Stigma as related to cognition in psychotic disorders: A scoping review of the literature

Cognitive impairment is a core feature of schizophrenia, affecting over 80% of diagnosed people and negatively impacting their daily lives. Recent research has identified stigma toward the cognitive impairment associated with schizophrenia, highlighting how changes in sense of self and perception interact with cognition to shape daily interactions and functioning. This scoping review sought to provide an overview of the published research linking stigma and cognition in psychotic disorders, in order to identify gaps in knowledge and directions for future research. The review followed PRISMA-ScR guidelines across PubMed, Web of Science, and PsycInfo databases. A total of 32 papers were eligible and reviewed for data extraction including study design, sample characteristics, and main findings reported. A total of 20 papers evaluated relationships between stigma and neurocognition, while 12 focused on social cognition or metacognition as related to stigma. The vast majority of papers (over 80%) focused on internalized stigma as related to cognition. This current literature suggests that subjective cognition, rather than performance-based cognition, is of importance for internalized stigma among people with psychotic disorders. Additional research is needed regarding how other stigma constructs, such as perceived stigma experiences or stigma specific to cognitive difficulties, may be associated with cognition and functional outcomes.