Systematic review and meta-analysis of internalised stigma and stigma resistance in patients with psychosis: The impact of individualism-collectivism culture and other individual factors

Abstract

Purpose:

This study aimed to meta-analysis the level of internalised stigma experienced by individuals with psychosis worldwide, and the impact of cultural differences, economic status of the studied regions and duration of illness on their levels of internalised stigma. Clinical and individual level factors associated with internalised stigma and stigma resistance were also systematically reviewed.

Methods:

A systematic search of keywords on two scholarly databases were conducted. The individualism index of the countries or regions where the studies were conducted was retrieved from Hofstede’s updated measurement of individualism. Economic status of regions was categorised based on their per capita gross national income. Meta-analysis and meta-regression were conducted using the ‘metafor’ package in R. Factors associated with internalised stigma and stigma resistance were also systematically consolidated.

Results:

Seventy-three articles were included in the meta-analysis and the pooled score of both internalised stigma and stigma resistance of individuals with psychosis were within the mild range (2.20 and 2.44, respectively). The meta-regression analysis found high collectivism culture is significantly related to a higher level of internalised stigma. Economic status was not significant. Thirty-five articles were included in the systematic review and clinical, psychological, psychosocial variables, cognition and sociodemographic factors were found to be associated with internalised stigma.

Conclusion:

Internalised stigma in psychosis is ubiquitous worldwide and high collectivism culture may be related with high internalised stigma. With the presence of multiple individual factors related to internalised stigma, intervention programmes to reduce internalised stigma should consider focussing on both macro- and micro-level factors.

Keywords

Psychosis internalised stigma stigma resistance individualism-collectivism

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References

Alexová

Kågström

Winkler

Kondrátová

Janoušková

(2019). Correlates of internalized stigma levels in people with psychosis in the Czech Republic. The International Journal of Social Psychiatry, 65(5), 347–353. https://doi.org/10.1177/0020764019850204

Adewuya

A. O.

Owoeye

O. A.

Erinfolami

A. R.

Coker

A. O.

Ogun

O. C.

Okewole

A. O.

Dada

M. U.

Eze

C. N.

Bello-Mojeed

M. A.

Akindipe

T. O.

Olagunju

A. T.

Etim

(2009). Prevalence and correlates of poor medication adherence amongst psychiatric outpatients in southwestern Nigeria. General Hospital Psychiatry, 31(2), 167–174. https://doi.org/10.1016/j.genhosppsych.2008.12.005

Angermeyer

M. C.

Matschinger

(2005). Causal beliefs and attitudes to people with schizophrenia. Trend analysis based on data from two population surveys in Germany. The British Journal of Psychiatry : The Journal of Mental Science, 186, 331–334. https://doi.org/10.1192/bjp.186.4.331

Arciniegas

D. B.

(2015). Psychosis. Continuum, 21(3), 715–736. https://doi.org/10.1212/01.CON.0000466662.89908.e7

Ball

(2001). Individualism, collectivism, and economic development. The ANNALS of the American Academy of Political and Social Science, 573(1), 57–84. https://doi.org/10.1177/000271620157300104

Berk

(2021). Analysis of the role of collectivism in light of the recent literature on the big triangle: Institutions, culture, and economic development. Russian Journal of Economics, 7(3), 185–199. https://doi.org/10.32609/j.ruje.7.57894

Brewer

Venaik

(2011). Individualism–Collectivism in hofstede and GLOBE. Journal of International Business Studies, 42, 436–445.

Brewer

Venaik

(2012). On the misuse of national culture dimensions. International Marketing Review, 29(6), 673–683. https://doi.org/10.1108/02651331211277991

Brohan

Elgie

Sartorius

Thornicroft

(2010). Self-stigma, empowerment and perceived discrimination among people with schizophrenia in 14 European countries: The GAMIAN-Europe study. Schizophrenia Research, 122(1–3), 232–238. https://doi.org/10.1016/j.schres.2010.02.1065

10.

Cullen

B. A.

Mojtabai

Bordbar

Everett

Nugent

K.L.

