Reduce Stigma and Perceived Devaluation in Patients with Schizophrenia with Mindfulness
By John M. de Castro, Ph.D.
“Stigma is the number one reason people do not seek help; therefore, efforts to reduce stigma are crucial to increasing people’s help-seeking behaviors.” – Sami Boomgarden
Stigma is a view that a distinguishing characteristic makes the individual less acceptable to others. This can lead to discrimination where stigmatized people are treated negatively either directly with ugly remarks such as “crazy” or “weird” or indirectly by being avoided or marginalized by others. This can produce fewer work opportunities, harassment, bullying, problems with insurance, and loneliness. The social isolation can even lead to early mortality. Stigma can lead to low self-esteem and self-stigmatization in which the individual adopts those negative stereotypes and as a result there is a loss of self-efficacy This leads to the individual ceasing trying to make things better, thinking “why try?”
Mindfulness promotes non-judgmental awareness in which the individual perceives things just as they are without labelling or making value judgements about them. It also promotes the ability to adaptively cope with emotions and reduces worry and rumination. These can be useful in overcoming stigmas and their effects, especially self-stigmas. So, mindfulness may buffer the individual from the effects of stigma and self-stigmatization in severe mental illnesses such as schizophrenia. Mindfulness-Based Cognitive Therapy (MBCT) involves the combination of mindfulness training and cognitive behavioral therapy. It contains sitting, walking and body scan meditations, and cognitive therapy that is designed to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. Hence, MBCT may be particularly effective in reducing stigma in patients diagnosed with schizophrenia.
In today’s Research News article “Effects of Mindfulness-Based Cognitive Therapy on Stigma in Female Patients With Schizophrenia.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8342917/ ) Tang and colleagues recruited patients diagnosed with schizophrenia and randomly assigned them to either receive 8 weeks of Mindfulness-Based Cognitive Therapy (MBCT) or to a treatment as usual control condition. They were measured before and after treatment for mindfulness, insight and treatment attitudes, and stigma including subscales measuring perceived devaluation-discrimination, stigma-coping orientation, and stigma-related feeling.
They found that in comparison to baseline and the control group, the participants who received Mindfulness-Based Cognitive Therapy (MBCT) had significantly higher levels of mindfulness and insight and treatment attitudes, and significantly lower levels of stigma, including perceived devaluation-discrimination and stigma-coping orientation. They also found that the higher the levels of mindfulness after treatment the lower the levels of stigma and the higher the levels of insight and treatment attitudes.
Stigma involves “shame, evaluative thoughts, and fear of enacted stigma that results from individuals’ identification with a stigmatized group”. Stigma is an impediment to successful treatment of mental illnesses and improvement of social function. In fact, many patients high in stigma refuse treatment all together. The findings of the present study suggest that mindfulness training can help patients diagnosed with schizophrenia overcome stigma and as a result improve their attitudes toward treatment. As a result, mindfulness training may improve the patient’s prognosis and make successful treatment more likely.
So, reduce stigma and perceived devaluation in patients with schizophrenia with mindfulness.
“mindfulness-based psychoeducation was effective in reducing stigma in patients with schizophrenia.” – Emine Yılmaz
CMCS – Center for Mindfulness and Contemplative Studies
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Tang, Q., Yang, S., Liu, C., Li, L., Chen, X., Wu, F., & Huang, X. (2021). Effects of Mindfulness-Based Cognitive Therapy on Stigma in Female Patients With Schizophrenia. Frontiers in psychiatry, 12, 694575. https://doi.org/10.3389/fpsyt.2021.694575
Mindfulness-based cognitive therapy (MBCT) has been increasingly recognized as effective in different mental illnesses, but these effects are limited in schizophrenia. For patients with schizophrenia, stigma is one of the most negative factors that affects treatment, rehabilitation and social function. This research aimed to determine the effects of MBCT on stigma in patients with schizophrenia. In total, 62 inpatients with schizophrenia were recruited and randomly assigned to the experimental group or control group. The experimental group received an 8-week MBCT intervention, and the control group were treated as usual. Link’s Stigma Scales (with three subscales, including perceived devaluation-discrimination (PDD), stigma-coping orientation, and stigma-related feeling), Five Facet Mindfulness Questionnaire (FFMQ), and Insight and Treatment Attitudes Questionnaire (ITAQ) were used to collect data before and after intervention. After intervention, the post-test score of PDD, stigma-coping orientation, FFMQ, and ITAQ were significantly different between the experimental group and the control group. In the experimental group, the PDD and stigma-coping orientation scores significantly decreased, and FFMQ and ITAQ scores increased remarkably (P < 0.05). In addition, correlation analysis revealed a significant negative correlation between mindfulness and stigma. MBCT was effective in reducing stigma in patients with schizophrenia, which mainly manifested as changes in the patients’ perception of stigma as well as the withdrawal and avoidance caused by schizophrenia. Enhancing mindfulness will help reduce the stigma level. MBCT is worthy of promotion and application in patients with schizophrenia.