Direct and indirect associations between dysfunctional attitudes, self-stigma, hopefulness and social inclusion in young people experiencing psychosis

Abstract

Objective: Social inclusion and vocational activity are central to personal recovery for young people with psychosis. Studies with people experiencing long term psychosis suggest negative self-beliefs are important, but less is known about whether this association is present for young service users or about the potential influence of positive self-beliefs such as hopefulness. The aim of the current paper was to investigate the direct and indirect associations between dysfunctional attitudes, self-stigma, hopefulness, social inclusion and vocational activity for young people with psychosis.

Method: A 5-month longitudinal study was conducted with young psychosis service users. Measures of dysfunctional attitudes and self-stigma and vocational activity were obtained at baseline. Measures of hopefulness, social inclusion and vocational activity were obtained at follow-up.

Results: Hopefulness mediates the associations between self-stigma, social inclusion and vocational activity. Self-stigma may have a greater influence on social inclusion with age. Dysfunctional attitudes do not significantly predict social inclusion or change in vocational activity status.

Conclusion: Findings suggest that the impact of self-stigma may extend beyond social and occupational withdrawal and undermine subjective community belonging. Findings encourage an increased emphasis on facilitating hopefulness for young people who experience psychosis.

Keywords: Hope; Psychosis; Self stigma; Social inclusion.