Eaton

W. W.

(2017). Social network, recovery attitudes and internal stigma among those with serious mental illness. The International Journal of Social Psychiatry, 63(5), 448–458. https://doi.org/10.1177/0020764017712302

11.

Chan

S. K. W.

Kao

S. Y. S.

Leung

S. L.

Hui

C. L. M.

Lee

E. H. M.

Chang

W. C.

Chen

E. Y. H.

(2017). Relationship between neurocognitive function and clinical symptoms with self-stigma in patients with schizophrenia-spectrum disorders. Journal of Mental Health, 28(6), 583–588. https://doi.org/10.1080/09638237.2017.1340599

12.

Chinese Culture Connection. (1987). Chinese values and the search for culture-free dimensions of culture. Journal of Cross-Cultural Psychology, 18(2), 143–164. https://doi.org/10.1177/0022002187018002002

13.

Chung

K.-F.

Tse

Lee

C.-T.

Wong

M. M.-C.

Chan

W.-M.

(2019). Experience of stigma among mental health service users in Hong Kong: Are there changes between 2001 and 2017? The International Journal of Social Psychiatry, 65(1), 64–72. https://doi.org/10.1177/0020764018815926

14.

Corrigan

P. W.

Rüsch

(2002). Mental illness stereotypes and clinical care: Do people avoid treatment because of stigma? Psychiatric Rehabilitation Skills, 6(3), 312–334. https://doi.org/10.1080/10973430208408441

15.

Corrigan

P. W.

Watson

(2002). The paradox of self-stigma and mental illness. Clinical Psychology: Science and Practice, 9(1), 35–53. https://doi.org/10.1093/clipsy.9.1.35

16.

Corrigan

P. W.

Watson

A. C.

Barr

(2006). The self-stigma of mental illness: Implications for self-esteem and self-efficacy. Journal of Social and Clinical Psychology, 25(8), 875–884. https://doi.org/10.1521/jscp.2006.25.8.875

17.

Crișan

Vlasin

Dutchievici

Nemeş

Micluţia

(2016). Awareness of illness, depression and self-stigma in Romanian patients with schizophrenia. Cognition, Brain, Behavior: An Interdisciplinary Journal, 20(4), 345–355.

18.

Del Rosal

González-Sanguino

Bestea

Boyd

Muñoz

. (2021). 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, 6(3), 324–334. https://doi.org/10.1037/sah0000267

19.

DeTore

N. R.

Balogun-Mwangi

Tepper

Cather

Russinova

Lanca

Mueser

K. T.

(2022). The interrelationships of motivation, positive symptoms, stigma, and role functioning in early psychosis. Early Intervention in Psychiatry, 16(7), 736–743. https://doi.org/10.1111/eip.13213

20.

Fadipe

Adebowale

T. O.

Ogunwale

Fadipe

Y. O.

Ojeyinka

A. H. A.

Olagunju

A. T.

(2018). Internalized stigma in schizophrenia: A cross-sectional study of prevalence and predictors. International Journal of Culture and Mental Health, 11(4), 583–594. https://doi.org/10.1080/17542863.2018.1450431

21.

Firmin

R. L.

Luther

Salyers

M. P.

Buck

K. D.

Lysaker

P. H.

(2017). Greater metacognition and lower fear of negative evaluation: potential factors contributing to improved stigma resistance among individuals diagnosed with schizophrenia. The Israel Journal of Psychiatry and Related Sciences, 54(1), 50–54.

22.

Firmin

R. L.

Lysaker

P. H.

Luther

Yanos

P. T.

Leonhardt

Breier

Vohs

J. L.

(2019). Internalised stigma in adults with early phase versus prolonged psychosis. Early Intervention in Psychiatry, 13(4), 745–751. https://doi.org/10.1111/eip.12553

23.

Furnham

Chan

(2004). Lay theories of schizophrenia. A cross-cultural comparison of British and Hong Kong Chinese attitudes, attributions and beliefs. Social Psychiatry and Psychiatric Epidemiology, 39(7), 543–552. https://doi.org/10.1007/s00127-004-0787-8

24.

Gerlinger

Hauser

De Hert

Lacluyse

Wampers

Correll

C. U.

(2013). Personal stigma in schizophrenia spectrum disorders: A systematic review of prevalence rates, correlates, impact and interventions. World Psychiatry, 12(2), 155–164. https://doi.org/10.1002/wps.20040

25.

