a reduced sense of disempowerment, which was, in turn, associated with lower levels of depressive and anxiety symptoms. Bootstrap analyses further demonstrated that mindfulness had significant indirect effects on depressive and anxiety symptoms via positive reappraisal, self-stigma content, and disempowerment and via negative rumination, self-stigma process, and disempowerment. CONCLUSIONS: Theoretically, this study revealed the potential pathways through which mindfulness could enable LGB individuals to mitigate self-stigma content and process and thereby alleviate depressive and anxiety symptoms. Practically, this study pointed to the potential utility of mindfulness training in facilitating LGB individuals to resist societal stigma, reduce internalized stigma, and lessen emotional distress.

How Sense of Community Affects Sense of Self Among Sexual Minorities: Critical Consciousness as a Mediating Mechanism.

Research shows that sense of community may enable lesbian, gay, and bisexual (LGB) individuals to resist and fight against societal heterosexism and increase their positive sense of self. Less is known, however, about the underlying processes. The present study examined whether sense of community would affect sense of self (i.e., identity affirmation and self-esteem) through critical consciousness (i.e., critical reflection and critical action) among LGB individuals. A total of 401 LGB individuals from Hong Kong, China, provided cross-sectional questionnaire data on sense of community, critical reflection, critical action, identity affirmation, and self-esteem. Structural equation modeling and bootstrap analyses were performed to analyze the direct and indirect relations among the variables. Results showed that sense of community was positively associated with critical action, and this association was mediated by critical reflection. Moreover, critical action was positively associated with self-esteem, and this association was mediated by identity affirmation. Theoretically, this study demonstrated how LGB individuals' sense of community may have a positive impact on their sense of self through the mechanism of critical consciousness. Practically, this study pointed to the utility of cultivating positive in-group perceptions among LGB individuals in liberating them from oppressive ideology, mobilizing them to resist social injustice, enhancing their identity affirmation, and increasing their self-esteem.

Linking Child Autism to Parental Depression and Anxiety: The Mediating Roles of Enacted and Felt Stigma.

This study examined whether child autistic symptoms would heighten parental affective symptoms through evoking enacted stigma from the community (i.e., public and courtesy stigma) and felt stigma within the parents (i.e., vicarious and self-stigma). Cross-sectional questionnaire data were collected from 441 parents of children with autism spectrum disorder. Path analyses showed that social communication and interaction deficits and restricted and repetitive behaviors in child autism were positively associated with public and courtesy stigma. While public stigma was positively associated with parental vicarious stigma, courtesy stigma was positively associated with parental self-stigma. Both vicarious and self-stigma were positively associated with depressive and anxiety symptoms among parents. Findings revealed how child autism could compromise parental well-being through exacerbating the family's stigmatizing experiences.

The Impact of Child Autistic Symptoms on Parental Marital Relationship: Parenting and Coparenting Processes as Mediating Mechanisms.

Research shows that parenting a child with autism spectrum disorder (ASD) is associated with increased marital conflicts and reduced marital love. Less is known, however, about the potential mechanism underlying these associations. The present study tested a family process model linking child autism to parental marriage. We hypothesized that child autistic symptoms would be associated with increased marital conflicts and reduced marital love among parents of children with ASD, and that these associations would be mediated by parenting stress and coparenting conflicts. A total of 382 parents of children with ASD from Hong Kong, China completed questionnaire measures of child autistic symptoms, parenting stress, coparenting conflicts, marital conflicts, and marital love. Structural equation modeling (SEM) and Bootstrap analyses were conducted to analyze the relations among the variables. SEM showed that child autistic symptoms were related to higher levels of parenting stress and coparenting conflicts, which were, in turn, related to increased marital conflicts and reduced marital love among parents of children with ASD. Bootstrap analyses further demonstrated that child autistic symptoms had significant indirect effects on marital conflicts and marital love via parenting stress and coparenting conflicts. Theoretically, this study revealed the potential pathways through which child autism symptomatology may adversely impact the family processes and compromise the marital relationships of parents of children with ASD. Practically, this study pointed to the utility of helping parents of children with ASD to manage child autistic symptoms, alleviate parenting stress, and reduce coparenting conflicts in improving their marital qualities. LAY SUMMARY: This study showed that child autistic symptoms were related to higher levels of parenting stress and coparenting conflicts, which were, in turn, related to increased marital conflicts and reduced marital love among parents of children with autism spectrum disorder (ASD). These findings pointed to the importance of helping parents of children with ASD to manage child autistic symptoms, alleviate parenting stress, and reduce coparenting conflicts in improving their marital qualities. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. Autism Res 2020, 13: 1516-1526. © 2020 International Society for Autism Research, Wiley Periodicals, Inc.

The impact of experienced discrimination and self-stigma on sleep and health-related quality of life among individuals with mental disorders in Hong Kong.

