Highlights
- •Learning how to face stigma is important for people with chronic persistent mental illness.
- •This study provides evidence of the effect of NECT on inpatients who were in the rehabilitation wards.
- •It is the first time NECT was conducted in Taiwan.
- •Finding indicated that people learned effective skills in group-based NECT.
Abstract
This study explored the effects of NECT on self-stigma among people with schizophrenia.
Eighty-six participants were recruited and assigned to two groups. The NECT group
received 20-session group meetings, while the control group received routine care.
Self-stigma was measured by Internalized Stigma of Mental Illness Scale (ISMIS) and
Discrimination and Stigma Scale (DISC). Generalized estimating equations were employed
to explore the intervention's effectiveness. The NECT group showed a significant reduction
in ISMIS total scores after 20 sessions and Stopping Self subscale scores of DISC
decreased over time. The intervention is effective for improving self-stigma in people
with schizophrenia.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Psychiatric NursingAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- An investigation of internalized stigma and recovery levels of patients registered in a community mental health center.2021https://doi.org/10.1111/ppc.13011
- Interventions to reduce internalized stigma in individuals with mental illness: A systematic review.Spanish Journal of Psychology. 2019; 22e27https://doi.org/10.1017/sjp.2019.9
- The ceiling effect, the floor effect, and the importance of active and placebo control arms in randomized controlled trials of an investigational drug.Indian Journal of Psychological Medicine. 2021; 43: 360-361https://doi.org/10.1177/02537176211021280
- Internal consistencies of the original and revised Beck depression inventory.Journal of Clinical Psychology. 1984; 40: 1365-1367https://doi.org/10.1002/1097-4679(198411)40:6<1365::aid-jclp2270400615>3.0.co;2-d
- Development and psychometric evaluation of the discrimination and stigma scale (DISC).Psychiatry Research. 2013; 208: 33-40https://doi.org/10.1016/j.psychres.2013.03.007
- Survey of stigma and discrimination experiences among people with schizophrenia.National Cheng Kung University, Tainan, Taiwan2010 (Master's thesis)
- Psychometric evaluation of the internalized stigma of mental illness scale for patients with mental illnesses: Measurement invariance across time.PLoS One. 2014; 9e98767https://doi.org/10.1371/journal.pone.0098767
- The relationship between hope, social support and demography of hospitalized patients with hemolymph neoplasm.Journal of Nursing Research. 1997; 5: 487-498https://doi.org/10.7081/NR.199712.0487
- Mortality among long-stay patients with schizophrenia during the setting-up of community facilities under the Yuli model.Health Psychology and Behavioral Medicine. 2014; 2: 602-612https://doi.org/10.1080/21642850.2014.908717
- Correlates and consequences of internalized stigma assessed through the internalized stigma of mental illness scale for people living with mental illness: A scoping review and meta-analysis from 2010.Stigma and Health. 2021; 6: 324-334https://doi.org/10.1037/sah0000267
- Self-stigma in serious mental illness: A systematic review of frequency, correlates, and consequences.Schizophrenia Bulletin. 2021; 47: 1261-1287https://doi.org/10.1093/schbul/sbaa181
- The effectiveness of narrative enhancement and cognitive therapy: A randomized controlled study of a self-stigma intervention.Social Psychiatry and Psychiatric Epidemiology. 2017; 52: 1415-1423https://doi.org/10.1007/s00127-017-1385-x
- Abbreviated instrument to measure hope: Development and psychometric evaluation.Journal of Advanced Nursing. 1992; 17: 1251-1259https://doi.org/10.1111/j.1365-2648.1992.tb01843.x
- Self-stigma versus stigma resistance in schizophrenia: Associations with resilience, premorbid adjustment, and clinical symptoms.Psychiatry Research. 2019; 271: 396-401https://doi.org/10.1016/j.psychres.2018.12.029
- Factors influencing the level of self-stigmatisation in people with mental illness.International Journal of Social Psychiatry. 2018; 64: 374-380https://doi.org/10.1177/0020764018766561
- Peer-to-peer contact, social support and self-stigma among people with severe mental illness in Hong Kong.International Journal of Social Psychiatry. 2021; 67: 622-631https://doi.org/10.1177/0020764020966009
- Insight, self-stigma and psychosocial outcomes in schizophrenia: A structural equation modelling approach.Epidemiology and Psychiatric Sciences. 2018; 27: 176-185https://doi.org/10.1017/s2045796016000950