Gorodnichenko

Roland

(2012). Understanding the individualism-collectivism cleavage and its effects: Lessons from cultural psychology. In Aoki

Kuran

Roland

(Eds.), Institutions and comparative economic development (pp. 213–236). Palgrave Macmillan. https://doi.org/10.1057/9781137034014_12

26.

Griffiths

K. M.

Nakane

Christensen

Yoshioka

Jorm

A. F.

Nakane

(2006). Stigma in response to mental disorders: A comparison of Australia and Japan. BMC Psychiatry, 6, 21. https://doi.org/10.1186/1471-244X-6-21

27.

Grover

Avasthi

Singh

Dan

Neogi

Kaur

Lakdawala

Rozatkar

A. R.

Nebhinani

Patra

Sivashankar

Subramanyam

A. A.

Tripathi

Gania

A. M.

Singh

G. P.

Behere

(2017). Stigma experienced by patients with severe mental disorders: A nationwide multicentric study from India. Psychiatry Research, 257, 550–558. https://doi.org/10.1016/j.psychres.2017.08.027

28.

Higgins

J. P. T.

Thompson

S. G.

Deeks

J. J.

Altman

D. G.

(2003). Measuring inconsistency in meta-analyses. BMJ, 327(7414), 557–560. https://doi.org/10.1136/bmj.327.7414.557

29.

Hofstede

(1980). Motivation, leadership, and organization: Do American theories apply abroad? Organizational Dynamics, 9(1), 42–63. https://doi.org/https://doi.org/10.1016/0090-2616(80)90013-3

30.

Hofstede

(1997). Cultures and organizations: Software of the mind. McGraw-Hill. https://books.google.com.hk/books?id=rge-wQEACAAJ

31.

Hofstede

G. J.

Minkov

(2010). Cultures and organizations: Software of the mind (3rd ed.). McGraw-Hill Education. https://books.google.com.hk/books?id=o4OqTgV3V00C

32.

Hofstede Insights. (2022). Compare countries – Hofstede Insights. https://www.hofstede-insights.com/fi/product/compare-countries/

33.

Holzinger

Beck

Munk

Weithaas

Angermeyer

M. C.

(2003). Stigma as perceived by schizophrenics and depressives. Psychiatrische Praxis, 30(7), 395–401. https://doi.org/10.1055/s-2003-43251

34.

Horsselenberg

E. M. A.

van Busschbach

J. T.

Aleman

Pijnenborg

G. H. M.

(2016). Self-stigma and its relationship with victimization, psychotic symptoms and self-esteem among people with schizophrenia spectrum disorders. PLoS ONE, 11(10), e0149763. https://doi.org/10.1371/journal.pone.0149763

35.

Joanna Briggs Institute. (2017). Checklist for systematic reviews and research syntheses. https://jbi.global/critical-appraisal-tools

36.

Kao

Y.-C.

Liu

Y.-P.

(2010). The Beck Cognitive Insight Scale (BCIS): Translation and validation of the Taiwanese version. BMC Psychiatry, 10. https://doi.org/10.1186/1471-244X-10-27

37.

Kogut

Singh

(1988). The effect of national culture on the choice of entry mode. Journal of International Business Studies, 19(3), 411–432. https://doi.org/10.1057/palgrave.jibs.8490394

38.

Koschorke

Padmavati

Kumar

Cohen

Weiss

H. A.

Chatterjee

Pereira

Naik

John

Dabholkar

Balaji

Chavan

Varghese

Thara

Thornicroft

Patel

(2014). Experiences of stigma and discrimination of people with schizophrenia in India. Social Science and Medicine, 123, 149–159. https://doi.org/10.1016/j.socscimed.2014.10.035

39.

Kyriacou

A. P.

(2016). Individualism–collectivism, governance and economic development. European Journal of Political Economy, 42, 91–104. https://doi.org/10.1016/j.ejpoleco.2015.11.005

40.

