•Mental health professionals (MHP) are considered to be one of the main sources of stigmatization of mental illness.•Studies showed that schizophrenia is one of the most stigmatized mental illnesses ...by MHP.•In comparison with other social groups, MHP reported less dangerousness beliefs and more positive beliefs regarding pharmacological treatment. Nevertheless, results were less consistent regarding prognosis and desire for social distance.•Age, education level, type of mental health profession, or length of practice were associated factors that showed inconsistent relations with stigma. Work setting and biological causal beliefs were more clearly associated with MHP stigma.
: The consequences of schizophrenia stigma are numerous and highly damaging to individuals, their families, the health care system and society. Mental health professionals (MHP) are considered to be one of the main sources of stigmatization.
: To identify the characteristics of MHP stigma in schizophrenia in comparison with other psychiatric disorders, the specificities of MHP compared with other social groups, and associated factors.
: Following PRISMA guidelines, we systematically searched multiple electronic databases for articles: (i) reporting original data published in English in peer-reviewed journals, (ii) reporting quantitative data with statistical analysis, (iii) assessing stigma in a broad sense, and (iv) including samples composed only of MHP.
: A total of 38 articles published from 1999 to 2019 and involving 10,926 MHP fulfilled our inclusion criteria. Studies showed that schizophrenia is the most stigmatized mental illnesses in MHP, despite recent results suggesting that borderline personality disorder and substance abuse may be more stigmatized. In comparison with other social groups, MHP reported less dangerousness beliefs and more positive beliefs regarding pharmacological treatment. Nevertheless, results were less consistent regarding prognosis and desire for social distance. Age, education level, type of mental health profession, or length of practice were associated factors that showed inconsistent relations with stigma. Work setting and biological causal beliefs were more clearly associated with MHP stigma.
: These findings provide strong support for the need to conduct specific research on schizophrenia stigma in MHP and the importance of controlling for several variables to identify predictors of stigma.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The objective of this study is to evaluate the relationship between social cognition (SC) and cognitive impairment in persons with multiple sclerosis (PwMS). A prospective study was conducted in 60 ...PwMS, 30 with relapsing-remitting MS (RRMS), 15 with secondary progressive MS (SPMS) and 15 with primary progressive MS (PPMS), and in healthy subjects (HS). All subjects were assessed by the Bordeaux Social Cognition Evaluation Protocol (PECS-B) (facial emotion recognition, theory of mind, emotional awareness and cognitive and affective alexithymia), by a large neuropsychological battery and by questionnaires (depression and anxiety). 43.3% of PwMS were impaired for at least one SC test. The proportion of PwMS with at least two impaired SC tests was similar in all three phenotypes (20%). Mean scores differed significantly between PwMS and HS only for the Reading the Mind in the Eyes Test, a test of Theory of Mind (ToM). ANOVA analyses showed an effect of phenotype on emotional awareness scores with lower scores in PPMS as compared to RRMS. ToM performance was significantly correlated (
r
2
= 0.56) with executive functions, working memory and episodic memory scores. SC impairment was found in all phenotypes and was more prominent in cognitively impaired MS patients. Executive functions, and working and episodic memory performance accounts for approximately 50% of ToM performance. Emotional awareness is more impaired in progressive MS.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Abstract This study explored in a non-clinical sample the associations between self-esteem, anxiety and depression symptoms and metacognitive awareness or metacognitive knowledge. Higher ...metacognitive awareness scores measured during the neuropsychological tasks were positively associated with higher depression scores in the social cognition test. Metacognitive knowledge score measured independently of ongoing neuropsychological tasks was positively associated with lower self-esteem, higher anxiety (state or trait) and depression scores.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Social cognition has received growing interest in many conditions in recent years. However, this construct still suffers from a considerable lack of consensus, especially regarding the dimensions to ...be studied and the resulting methodology of clinical assessment. Our review aims to clarify the distinctiveness of the dimensions of social cognition.
Based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements, a systematic review was conducted to explore the factor structure of social cognition in the adult general and clinical populations.
