Table 4.
Cross-sectional Correlates and Consequences of Self-stigma
| A | B | C | D | E | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Number of studies (n = 272) | Non-significant relationship (P > 0.05) | Significant relationship (P < 0.05) | Positive relationship (P < 0.05) | Negative relationship (P < 0.05) | ||||||
| Variables | n | % | n | % | n | % | n | % | n | % |
| Sociodemographic | ||||||||||
| Gender (1) | 62 | 22.8 | 50 | 80.7 | 12 | 19.3 | 3 | 25.0 | 9 | 75.0 |
| Age | 68 | 25.0 | 49 | 72.1 | 19 | 27.9 | 12 | 63.2 | 7 | 36.8 |
| Education | 60 | 22.1 | 37 | 61.7 | 23 | 38.3 | 10 | 43 | 13 | 57 |
| Employment(2) | 37 | 13.6 | 16 | 43.2 | 21 | 56.8 | 2 | 9.5 | 19 | 90.5 |
| Marital status(3) | 40 | 14.7 | 28 | 70 | 12 | 30 | 3 | 25.0 | 9 | 75.0 |
| Income | 16 | 5.9 | 5 | 31.2 | 11 | 68.8 | 0 | 0 | 11 | 100 |
| Source of income (4) | 11 | 4.0 | 6 | 54.5 | 5 | 45.5 | 3 | 60 | 2 | 40 |
| Immigrant status | 1 | 0.4 | 0 | 0 | 1 | 100 | 1 | 100 | 0 | 0 |
| History of incarceration/homelessness | 2 | 0.7 | 0 | 0 | 2 | 100 | 2 | 100 | 0 | 0 |
| Experience of victimization | 2 | 0.7 | 0 | 0 | 2 | 100 | 2 | 100 | 0 | 0 |
| Parenting status (5) | 2 | 0.7 | 1 | 50 | 1 | 50 | 1 | 100 | 0 | 0 |
| Internalizing personality traits | 6 | 2.2 | 0 | 0 | 6 | 100 | 6 | 100 | 0 | 0 |
| Self-compassion/mindfulness | 2 | 0.7 | 1 | 50 | 1 | 50 | 0 | 0 | 1 | 100 |
| Locality (urban/rural) (6) | 7 | 2.6 | 4 | 57.1 | 3 | 42.9 | 1 | 33.3 | 2 | 66.7 |
| Illness-related | ||||||||||
| Severity of psychiatric symptoms | 65 | 23 | 10 | 15.4 | 55 | 84.6 | 55 | 100 | 0 | 0 |
| Higher distress from sub-threshold psychotic symptoms/psychiatric symptoms | 2 | 0.7 | 0 | 0 | 2 | 100 | 2 | 100 | 0 | 0 |
| Age of onset | 26 | 9.6 | 19 | 73.0 | 7 | 27.0 | 0 | 0 | 7 | 100 |
| Illness duration | 32 | 11.8 | 22 | 68.7 | 10 | 31.3 | 7 | 70.0 | 3 | 30.0 |
| Stage of illness | 1 | 0.4 | 1 | 100 | 0 | 0 | - | - | - | - |
| Diagnosis(7) | 38 | 14.0 | 20 | 52.6 | 18 | 47.4 | NA | - | NA | - |
| Insight | 32 | 11.8 | 0 | 0 | 32 | 100 | 32 | 100 | 0 | 0 |
| Parental insight | 1 | 0.4 | 0 | 0 | 1 | 100 | 1 | 100 | 0 | 0 |
| Subjective clinical severity | 3 | 1.1 | 0 | 0 | 3 | 100 | 3 | 100 | 0 | 0 |
| Perceived cognitive dysfunction | 4 | 1.5 | 0 | 0 | 4 | 100 | 4 | 100 | 0 | 0 |
| Hospitalizations | 38 | 14.0 | 23 | 60.5 | 15 | 39.5 | 14 | 93.3 | 1 | 6.7 |