Lagger

Amering

Sibitz

Gmeiner

Schrank

(2018). Stability and mutual prospective relationships of stereotyped beliefs about mental illness, hope and depressive symptoms among people with schizophrenia spectrum disorders. Psychiatry Research, 268, 484–489. https://doi.org/10.1016/j.psychres.2018.08.010

41.

Lau

Y. W.

Picco

Pang

Jeyagurunathan

Satghare

Chong

S. A.

Subramaniam

(2017). Stigma resistance and its association with internalised stigma and psychosocial outcomes among psychiatric outpatients. Psychiatry Research, 257, 72–78. https://doi.org/10.1016/j.psychres.2017.07.027

42.

Lien

Y.-J.

Kao

Y.-C.

Liu

Y.-P.

Chang

H.-A.

Tzeng

N.-S.

C.-W.

Loh

C.-H.

(2015). Internalised stigma and stigma resistance among patients with mental illness in Han Chinese population. Psychiatric Quarterly, 86(2), 181–197. https://doi.org/10.1007/s11126-014-9315-5

43.

Livingston

J. D.

Boyd

J. E.

(2010). Correlates and consequences of internalised stigma for people living with mental illness: A systematic review and meta-analysis. Social Science & Medicine, 71(12), 2150–2161. https://doi.org/10.1016/j.socscimed.2010.09.030

44.

Wolf

Wang

(2013). Experienced stigma and self-stigma in Chinese patients with schizophrenia. General Hospital Psychiatry, 35(1), 83–88. https://doi.org/10.1016/j.genhosppsych.2012.07.007

45.

Lysaker

P. H.

Davis

L. W.

Warman

D. M.

Strasburger

Beattie

(2007). Stigma, social function and symptoms in schizophrenia and schizoaffective disorder: Associations across 6 months. Psychiatry Research, 149(1–3), 89–95. https://doi.org/10.1016/j.psychres.2006.03.007

46.

Lysaker

P. H.

Roe

Yanos

P. T.

(2007). Toward understanding the insight paradox: Internalised stigma moderates the association between insight and social functioning, hope, and self-esteem among people with schizophrenia spectrum disorders. Schizophrenia Bulletin, 33(1), 192–199. https://doi.org/10.1093/schbul/sbl016

47.

Makanjuola

Esan

Oladeji

Kola

Appiah-Poku

Harris

Othieno

Price

Seedat

Gureje

(2016). Explanatory model of psychosis: impact on perception of self-stigma by patients in three sub-saharan African cities. Social Psychiatry and Psychiatric Epidemiology, 51(12), 1645–1654. https://doi.org/10.1007/s00127-016-1274-8

48.

Margetić

B. A.

Jakovljević

Ivanec

Margetić

Tošić

(2010). Relations of internalised stigma with temperament and character in patients with schizophrenia. Comprehensive Psychiatry, 51(6), 603–606. https://doi.org/10.1016/j.comppsych.2010.02.010

49.

Mersh

Jones

Oliver

(2015). Mindfulness, self-stigma and social functioning in first episode psychosis: A brief report. Psychosis: Psychological, Social and Integrative Approaches, 7(3), 261–264. https://doi.org/10.1080/17522439.2015.1024714

50.

Moola

Munn

Tufanaru

Aromataris

Sears

Sfetcu

Currie

Lisy

Qureshi

Mattis

(2020). Chapter 7: Systematic reviews of etiology and risk. In Aromataris

Munn

(Eds.), JBI manual for evidence synthesis (pp. 217–267). JBI. https://doi.org/10.46658/JBIMES-20-08

51.

Mosanya

T. J.

Adelufosi

A. O.

Adebowale

O. T.

Ogunwale

Adebayo

O. K.

(2014). Self-stigma, quality of life and schizophrenia: An outpatient clinic survey in Nigeria. The International Journal of Social Psychiatry, 60(4), 377–386. https://doi.org/10.1177/0020764013491738

52.

Nabors

L. M.

Yanos

P. T.

Roe

Hasson-Ohayon

Leonhardt

B. L.

Buck

K. D.

Lysaker

P. H.

(2014). Stereotype endorsement, metacognitive capacity, and self-esteem as predictors of stigma resistance in persons with schizophrenia. Comprehensive Psychiatry, 55(4), 792–798. https://doi.org/10.1016/j.comppsych.2014.01.011

53.

