John Jay College of Criminal Justice and the Graduate Center, City University of New York, New York, New York, USA.
University of Haifa, Haifa, Israel.
J Clin Psychol. 2021 Oct;77(10):2341-2352. doi: 10.1002/jclp.23155. Epub 2021 May 8.
The Illness Identity model posits that self-stigma reduces hope and self-esteem among persons with severe mental illnesses, impacting a range of outcomes. The "insight paradox" anticipates that the negative effects of self-stigma are amplified by insight. This study tested these predictions using both cluster and path analyses.
A total of 117 participants meeting the criteria for schizophrenia-spectrum disorders completed measures of self-stigma, self-esteem, hopelessness, insight, social functioning, coping, and symptoms.
Cluster analysis supported the insight paradox; persons with low self-stigma/high insight had fewer psychiatric symptoms and better interpersonal functioning than persons with high self-stigma/low insight. Path analysis did not support the insight paradox, but indicated that self-stigma and insight impact different outcomes.
Findings suggest that support for the predictions of the Illness Identity model and insight paradox are supported may depend on analytic method.
Finding suggest that the benefits of self-stigma reduction may be constrained by insight.
疾病认同模型提出，自我污名感会降低严重精神疾病患者的希望和自尊，从而影响一系列结果。“洞察力悖论”预测，自我污名感的负面影响会因洞察力而放大。本研究使用聚类分析和路径分析来检验这些预测。
共有 117 名符合精神分裂症谱系障碍标准的参与者完成了自我污名感、自尊、绝望感、洞察力、社会功能、应对方式和症状的测量。
聚类分析支持了洞察力悖论；低自我污名感/高洞察力的人比高自我污名感/低洞察力的人精神病症状更少，人际关系功能更好。路径分析不支持洞察力悖论，但表明自我污名感和洞察力会影响不同的结果。
研究结果表明，支持疾病认同模型和洞察力悖论的预测可能取决于分析方法。
研究结果表明，自我污名感降低的好处可能受到洞察力的限制。