The initial search provided 441 articles published between January 1982 and March 2017. Eleven studies were included, all conducted in psychiatric populations and/or healthy participants. Most studies were in favor of a two-factor solution. Four studies drew a distinction between low-level (e.g., facial emotion/prosody recognition) and high-level (e.g., theory of mind) information processing. Four others reported a distinction between affective (e.g., facial emotion/prosody recognition) and cognitive (e.g., false beliefs) information processing. Interestingly, attributional style was frequently reported as an additional separate factor of social cognition.
Results of factor analyses add further support for the relevance of models differentiating level of information processing (low- vs. high-level) from nature of processed information (affective vs. cognitive). These results add to a significant body of empirical evidence from developmental, clinical research and neuroimaging studies. We argue the relevance of integrating low- versus high-level processing with affective and cognitive processing in a two-dimensional model of social cognition that would be useful for future research and clinical practice. (JINS, 2018, 24, 391-404).
The aims of this prospective study were to explore in subjects with psychosis participating in a rehabilitation program whether cognitive performances at baseline predicted (i) psychosocial ...functioning over a 15–16 month follow-up; (ii) improvement in psychosocial functioning over the rehabilitation program. Visuo-spatial tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB) were administered to assess cognitive performance in 55 subjects with schizophrenia spectrum disorders who completed a rehabilitation program. The Multnomah Community Ability Scale (MCAS) was used to measure dimensions of community functioning. One subscale of the Client's Assessment of Strengths, Interests, and Goals (CASIG) provided a measure of subjective quality of life (QoL). Improvement was defined as a 15% or more increase in psychosocial scores between baseline and follow-up. Worse baseline sustained attention predicted better self-rated quality of life, and better baseline visual memory predicted better community functioning over the rehabilitation follow-up period, in particular, higher autonomy in activities of daily living, and less physical and psychiatric symptoms that could interfere with rehabilitation. Baseline cognitive performances predicted community functioning improvement during the follow-up period: visual memory predicted improvement in daily living autonomy and in social competence; sustained attention predicted improvement in behavioral problems (such as medication compliance, collaboration with treatment providers or impulse control) and social competence; planning performances predicted improvement in social competence. These cognitive functions could be specifically targeted in a rehabilitation program aimed at enhancing functioning in those particular dimensions.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Introduction. This study explored whether integrity of executive functioning is required for good neurocognitive insight (NI) in subjects with schizophrenia.
Methods. NI was measured by subtracting ...executive difficulties (errors in the Modified Card Sorting Task) from executive cognitive complaints (Subjective Scale to Investigate Cognition in Schizophrenia) in 40 outpatients with schizophrenia and 42 normal controls. The schizophrenia sample was a priori divided into two subgroups on the basis of executive level. Multivariate analyses were conducted to compare groups and to control for potential confounding factors.
Results. Only the schizophrenia dysexecutive subgroup had a poorer NI compared to normal controls. Group differences remained significant after adjustment for potential confounding factors (education, depression, anxiety and self-esteem).
Conclusion. These results provide support for the hypothesis that executive dysfunctioning is a limiting factor for NI, independently from depressive and anxiety symptoms.
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BFBNIB, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Growing evidence has shown continuum beliefs as a promising tool to reduce psychiatric stigma in the general population, but data still lack regarding mechanisms underlying this effect. This study ...aims at testing the hypothesis that continuum beliefs affect public stigma and self-stigma by increasing perceived similarities between oneself and people with schizophrenia. Perceiving such similarities may reduce public stigma and increase self-stigma in the general population. The current study was preregistered on OSF. Data were collected via an on-line survey (N = 565). Participants were randomly assigned to one of the three experimental conditions. Continuum beliefs were induced with short videos supporting either a continuum viewpoint of schizophrenia, a categorial viewpoint of schizophrenia, or a neutral video. A scale of Perceived similarities between oneself and people with schizophrenia was administered. Public stigma was measured with an Essentialism scale and Self-stigma with a scale of self-stereotype association. Mediation analyses showed that the effects of categorial and continuum beliefs on essentialism and self-stereotype association were mediated by perceived similarities. Our results suggest that continuum beliefs about schizophrenia act as a recategorization mechanism, by enhancing perceived similarities with the stereotyped group.