| Treatment setting (8) | 6 | 2.2 | 3 | 50 | 3 | 50 | 1 | 33.3 | 2 | 66.7 |
| Involuntary hospitalizations (IH) | 3 | 1.1 | 1 | 33.3 | 2 | 66.7 | 2 | 100 | 0 | 0 |
| Negative emotional reactions to IH | 2 | 0.7 | 0 | 0 | 2 | 100 | 2 | 100 | 0 | 0 |
| Forensic patient status | 3 | 1.1 | 2 | 66.7 | 1 | 33.3 | 1 | 100 | 0 | 0 |
| Compulsory community treatment | 1 | 0.4 | 1 | 100 | 0 | 0 | - | - | - | - |
| History of suicide attempt | 6 | 2.2 | 1 | 16.7 | 5 | 83.3 | 5 | 100 | 0 | 100 |
| Social anxiety | 3 | 1.1 | 0 | 0 | 3 | 100 | 3 | 100 | 0 | 0 |
| Comorbid post-traumatic stress disorder | 2 | 0.7 | 0 | 0 | 2 | 100 | 2 | 100 | 0 | 0 |
| Comorbid personality disorder | 2 | 0.7 | 0 | 0 | 2 | 100 | 2 | 100 | 0 | 0 |
| Cormorbid substance use disorder | 3 | 1.1 | 1 | 33.3 | 2 | 66.7 | 2 | 100 | 0 | 0 |
| Drug extra-pyramidal side-effects | 4 | 1.5 | 0 | 0 | 4 | 100 | 4 | 100 | 0 | 0 |
| Cognitive functioning | 6 | 2.2 | 1 | 16.7 | 5 | 83.3 | 0 | 0 | 5 | 100 |
| Social cognition | 4 | 1.5 | 1 | 25 | 3 | 75 | 0 | 0 | 3 | 100 |
| Metacognitive abilities | 7 | 2.6 | 0 | 0 | 7 | 100 | 0 | 0 | 7 | 100 |
| Dysfunctional attitudes | 1 | 0.4 | 0 | 0 | 1 | 100 | 1 | 100 | 0 | 0 |
| Use of negative coping strategies | 8 | 2.9 | 0 | 0 | 8 | 100 | 8 | 100 | 0 | 0 |
| Environment-related | ||||||||||
| Country level of public stigma | 6 | 2.2 | 0 | 0 | 6 | 100 | 6 | 100 | 0 | 0 |
| Perceived stigma | 18 | 6.6 | 0 | 0 | 18 | 100 | 18 | 100 | 0 | 0 |
| Self-labelling | 3 | 1.1 | 0 | 0 | 3 | 100 | 3 | 100 | 0 | 0 |
| Stigma stress | 4 | 1.5 | 0 | 0 | 4 | 100 | 4 | 100 | 0 | 0 |
| Group value | 3 | 1.1 | 0 | 0 | 3 | 100 | 0 | 0 | 3 | 100 |
| Perceived legitimacy | 2 | 0.7 | 0 | 0 | 2 | 100 | 2 | 100 | 0 | 0 |
| Social network | 11 | 4.0 | 0 | 0 | 11 | 100 | 0 | 0 | 11 | 100 |
| Sense of belonging | 2 | 0.7 | 0 | 0 | 2 | 100 | 0 | 0 | 2 | 100 |
| Perceived social support | 21 | 8.4 | 0 | 0 | 21 | 100 | 0 | 0 | 21 | 100 |
| Loneliness | 2 | 0.7 | 0 | 0 | 2 | 100 | 2 | 100 | 0 | 0 |
| Family sense of coherence | 1 | 0.4 | 0 | 0 | 1 | 100 | 0 | 0 | 1 | 100 |
| Experienced and anticipated stigma | 13 | 4.8 | 0 | 0 | 13 | 100 | 13 | 100 | 0 | 0 |
| Expressed emotion in families | 1 | 0.4 | 0 | 0 | 1 | 100 | 1 | 100 | 0 | 0 |
| Associative stigma in MHP | 1 | 0.4 | 0 | 0 | 1 | 100 | 1 | 100 | 0 | 0 |
| Cultural factors | ||||||||||