PURPOSE: For many individuals with mental disorders, stigma may represent a potent stressor that can disrupt sleep and impair health and quality of life. In this study, we tested a stigma model of sleep health, hypothesizing that public stigma (as indicated by experienced discrimination) and internalized stigma (as indicated by self-stigma content and process) would affect sleep and, in turn, health-related quality of life (HRQoL) among individuals with mental disorders. METHODS: A total of 282 individuals with mental disorders from Hong Kong, China, completed questionnaire measures of experienced discrimination, self-stigma content and process, sleep disturbance, and physical and mental HRQoL. Structural equation modeling and Bootstrap analyses were conducted to analyze the relations among the variables. RESULTS: Structural equation modeling showed that experienced discrimination was positively associated with self-stigma content and process, which were, in turn, linked to greater sleep disturbance and consequently poorer physical and mental HRQoL. Bootstrap analyses further demonstrated that experienced discrimination had significant indirect effects on sleep disturbance, via self-stigma content and process, and on physical and mental HRQoL, via self-stigma content and process and sleep disturbance. CONCLUSIONS: Theoretically, this study highlighted the importance of considering the contributions of both public and internalized stigma, and differentiating between self-stigma content and process, when evaluating the sleep quality and health status of individuals with mental disorders. Practically, this study pointed to the necessity of developing anti-stigma and anti-self-stigma interventions at societal and individual levels in order to reduce stigma-related stress and improve sleep and health outcomes among individuals with mental disorders.

The impact of familial expressed emotion on clinical and personal recovery among patients with psychiatric disorders: The mediating roles of self-stigma content and process.

The present study examined the associations of familial expressed emotion (EE) with clinical and personal recovery among patients with psychiatric disorders, as well as the potential mechanisms underlying these associations. Guided by the content-process theory of self-stigma, we hypothesized that EE would be negatively associated with clinical and personal recovery and that these associations would be mediated by self-stigma content and process. A total of 311 patients with psychiatric disorders completed questionnaires on their perceptions of EE, self-stigma, and recovery. Structural equation modeling demonstrated that EE was positively associated with self-stigma content and process, which were in turn negatively associated with clinical and personal recovery. The indirect effects of EE on clinical and personal recovery, via self-stigma content and process, were also significant. Multigroup analyses further demonstrated that the impact of EE on self-stigma and recovery was generalizable across patients with psychotic and nonpsychotic disorders. Theoretically, our findings revealed the potential pathways through which EE may adversely affect psychiatric recovery. Practically, our findings highlighted the importance of designing multipronged intervention programs to reduce familial EE and its potential harmful impact on psychiatric patients. In addition to helping family members improve their knowledge about psychiatric disorders and adjust their communication styles, practitioners should help psychiatric patients develop resilience against EE, mitigate self-stigma, and achieve recovery. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

From child autistic symptoms to parental affective symptoms: A family process model.

BACKGROUND: Depression and anxiety are prevalent among parents of children with autism spectrum disorder (ASD), but limited research has investigated why parenting a child with ASD is associated with elevated distress and increased risks of mental health problems. We responded to this gap in the literature by examining the associations between child autistic symptoms and parental affective symptoms, as well as the potential underlying mechanisms. Guided by a family process theory, we hypothesized that child autistic symptoms would be positively associated with parental depressive and anxiety symptoms, and that these associations would be mediated by parents' concerns about their children's characteristics (future-related worry), parental roles (parenting stress), marital relationships (marital conflicts), and family conditions (family economic pressure). METHODS: Cross-sectional questionnaire data were collected from 375 parents of children with ASD residing in Hong Kong, China. The hypotheses were tested using structural equation modeling. RESULTS: Child autistic symptoms were positively associated with parental depressive and anxiety symptoms. These associations were mediated by future-related worry, parenting stress, marital conflicts, and family economic pressure. CONCLUSIONS: Our findings revealed the potential pathways through which child autism symptomatology may adversely affect parental mental health. Our findings also highlighted the importance of designing multipronged intervention programs for families raising children with ASD in order to improve relevant family processes and reduce parental affective symptoms.

Correlates of insight with symptomatology and executive function in patients with first-episode schizophrenia-spectrum disorder: a longitudinal perspective.

The present study aimed to examine the relationships of insight with symptomatology and executive function, both cross-sectionally and longitudinally in patients with first-episode schizophrenia-spectrum disorders. Ninety-two medication-naïve patients were recruited and 71 completed the assessments. Insight, symptoms and executive function were assessed at baseline, 6 months and 1 year. Insight was measured with the abridged version of Scale of Unawareness of Mental Disorder (SUMD). Symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS). Executive function was measured with the Modified Wisconsin Card Sorting Test (MCST). The most significant improvement of insight and symptomatology was found over the first 6 months, whereas the perseverative errors of MCST were significantly improved between 6 and 12 months. Differential correlations of perseverative errors of the MCST and PANSS scores with SUMD were found at different time points. This suggests the involvement of different mechanisms in insight deficit at different stages of the illness. The baseline MCST perseverative errors were correlated significantly with the SUMD total score at 6 months and the change of SUMD scores over the first 6 months. Although the variance explained was small, it suggests better set-shifting capacity facilitates the improvement of insight at an early stage of the illness.

Random number generation deficit in early schizophrenia.

Random number generation with a written response mode provides a potentially appealing marker for executive processes. Impaired performance on written random number generation tasks has been reported in chronic schizophrenic patients. However, no study has investigated whether such a deficit occurs in early schizophrenia and whether its profile and severity are similar to those in patients with chronic illness. This study investigated the ability to generate random numbers in patients with early schizophrenia (n = 44) and a healthy control group (n = 48). Patients were less able to maintain several production strategies and generated more stereotyped response sequences, whereas their abilities to identify randomness with an even-handed treatment of digits and to monitor the equality of occurrence of single digits appeared to remain intact. These results provide evidence that some aspects of the deficits in random number generation among chronic schizophrenic patients are also present at early psychotic episode, while some other aspects are relatively less affected in the early years.