Stigma Resistance and Well- being among People in Treatment for Psychosis

We examine whether individuals ’ coping strategies help to explain the negative relationships of stigma-related stressors (perceived public devaluation, discrimination experiences, and internalized stigma) with their well-being (self-esteem, depressive symptoms, and quality of life). Two forms of stigma resis-tance (challenging and deflecting) were compared with concealment responses (maintaining secrecy, avoid-ing other people). Patients with psychoses at four psychiatric hospitals were interviewed (N = 65). Patients who perceived public devaluation made fewer attempts at stigma resistance. Those who experienced dis-crimination engaged in both concealing and resisting responses. Individuals with internalized stigma used concealment strategies only. Patients employing concealment tactics had lower self-esteem and greater depression, while those who challenged stereotypes or held deflection beliefs (‘‘I am not mentally ill’’) trended to higher self-esteem and had more positive quality of life. Coping tactics rarely mediated the links between stigma-related stressors and well-being; given these data are cross-sectional, other plausible stress dynamics need examination. Longitudinal data verifying that stigma resistance is beneficial could lead to future interventions. Keyword