O’Connor

L. K.

Yanos

P. T.

Firmin

R. L.

(2018). Correlates and moderators of stigma resistance among people with severe mental illness. Psychiatry Research, 270, 198–204. https://doi.org/10.1016/j.psychres.2018.09.040

54.

Olçun

Şahin Altun

. (2017). The Correlation Between Schizophrenic Patients’ Level of Internalized Stigma and Their Level of Hope. Archives of Psychiatric Nursing, 31(4), 332–337. https://doi.org/10.1016/j.apnu.2017.03.001

55.

Outcalt

S. D.

Lysaker

P. H.

(2012). The relationships between trauma history, trait anger, and stigma in persons diagnosed with schizophrenia spectrum disorders. Psychosis: Psychological, Social and Integrative Approaches, 4(1), 32–41. http://dx.doi.org/10.1080/17522439.2011.591422

56.

Papadopoulos

(2009). Stigma towards people with mental health problems: An individualism-collectivism cross-cultural comparison. Middlesex University.

57.

Papadopoulos

Foster

Caldwell

(2013). “Individualism-collectivism” as an explanatory device for mental illness stigma. Community Mental Health Journal, 49(3), 270–280. https://doi.org/10.1007/s10597-012-9534-x

58.

Park

S. G.

Bennett

M. E.

Couture

S. M.

Blanchard

J. J.

(2013). Internalised stigma in schizophrenia: Relations with dysfunctional attitudes, symptoms, and quality of life. Psychiatry Research, 205(1–2), 43–47. https://doi.org/10.1016/j.psychres.2012.08.040

59.

Patel

Maj

Flisher

A. J.

De Silva

M. J.

Koschorke

Prince

(2010). Reducing the treatment gap for mental disorders: A WPA survey. World Psychiatry, 9(3), 169–176. https://doi.org/10.1002/j.2051-5545.2010.tb00305.x

60.

Pescosolido

B. A.

Martin

J. K.

Long

J. S.

Medina

T. R.

Phelan

J. C.

Link

B. G.

(2010). “A disease like any other”? A decade of change in public reactions to schizophrenia, depression, and alcohol dependence. The American Journal of Psychiatry, 167(11), 1321–1330. https://doi.org/10.1176/appi.ajp.2010.09121743

61.

Picco

Pang

Lau

Y. W.

Jeyagurunathan

Satghare

Abdin

Vaingankar

J. A.

Lim

Poh

C. L.

Chong

S. A.

Subramaniam

(2016). Internalized stigma among psychiatric outpatients: Associations with quality of life, functioning, hope and self-esteem. Psychiatry Research, 246, 500–506. https://doi.org/10.1016/j.psychres.2016.10.041

62.

Pribadi

Lin

E. C.-L.

Chen

P.-S.

Lee

S.-K.

Fitryasari

Chen

C.-H.

(2020). Factors associated with internalised stigma for Indonesian individuals diagnosed with schizophrenia in a community setting. Journal of Psychiatric and Mental Health Nursing, 27(5), 584–594. https://doi.org/10.1111/jpm.12611

63.

Ran

M.-S.

Zhang

T.-M.

Wong

I. Y.-L.

Yang

Liu

C.-C.

Liu

Luo

Kuang

W.-H.

Thornicroft

Chan

C. L.-W.

(2018). Internalised stigma in people with severe mental illness in rural China. The International Journal of Social Psychiatry, 64(1), 9–16. https://doi.org/10.1177/0020764017743999

64.

Ritsher

J. B.

Otilingam

P. G.

Grajales

(2003). Internalized stigma of mental illness: psychometric properties of a new measure. Psychiatry Research, 121(1), 31–49.

65.

Saxena

Thornicroft

Knapp

Whiteford

(2007). Resources for mental health: scarcity, inequity, and inefficiency. Lancet, 370(9590), 878–889. https://doi.org/10.1016/S0140-6736(07)61239-2

66.

