Positive Reframing of Psychosis Risk Reduces Social Stigma and Desire for Social Distance Among Adolescents:...

Communication about the at-risk mental state may shape not only clinical understanding but also peer-directed social evaluations. Prior work from our group has shown that positively reframing psychosis-risk feedback reduces perceived emotional harm and clinician stigma. The present study examined whether positive reframing influences adolescents' peer-directed social stigma and desire for social distance toward an at-risk youth, and whether these effects are moderated by adolescents' own distressing prodromal experiences, sex, and cultural background.

One hundred eight community-dwelling adolescents were randomly assigned to view either positively or negatively framed simulated clinical feedback about an at-risk youth. Participants then completed measures of social stigma and desired social distance. Prodromal experiences were assessed prior to the experimental manipulation.

Across stigma and social distance indices, framing effects were directionally consistent with a priori hypotheses, with positive reframing generally associated with lower stigma-related responses. However, effects were selective in magnitude. Statistically significant effects emerged primarily for willingness for limited social proximity, whereas effects for perceived dangerousness were marginal. Effects on other stigma dimensions were more modest and did not reach conventional levels of statistical significance. Framing effects varied by adolescents' own prodromal experiences, and exploratory analyses suggested additional moderation by sex and cultural background.

Positive reframing may shape adolescents' peer-directed social evaluations of the at-risk state in systematic but selective ways. In particular, it may contribute to a reduction in specific aspects of socially consequential stigma, including perceptions of dangerousness that may contribute to social avoidance. These findings underscore the importance of developmentally and culturally sensitive risk communication and highlight positive framing as a context-dependent strategy with potential social implications beyond the clinical encounter.