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An Integrative Cognitive Model of Internalized Stigma in Psychosis

Published online by Cambridge University Press:  10 May 2017

Lisa Wood*
Affiliation:
North East London Foundation Trust, Goodmayes Hospital, Barley Lane, Ilford IG3 8XJ and Division of Psychology and Mental Health, University of Manchester, School of Health Sciences, Zochonis Building, ManchesterM13 9PL
Rory Byrne
Affiliation:
Psychosis Research Unit, Greater Manchester West NHS Foundation Trust, Rico House, Prestwich, ManchesterM25 9WL
Anthony P Morrison
Affiliation:
Division of Psychology and Mental Health, University of Manchester, School of Health Sciences, Zochonis Building, Manchester M13 9PL and Psychosis Research Unit, Greater Manchester West NHS Foundation Trust, Rico House, Prestwich, ManchesterM25 9WL
*
*Correspondence to Lisa Wood, North East London Foundation Trust, Goodmayes Hospital, Barley Lane, IlfordIG3 8XJ. E-mail: lisawood3@nhs.net

Abstract

Background: Internalized stigma is a significant difficulty for those who experience psychosis, but it has never been conceptualized using cognitive theory. Aims: The aim of this paper is to outline a cognitive model conceptualizing internalized stigma experienced by people who also experience psychosis. Method: Previous literature is reviewed, critiqued and synthesized to develop the model. It draws upon previous social cognitive models of internalized stigma and integrates cognitive behavioural theory and social mentality theory. Results: This paper identifies key cognitive, behavioural and emotional processes that contribute to the development and maintenance of internalized stigma, whilst also recognizing the central importance of cultural context in creating negative stereotypes of psychosis. Moreover, therapeutic strategies to alleviate internalized stigma are identified. A case example is explored and a formulation and brief intervention plan was developed in order to illustrate the model in practice. Conclusion: An integrative cognitive model is presented, which can be used to develop individualized case formulations, which can guide cognitive behavioural interventions targeting internalized stigma in those who experience psychosis. More research is required to examine the efficacy of such interventions. In addition, it is imperative to continue to research interventions that create change in stigma at a societal level.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2017 

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