ArticleInternational journal of mental health systems2018
"My bitterness is deeper than the ocean": understanding internalized stigma from the perspectives of persons with schizophrenia and their family caregivers.
Article in International journal of mental health systems, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 54 citations in OpenAlex.
- Using Photovoice in a Mindfulness-Based Program to Understand the Experiences of Caregivers of Young Adults with Psychosis.International journal of environmental research and public health · 2022Trial
- Prevalence and associated factors of burden, depression, and anxiety among informal caregivers of individuals with severe mental disorders within the '686 program': a community-based cross-sectional study.Social psychiatry and psychiatric epidemiology · 2026Article
- Aging while caregiving: a life course qualitative study of left-behind older parents caring for adult children with schizophrenia in rural China.International journal for equity in health · 2026Article
- Affiliate stigma among family caregivers of people with mental disorders: results from a national survey in Italy.Social psychiatry and psychiatric epidemiology · 2026Article
- Resistance and Reproduction: Mental Illness Stigma Observed in a Chinese Psychiatric Hospital.Culture, medicine and psychiatry · 2026Observational
- Affiliate stigma and health-related quality of life among caregivers of people with severe mental illness in a collectivist context: a cross-sectional study.Frontiers in psychiatry · 2026Article
- Preliminary testing for affiliate stigma scale: A reliable and valid stigma measure for caregivers of women with breast cancer.Asia-Pacific journal of oncology nursing · 2025Article
- Economic well-being and its association with family caregiving experiences of households affected by schizophrenia in China.Schizophrenia (Heidelberg, Germany) · 2025Article
- Development and evaluation of a risk prediction model for social disability in schizophrenia patients.Frontiers in psychiatry · 2025Article
- Visitor characteristics and changes in mental health stigma after attending the Mind Space mental health experience exhibition.Frontiers in psychiatry · 2024Article
- Investigation of the Relationship Between Internalized Stigma and Happiness Levels of Individuals Diagnosed with Schizophrenia.Florence Nightingale journal of nursing · 2023Article
- Recovery journey of people with a lived experience of schizophrenia: a qualitative study of experiences.BMC psychiatry · 2023Article
- The relationship between personal and interpersonal mental health experiences and stigma-related outcomes in Hong Kong.BJPsych open · 2023Article
- Stigma, lost opportunities, and growth: Understanding experiences of caregivers of persons with mental illness in Tamil Nadu, India.Transcultural psychiatry · 2023Article
- The experience of stigma in family caregivers of people with schizophrenia spectrum disorders: A meta-synthesis study.Heliyon · 2023Review
- Mental health-related stigma and attitudes toward patient care among providers of mental health services in a rural Chinese county.The International journal of social psychiatry · 2022Article
- Relationships of Family Emotional Support and Negative Family Interactions with the Quality of Life among Chinese People with Mental Illness and the Mediating Effect of Internalized Stigma.The Psychiatric quarterly · 2021Article
- Reliability and Validity of the Chinese Version of the Scale for Assessing the Stigma of Mental Illness in Nursing.Frontiers in psychiatry · 2021Article
- Stigma towards people with a diagnosis of severe mental disorder in primary healthcare centers: perspectives of service users and health teams in Chile.International journal of mental health systems · 2020Article
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIt is estimated that 8 million of the Chinese adult population had a diagnosis of schizophrenia. Stigma associated with mental illness, which is pervasive in the Chinese cultural context, impacts both persons with schizophrenia and their family caregivers. However, a review of the literature found a dearth of research that explored internalized stigma from the perspectives of both patients and their caregivers.
methodsWe integrated data from standardized scales and narratives from semi-structured interviews obtained from eight family-dyads. Interview narratives about stigma were analyzed using directed content analysis and compared with responses from Chinese versions of the Internalized Stigma of Mental Illness Scale and Affiliated Stigma Scale. Scores from the two scales and number of text fragments were compared to identify consistency of responses using the two methods. Profiles from three family-dyads were analyzed to highlight the interactive aspect of stigma in a dyadic relationship.
resultsOur analyses suggested that persons with schizophrenia and their caregivers both internalized negative valuation from their social networks and reduced engagement in the community. Participants with schizophrenia expressed a sense of shame and inferiority, spoke about being a burden to their family, and expressed self-disappointment as a result of having a psychiatric diagnosis. Caregivers expressed high level of emotional distress because of mental illness in the family. Family dyads varied in the extent that internalized stigma were experienced by patients and caregivers.
conclusionsFamily plays a central role in caring for persons with mental illness in China. Given the increasingly community-based nature of mental health services delivery, understanding internalized stigma as a family unit is important to guide the development of cultural-informed treatments. This pilot study provides a method that can be used to collect data that take into consideration the cultural nuances of Chinese societies.
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