| Attributing mental illness to supernatural causes | 3 | 1.1 | 0 | 0 | 3 | 100 | 3 | 100 | 0 | 0 |
| History of traditional treatment | 2 | 0.7 | 0 | 0 | 2 | 100 | 2 | 100 | 0 | 0 |
| Loss of face in Eastern countries | 2 | 0.7 | 0 | 0 | 2 | 100 | 2 | 100 | 0 | 0 |
| Psychosocial | ||||||||||
| Self-efficacy | 13 | 4.8 | 0 | 0 | 13 | 100 | 0 | 0 | 13 | 100 |
| Empowerment | 11 | 4.0 | 0 | 0 | 11 | 100 | 0 | 0 | 11 | 100 |
| Self-esteem | 44 | 16.2 | 0 | 0 | 44 | 100 | 0 | 0 | 44 | 100 |
| Hope | 19 | 7.0 | 0 | 0 | 19 | 100 | 0 | 0 | 19 | 100 |
| Depression | 41 | 15.1 | 0 | 0 | 41 | 100 | 41 | 100 | 0 | 0 |
| Suicide risk | 15 | 5.5 | 1 | 6.7 | 14 | 93.3 | 14 | 100 | 0 | 0 |
| Help-seeking/Therapeutic alliance | 5 | 1.8 | 0 | 0 | 5 | 100 | 0 | 0 | 5 | 100 |
| Treatment adherence | 15 | 5.5 | 0 | 0 | 15 | 100 | 0 | 0 | 15 | 100 |
| Subjective social status | 1 | 0.4 | 0 | 0 | 1 | 100 | 0 | 0 | 1 | 100 |
| Psychosocial function | 27 | 9.9 | 0 | 0 | 27 | 100 | 0 | 0 | 27 | 100 |
| Activity | 1 | 0.4 | 0 | 0 | 1 | 100 | 0 | 0 | 1 | 100 |
| Self-reported physical health | 2 | 0.7 | 0 | 0 | 2 | 100 | 0 | 0 | 2 | 100 |
| Capacity for intimacy/satisfaction in intimate relationships | 4 | 1.5 | 0 | 0 | 4 | 100 | 0 | 0 | 4 | 100 |
| Self-reported parenting experiences | 1 | 0.4 | 0 | 0 | 1 | 0 | 0 | 0 | 1 | 100 |
| Quality of life | 41 | 15.1 | 0 | 0 | 41 | 100 | 0 | 0 | 41 | 100 |
| Wellbeing | 9 | 3.3 | 0 | 0 | 9 | 100 | 0 | 0 | 9 | 100 |
| Satisfaction with life | 8 | 2.9 | 0 | 0 | 8 | 100 | 0 | 0 | 8 | 100 |
| “why try effect” | 2 | 0.7 | 0 | 0 | 2 | 100 | 2 | 100 | 0 | 0 |
| Coming out (CO)/CO assertiveness | 1 | 0.4 | 1 | 100 | 0 | 0 | - | - | - | - |
| Benefits from being out | 1 | 0.4 | 0 | 0 | 1 | 100 | 0 | 0 | 1 | 100 |
| Stigma resistance | 11 | 4.0 | 0 | 0 | 11 | 100 | 0 | 0 | 11 | 100 |
| Resilience | 7 | 2.6 | 0 | 0 | 7 | 100 | 0 | 0 | 7 | 100 |
| Personal recovery | 22 | 8.1 | 0 | 0 | 22 | 100 | 0 | 0 | 22 | 100 |
1)Columns D + E; 1 = Men.
2) Columns D + E; 1 = Employed.
3) Columns D + E; 1 = Married.
4) Columns D + E; 1 = Income earner.
5) Columns D + E; 1 = Mothers.
6) Columns D + E; 1 = Urban.
7) Columns D+ E; not applicable (heterogeneity of the samples).
8) Columns D + E; 1= Inpatients.
Table 4 presents the relationships between sociodemographic, illness-related, environment-related, cultural and psychosocial variables with self-stigma (includes 272 studies).