Stigma apprehension among adolescents discharged from brief psychiatric hospitalization

This study explores stigma apprehension (fear of being devalued or rejected) and its correlates among 102 adolescents, interviewed within 7 days of discharge from their first psychiatric hospitalization. Components of the Model of Stigma-Induced Identity Threat by Major and O'Brien (Annu Rev Psychol 56:393-421, 2005) comprise the study model, including collective stigma representations and group and domain identification; additional clinical, personal, and contextual characteristics such as social affiliation, interpersonal support, self-identification as having a mental disorder, and perceived need for others' approval were added to the model. We found that, on average, the participants reported "a little" stigma apprehension, and 21% reported substantial stigma apprehension. Multivariate analysis demonstrated that higher stigma apprehension was most associated with the female sex, younger age at initiation of mental health treatment, lower self-esteem, greater need for others' approval, more experiences with personal stigmatization, and not identifying or affiliating with peers who have mental health or behavior challenges. These factors collectively accounted for 46% of the variance. The study's findings particularly highlight the role of social context and external contingencies of self-worth in determining adolescents' perceptions of stigma-related threat.