- Effects of rehabilitation models on self-stigma among persons with mental illness.Healthcare. 2022; 10: 213https://doi.org/10.3390/healthcare10020213
- Reliability and validity of the Chinese version of the Beck depression inventory-II.Taiwanese Journal of Psychiatry. 2002; 16: 301-310
- Toward understanding the insight paradox: Internalized stigma moderates the association between insight and social functioning, hope, and self-esteem among people with schizophrenia spectrum disorders.Schizophrenia Bulletin. 2007; 33: 192-199https://doi.org/10.1093/schbul/sbl016
- Prevalence of self-stigma and its association with self-esteem among psychiatric patients in a nepalese teaching hospital: A cross-sectional study.BMC Psychiatry. 2019; 19: 347https://doi.org/10.1186/s12888-019-2344-8
- Internalized stigma among bedouin and jews with mental illness: Comparing self-esteem, hope, and quality of life.Psychiatric Quarterly. 2020; 91: 1381-1393https://doi.org/10.1007/s11126-020-09758-x
- The impact of self-stigma on self-esteem among persons with different mental disorders.International Journal of Social Psychiatry. 2019; 65: 558-565https://doi.org/10.1177/0020764019867352
- The relationship between self-stigma and depression among people with schizophrenia-spectrum disorders: A longitudinal study.Psychiatry Research. 2019; 275: 115-119https://doi.org/10.1016/j.psychres.2019.03.022
- Efficacy of coming out proud to reduce stigma's impact among people with mental illness: Pilot randomised controlled trial.British Journal of Psychiatry. 2014; 204: 391-397https://doi.org/10.1192/bjp.bp.113.135772
- Treating self-stigma in severely mentally ill (SMI) populations: Group based narrative enhancement and cognitive therapy (NECT).International Journal of Group Psychotherapy. 2021; 72: 94-101https://doi.org/10.1080/00207284.2021.1969236
- Internalized stigma of mental illness: Psychometric properties of a new measure.Psychiatry Research. 2003; 121: 31-49https://doi.org/10.1016/j.psychres.2003.08.008
- The dose-response effect in routinely delivered psychological therapies: A systematic review.Psychotherapy Research. 2020; 30: 79-96https://doi.org/10.1080/10503307.2019.1566676
- Different roads lead to Rome: Exploring patterns of change among narrative enhancement and cognitive therapy (NECT) participants.Israel Journal of Psychiatry and Related Sciences. 2017; 54: 62-70
- Society and the adolescent self-image.Princeton University Press, 1965
- Random allocation software for parallel group randomized trials.BMC Medical Research Methodology. 2004; 4https://doi.org/10.1186/1471-2288-4-26
- Effectiveness of group narrative therapy on depression, quality of life, and anxiety in people with amphetamine addiction: A randomized clinical trial.Iranian Journal of Medical Sciences. 2020; 45: 91-99https://doi.org/10.30476/ijms.2019.45829
- Attrition in trials evaluating complex interventions for schizophrenia: Systematic review and meta-analysis.Journal of Psychiatric Research. 2017; 90: 67-77https://doi.org/10.1016/j.jpsychires.2017.02.009
- Mental illness stigma’s reasons and determinants (MISReaD) among Singapore’s lay public: A qualitative inquiry.BMC Psychiatry. 2020; 20(1), Article 422https://doi.org/10.1186/s12888-020-02823-6
- Global pattern of experienced and anticipated discrimination against people with schizophrenia: A cross-sectional survey.Lancet. 2009; 373: 408-415https://doi.org/10.1016/s0140-6736(08)61817-6
- Self-esteem as an outcome measure in studies of vocational rehabilitation for adults with severe mental illness.Psychiatric Services. 2000; 51: 229-233https://doi.org/10.1176/appi.ps.51.2.229
- Evaluation of the Rosenberg self-esteem scale using the rating scale model.Psychological Testing. 2013; 60: 263-289
- The impact of illness identity on recovery from severe mental illness: A review of the evidence.Psychiatry Research. 2020; 288: 112950https://doi.org/10.1016/j.psychres.2020.112950
- A randomized-controlled trial of treatment for self-stigma among persons diagnosed with schizophrenia-spectrum disorders.Social Psychiatry and Psychiatric Epidemiology. 2019; 54: 1363-1378https://doi.org/10.1007/s00127-019-01702-0
- Narrative enhancement and cognitive therapy: A new group-based treatment for internalized stigma among persons with severe mental illness.International Journal of Group Psychotherapy. 2011; 61: 577-595https://doi.org/10.1521/ijgp.2011.61.4.576
Article info
Publication history
Published online: April 14, 2023
Accepted:
April 9,
2023
Received in revised form:
March 10,
2023
Received:
November 1,
2022
Identification
Copyright
© 2023 Elsevier Inc. All rights reserved.
