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Updated: Jun 18, 2026

The Social Dimension of Stress: Experimental Manipulations of Social Support and Social Identity in the Trier Social Stress Test
Published on: November 19, 2015
Self-stigma, group identification, perceived legitimacy of discrimination and mental health service use
Nicolas Rüsch1, Patrick W Corrigan, Abigail Wassel
1Illinois Institute of Technology, Chicago, IL, USA. nicolas.ruesch@uniklinik-freiburg.de
Abstract:
Stigma may interfere with mental health service use. We measured self-stigma and stigma-related cognitions (group identification and perceived legitimacy of discrimination) at baseline in 85 people with schizophrenia, schizoaffective or affective disorders. After 6 months, 75 (88%) had reported use of mental health services. Controlling for baseline psychopathology, perceived stigma and diagnosis, low perceived legitimacy of discrimination predicted use of counselling/psychotherapy. Strong group identification was associated with participation in mutual-help groups. More self-stigma predicted psychiatric hospitalisation. Cognitive indicators of stigma resilience may predict out-patient service use, whereas self-stigma may increase the risk of psychiatric hospitalisation.
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