Segalovich

Doron

Behrbalk

Kurs

Romem

(2013). Internalization of stigma and self-esteem as it affects the capacity for intimacy among patients with schizophrenia. Archives of Psychiatric Nursing, 27(5), 231–234. https://doi.org/10.1016/j.apnu.2013.05.002

67.

Schimmack

Oishi

Diener

(2005). Individualism: A valid and important dimension of cultural differences between nations. Personality and Social Psychology Review, 9(1), 17–31. https://doi.org/10.1207/s15327957pspr0901_2

68.

Schwarzbold

M. L.

Kern

R. S.

Novacek

D. M.

McGovern

J. E.

Catalano

L. T.

Green

M. F.

(2021). Self-stigma in psychotic disorders: Clinical, cognitive, and functional correlates in a diverse sample. Schizophrenia Research, 228, 145–150. https://doi.org/10.1016/j.schres.2020.12.003

69.

Shamblaw

A. L.

Botha

F. B.

Dozois

D. J. A.

(2015). Accounting for differences in depression stigma between Canadian Asians and Europeans. Journal of Cross-Cultural Psychology, 46(4), 597–611. https://doi.org/10.1177/0022022115575076

70.

Shin

Dovidio

J. F.

Napier

J. L.

(2013). Cultural differences in targets of stigmatization between individual- and group-oriented cultures. Basic and Applied Social Psychology, 35(1), 98–108. https://doi.org/10.1080/01973533.2012.746604

71.

Shin

Y.-J.

Joo

Y.-H.

Kim

J.-H.

(2016). Self-perceived cognitive deficits and their relationship with internalised stigma and quality of life in patients with schizophrenia. Neuropsychiatric Disease and Treatment, 12, 1411–1417. https://doi.org/10.2147/NDT.S108537

72.

Shrivastava

Gath

Thakar

Shrivastava

Sarkhel

Sunita

(2011). Origin and impact of stigma and discrimination in schizophrenia-patients’ perception: Mumbai study. Stigma Res Action, 1, 67–72.

73.

Sibitz

Amering

Unger

Seyringer

M. E.

Bachmann

Schrank

Benesch

Schulze

Woppmann

(2011). The impact of the social network, stigma and empowerment on the quality of life in patients with schizophrenia. European Psychiatry: The Journal of the Association of European Psychiatrists, 26(1), 28–33. https://doi.org/10.1016/j.eurpsy.2010.08.010

74.

Sibitz

Unger

Woppmann

Zidek

Amering

(2011). Stigma resistance in patients with schizophrenia. Schizophrenia Bulletin, 37(2), 316–323. https://doi.org/10.1093/schbul/sbp048

75.

Singh

Mattoo

S. K.

Grover

(2016). Stigma and its correlates in patients with schizophrenia attending a general hospital psychiatric unit. Indian Journal of Psychiatry, 58(3), 291–300. https://doi.org/10.4103/0019-5545.192024

76.

Sterne

J. A.

Egger

Smith

G. D.

(2001). Systematic reviews in health care: Investigating and dealing with publication and other biases in meta-analysis. BMJ, 323(7304), 101–105. https://doi.org/10.1136/bmj.323.7304.101

77.

Sum

M. Y.

Chan

S. K. W.

Suen

Y. N.

Cheung

Hui

C. L. M.

Chang

W. C.

Lee

E. H. M.

Chen

E. Y. H.

(2022) The role of education level on changes in endorsement of medication treatment and perceived public stigma towards psychosis in Hong Kong: Comparison of three population-based surveys between 2009 and 2018. BMC Psychiatry, 22(1), 641. https://doi.org/10.1186/s12888-022-04288-1

78.

Sum

M. Y.

Chan

S. K. W.

Tse

Bola

J. R.

R. M. K.

Hui

C. L. M.

Lee

E. H. M.

Chang

W. C.

Chen

E. Y. H.

(2022). Elucidating the relationship between internalised stigma, cognitive insight, illness severity, and functioning in patients with schizophrenia using a path analysis approach. Journal of Mental Health, 31(1), 29–38. https://doi.org/10.1080/09638237.2020.1836553

79.

United Nations Department of Economic and Social Affairs. (2019). World economic situation and prospects 2019. United Nations. https://doi.org/10.18356/a97d12e3-en

80.

