SA119. Defeatist Attitudes and Self-Stigma Associations in Patients With Schizophrenia

• Published in: Schizophrenia bulletin 2017-03, Vol.43 (suppl_1), p.S155-S155
• Main Authors: Mikhael, Tanya, Holden, Jason, Link, Peter, Granholm, Eric
• Format: Article
• Language: English
• Subjects: Abstracts
• ISSN: 0586-7614; 1745-1701
• DOI: 10.1093/schbul/sbx023.115

Background: Recent research has explored relationships among stigma, self-esteem, defeatist performance attitudes, and outcomes in schizophrenia. Internalized stigma has been associated with diminished self-esteem, hopelessness, and defeatist performance attitudes that have been associated with symptoms and poor functioning in schizophrenia. Internalized stigma can be viewed as self-defeating beliefs linked to illness, whereas defeatist attitudes as measured with the Defeatist Performance Attitude Scale (DPAS) are more generalized defeatist beliefs that may come from self-stigma related to illness as well as other factors such as failure experiences that are not attributed to illness. Methods: This study examined the relationships between these constructs as measured by the DPAS (Cane, Olinger, Gotlib, & Kuiper, 2006), the short form of the Self-Stigma of Mental Illness Scale (SSMIS-SF) and the Self-Esteem Rating Scale (SERS), and the Beck Hopelessness Scale (BHS). Participants (N = 60) enrolled in a randomized clinical trial for older adults with schizophrenia (mean age = 56) completed these assessments along with a battery of symptom, functioning, and neuropsychological measures. Results: Defeatist attitudes were moderately correlated with the Apply to Self ( r  = .453, P  = .000), and Harm to Self-Esteem ( r  = .349, P  = .006) subscales of the SSMIS-SF as well as both SERS subscales (positive: r  = −.332, P  = .002, negative: r  = .461, P  = .000), hopelessness ( r  = .391, P  = .000), positive symptoms (Positive and Negative Syndrome (PANSS) positive subscale: r  = .421, P < .001), and performance-based functioning (Maryland Assessment of Social Competence: r  = −.274, P  = .013). Both subscales of the SSMIS were correlated with SERS positive ( r  = −.454, P  = .000, = −.419, P  = .001) and negative ( r  = .553, P  = .000, r  = .552, P  = .000) self-esteem, hopelessness ( r  = .335, P  = .000, r  = .372, P  = .000), and positive symptoms ( r  = .256, P  = .048, r  = .308, P  = .017). Simultaneous regressions with both SSMIS subscales and DPAS as predictors were significant only for SERS positive ( R 2  = .226, F (3, 55) = 5.342, P < .003) and SERS negative ( R 2  = .385, F (3, 55) = 11.467, P < .000) self-esteem, hopelessness ( R 2 =.216, F (3, 55) = 5.036, P < .004), and PANSS positive symptoms( R 2  = .159, F (3, 56) = 3.540, P < .020). In these models, defeatist attitudes, but not the stigma subscales, were a significant independent predictor of SE