•Stigma is widely recognized as a major barrier to recovery from mental illness.•Continuum beliefs (CB) between normality and schizophrenia reduce public stigma.•Self-stigma and mediators of CB on stigma have not been investigated.•Perceived similarities between oneself and schizophrenia act as a mediator.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Personal recovery represents a paradigm shift in mental healthcare. Validated self-report outcome measures (PROMs) are needed to facilitate the transformation towards recovery-oriented practices and ...services. Objectives were to identify published measures and analyze their measurement properties using a standardized methodology.
Following the COSMIN guidelines, we conducted a systematic review of personal recovery PROMs in serious mental illness. The MEDLINE, PMC, PsycINFO, PsycARTICLES, PBSC and Scopus electronic databases were searched for articles published between May 2012 and February 2024. Full-text articles from a previous systematic review were also examined.
91 studies were included in the review, describing 25 PROMs. Ten of them had not been identified in previous reviews. Quality of evidence was globally poor for most PROM measurement properties. Very little evidence was found for cross-cultural validity, measurement invariance, measurement error and criterion validity. The Recovery Assessment Scale and Questionnaire about the Process of Recovery showed the strongest evidence for sufficient psychometric data on a wide range of measurement properties.
Several personal recovery measures are now available. While research is still needed to enhance their validity on some psychometric properties, the current tools appear sufficient to cover most research and clinical needs.
•Validated personal recovery measures are needed to transform mental health services.•A systematic review identifies 25 self-report measures assessing personal recovery.•No measure shows sufficient psychometrics on all domains with high level of evidence.•Five outcome measures with the best psychometrics properties are discussed.•We propose an additional content validity analysis with a model of personal recovery.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Introduction: Stigma is widely recognised as a major barrier to recovery. In schizophrenia, internalised stigma (IS) strongly impacts self-esteem, but the mechanisms underlying this phenomenon remain ...poorly understood. In this study, we suggest that IS alters self-esteem by leading people to perceive their cognitive functioning as inefficient. We investigated whether off-line metacognitive complaints mediate the effect of IS on self-esteem in schizophrenia.
Methods: We included 78 participants diagnosed with schizophrenia or schizoaffective disorder. IS was measured with the Internalised Stigma of Mental Illness scale, self-esteem by the Rosenberg Self-Esteem scale, and off-line metacognitive complaints with the Subjective Scale to Investigate Cognition in Schizophrenia.
Results: Mediation analysis revealed that the effect of IS on self-esteem was mediated by off-line metacognitive complaints.
Conclusion: Results suggest that IS reduces self-esteem by negatively impacting metacognition, such as perception of cognitive difficulties. We suggest that taking metacognition into account in the form of metacognitive complaints may be relevant in interventions aiming at reducing IS in psychosis.
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BFBNIB, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
La stigmatisation des personnes souffrant d’un trouble du spectre schizophrénique a pour origine l’existence d’un stéréotype associé à une catégorie sociale, ici la schizophrénie. L’objectif de cet ...article bref est de proposer une courte synthèse de la littérature récente ayant exploré le contenu du stéréotype associé à la schizophrénie, en anglais et en français, et de proposer des perspectives de recherche basées sur les évolutions récentes de ce domaine.
Le stéréotype associé à la maladie mentale en général est clairement négatif. Le modèle le plus répandu dans la littérature postule l’existence de quatre facteurs qui en constituent le contenu : attribution de la responsabilité de la maladie, dangerosité, faible pronostic, imprévisibilité et incompétence dans les rôles sociaux. Si le stéréotype peut varier selon les pays, il est clairement associé à la discrimination et au désir de mettre les personnes à distance socialement. Le stéréotype diffère également entre les maladies mentales. En comparaison aux troubles bipolaires ou à l’autisme, la schizophrénie concentre les aspects les plus négatifs du stéréotype associé à la maladie mentale, notamment en termes de dangerosité et de distance sociale.
L’étude du stéréotype, en pleine expansion, demande encore des études spécifiques et la mise à l’épreuve des modèles non validés, pourtant largement utilisés dans la littérature psychiatrique. L’importation des méthodes et des modèles de la psychologie sociale constitue une piste prometteuse. Ainsi, la production de données utilisables par tous les acteurs du terrain, usagers, familles et professionnels, implique la constitution d’équipes pluridisciplinaires dans les projets futurs.
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