United Nations Department of Economic and Social Affairs. (2022). World economic situation and prospects 2022. United Nations. https://doi.org/10.18356/9789210011839

81.

van Ginneken

Tharyan

Lewin

Rao

G. N.

Meera

S. M.

Pian

Chandrashekar

Patel

. (2013). Non-specialist health worker interventions for the care of mental, neurological and substance-abuse disorders in low- and middle-income countries. The Cochrane Database of Systematic Reviews, 11, CD009149. https://doi.org/10.1002/14651858.CD009149.pub2

82.

Vidović

Brecić

Vilibić

Jukić

(2016). Insight and self-stigma in patients with schizophrenia. Acta Clinica Croatica, 55(1), 23–27. https://doi.org/10.20471/acc.2016.55.01.4

83.

Viechtbauer

(2007). Accounting for heterogeneity via random-effects models and moderator analyses in meta-analysis. Zeitschrift Fur Psychologie / Journal of Psychology, 215, 104–121. https://doi.org/10.1027/0044-3409.215.2.104

84.

Viechtbauer

(2010). Conducting meta-analyses in R with the metafor package. Journal of Statistical Software, 36(3), 1–48. https://doi.org/10.18637/jss.v036.i03

85.

Vrbova

Prasko

Holubova

Kamaradova

Ociskova

Marackova

Latalova

Grambal

Slepecky

Zatkova

(2016). Self-stigma and schizophrenia: a cross-sectional study. Neuropsychiatric Disease and Treatment, 12, 3011–3020. https://doi.org/10.2147/NDT.S120298

86.

Vrbová

Kamarádová

Látalová

Ocisková

Praško

Mainerová

Cinculová

Kubínek

Ticháčková

(2014). Self-stigma and adherence to medication in patients with psychotic disorders–cross-sectional study. Neuro endocrinology letters, 35(7), 645–652.

87.

Vrbova

Prasko

Holubova

Kamaradova

Ociskova

Marackova

Latalova

Grambal

Slepecky

Zatkova

(2016). Self-stigma and schizophrenia: a cross-sectional study. Neuropsychiatric Disease and Treatment, 12, 3011–3020. https://doi.org/10.2147/NDT.S120298

88.

Vrbova

Prasko

Holubova

Slepecky

Ociskova

(2018). Positive and negative symptoms in schizophrenia and their relation to depression, anxiety, hope, self-stigma and personality traits – A cross-sectional study. Neuro Endocrinology Letters, 39(1), 9–18.

89.

Werner

Aviv

Barak

(2008). Self-stigma, self-esteem and age in persons with schizophrenia. International Psychogeriatrics, 20(1), 174–187. https://doi.org/10.1017/S1041610207005340

90.

Wood

Byrne

Morrison

A. P.

(2017). An integrative cognitive model of internalized stigma in psychosis. Behavioural and Cognitive Psychotherapy, 45(6), 545–560. https://doi.org/10.1017/S1352465817000224

91.

Wood

Byrne

Varese

Morrison

A. P.

(2016). Psychosocial interventions for internalised stigma in people with a schizophrenia-spectrum diagnosis: A systematic narrative synthesis and meta-analysis. Schizophrenia Research, 176(2–3), 291–303. https://doi.org/10.1016/j.schres.2016.05.001

92.

Yanos

P. T.

Roe

Markus

Lysaker

P. H.

(2008). Pathways between internalized stigma and outcomes related to recovery in schizophrenia spectrum disorders. Psychiatric Services, 59(12), 1437–1442. https://doi.org/10.1176/ps.2008.59.12.1437

93.

Yildirim

Kavak Budak

(2020). The relationship between internalised stigma and loneliness in patients with schizophrenia. Perspectives in Psychiatric Care, 56(1), 168–174. https://doi.org/10.1111/ppc.12399

94.

B. C. L.

Chio

F. H. N.

Mak

W. W. S.

Corrigan

P. W.

Chan

K. K. Y.

(2021). Internalization process of stigma of people with mental illness across cultures: A meta-analytic structural equation modeling approach. Clinical Psychology Review, 87, 102029. https://doi.org/10.1016/J.CPR.2021.102029

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