Date of Award

12-31-2021

Document Type

Campus Access Dissertation

Degree Name

Master of Arts (MA)

Department

Clinical Psychology

First Advisor

Paul G. Nestor

Second Advisor

Kristen A. Woodberry

Third Advisor

Alice S. Carter

Abstract

This study examined the nature of risk of psychosis and its relation to illness stigma in a sample of 116 participants between the ages of 12 and 35 years who were referred to Maine Medical Center and Harvard University/Beth Israel Deaconess Medical Center due to concerns regarding worsening mental health. Participants were assessed for risk of both psychotic and non-psychotic affective illnesses and eligible participants were asked about attitudes and beliefs about being “at-risk for” or “developing” mental illness, including their feelings and concerns about diagnosis, disclosure of illness status, and psychiatric treatment. This study looked at disclosure of illness labels and symptoms and divided participants into groups depending on which illness impacted their identity the most (non-psychotic group: anxiety, depression, bipolar; psychotic group: psychosis, schizophrenia). For this analysis, the principal hypothesis predicted that self-disclosure rates of mental health status would be significantly lower for participants who believed they were at-risk for psychotic disorders as compared to participants who believed they were at-risk for non-psychotic disorders. Results indicated disclosure rates were statistically significantly higher, not lower, in psychotic (M= 2.26, SD=2.26) than non-psychotic (M=2.21, SD=1.25) diagnostic risk groups, t(111)=-2.01, p=.047. To the degree that disclosure reflects lower levels of stigma, these results suggest that the stigma seen in adults with diagnosable psychotic disorders was not observed in this sample of at-risk youth. This lack of evidence for the current research hypothesis is discussed in relation to several contextual factors and is offered as a heuristic framework to examine these unexpected yet novel findings, albeit one that is caveated by the post-hoc nature of these interpretations. Why the psychotic diagnostic risk group disclosed at higher rates remains an important question. From a clinical perspective, the results offer insights on how youth cope with learning about their illness vulnerability and underscore the importance for mental health professionals of relying on individual feedback from their clients to understand the impacts of at-risk labels. Qualitative research may be highly informative for understanding the impact of stigma on youth at high risk for serious and persistent mental illnesses.

Comments

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