The impact of self-stigma on self-esteem among persons with different mental disorders

This study assumes that just as public stigma differs depending on types of mental disorder, so too does self-stigma.

This study aims to compare self-stigma among persons with schizophrenia, alcohol use disorder and gambling disorder, and thereby analyze the effects of self-stigma on their self-esteem.

A total of 321 Korean adults involved in community mental services for schizophrenia (N = 116), alcohol use disorder (N = 102) and gambling disorder (N = 103) were surveyed (M_age = 40.74, standard deviation (SD) = 10.10, 83.8% male, 16.2% female). Participants were questioned on self-stigma and self-esteem. One-way analysis of variance (ANOVA) was used to compare the self-stigma by mental disorder type. Furthermore, in order to analyze the effects of self-stigma on self-esteem with subjects' age and educational background controlled, hierarchical regression analysis was used.

The self-stigma of gambling disorder group was highest not only in overall self-stigma but also some of its subscales - alienation, stereotype endorsement and stigma resistance - followed by alcohol use disorder group and schizophrenia group. In all three groups, self-stigma had a negative effect on self-esteem, while stigma resistance of subscales was the most important predictor. In addition to stigma resistance, alienation was a predictor in the schizophrenia group, alienation and social withdrawal in the alcohol use disorder group and social withdrawal was a significant predictor in the gambling disorder group. Therefore, the predictors of self-esteem differed depending on the type of mental disorder.

Based on these results, we suggest cognitive-behavioral intervention to raise subject awareness of the unjust social stigma and boost self-advocacy to resist the stigma.