A brief video intervention targeting self-stigma among childhood maltreatment survivors: an international,...

Self-stigma is a barrier to treatment-seeking among survivors of childhood maltreatment. Although brief online interventions have effectively reduced stigma toward mental disorders, few have targeted self-stigma among childhood maltreatment survivors, with none being tested across multiple countries. Here we examined whether a brief, social contact-based video could reduce self-stigma and increase help-seeking intentions across six countries.

In this completed, international, multicentre, single-blind, randomised controlled trial (ClinicalTrials.gov: NCT06159075) with 1:1 allocation and concealed assignment, young adults with a history of childhood maltreatment from the USA, Sweden, Switzerland, Japan, South Africa, and Türkiye were randomly assigned to either a social-contact video intervention (featuring a survivor's personal story acknowledging shame and modelling recovery) or a length-matched psychoeducation control. Participant blinding was not feasible; participants were unaware of the alternative condition, and investigators and analysts were blinded throughout. Prespecified primary outcomes were self-stigma (comprising of Alienation, Stereotype Endorsement, Secrecy, Perceived Recovery) and help-seeking intentions, assessed before and after intervention and at 30-day follow-up; following peer review, Perceived Recovery was designated the focal outcome for hypothesis testing, with the remaining domains analysed as secondary outcomes. Between-group differences at each timepoint were estimated using linear mixed-effects models adjusting for baseline scores. Adverse events were not assessed; no harms were reported.

Enrolment began on April 1st, 2024, and was completed on August 29, 2025. The intention-to-treat analysis included 2499 participants (mean age 27.1 years, SD 5.1; 1488 (61.9%) female). The social contact intervention produced a small but statistically significant improvement in Perceived Recovery relative to the psychoeducational control after intervention (adjusted mean difference [AMD] 0.201, 95% CI 0.076-0.327; p = 0.0020). No significant between-group differences emerged for Alienation, Stereotype Endorsement, Secrecy, or Help-Seeking Intentions, and all remained non-significant after Benjamini-Hochberg false discovery rate correction. Among US participants-the only site with sufficient follow-up data-no significant between-group difference was observed in Perceived Recovery at 30-day follow-up (AMD 0.050, 95% CI -0.306 to 0.407; p = 0.78), indicating that a single brief exposure was insufficient to produce durable change.

A single social contact-based video did not reduce most self-stigma domains or improve help-seeking relative to a psychoeducational control. More intensive or targeted approaches are needed to meaningfully address self-stigma among childhood maltreatment survivors.

SHN received support from the Azrieli Foundation Early Career Faculty Fellowship. Data collection in the USA was funded from discretionary research funds at NYSPI. Regarding data collection in Japan, this work was supported by JSPS, KAKENHI Grant Number JP 23K02998. In South Africa, the study was supported by the South African Medical Research Council Unit on the Genomics of Brain Disorders. Data collection costs in other countries were covered by the participating institutions/researchers.