Cognitive Emotion Regulation and Internalised Stigma Amongst Relatives of Individuals With First-Episode Psychosis

Family members of individuals experiencing a first-episode psychosis may experience disruptions in their interpersonal emotion regulation processes during this period, which may in turn lead to internalised stigma.

A cross-sectional study was conducted between January 2023 and January 2024 with 101 relatives of patients receiving inpatient treatment for first-episode psychosis in a state hospital in Türkiye. Data were collected using a sociodemographic form, the Self-Stigma Inventory for Families of Patients with Schizophrenia and the Cognitive Emotion Regulation Questionnaire. Group comparisons were performed using Mann-Whitney U and Kruskal-Wallis H tests. Associations were examined using Spearman's correlation, and linear regression assessed the association between self-stigma (independent variable) and total cognitive emotion regulation (dependent variable).

Levels of internalised stigma were found to be low; however, they were significantly associated with total cognitive emotion regulation scores (β = 0.172, p = 0.049). Amongst the maladaptive strategies, self-blame, catastrophising and blaming others were positively associated with social withdrawal and concealment of the illness, whereas putting events into perspective was negatively associated with perceived worthlessness (p < 0.05). Differences were observed in certain subscales of the Cognitive Emotion Regulation Questionnaire across some sociodemographic variables; however, no significant differences were identified in the subscales of the Inventory for Families of Patients with Schizophrenia (p > 0.05).

Maladaptive cognitive emotion regulation strategies are associated with higher internalised stigma and social withdrawal amongst relatives of individuals with first-episode psychosis. Integrating cognitive emotion regulation assessment into early intervention frameworks may strengthen family-focused psychosocial support.