Association of media portrayals and negative interpersonal experiences with internalized stigma among outpatients...

Objective: This study examined factors associated with internalized stigma among community-dwelling individuals with schizophrenia, focusing on associations with negative interpersonal experiences, media representations, and illness duration. Materials and Methods: A cross-sectional survey was conducted with 80 outpatients at a university hospital using the Japanese version of the Internalized Stigma of Mental Illness Scale (ISMI-10). Associations between self-stigma and treatment duration, negative interpersonal reactions, and perceived discrepancies in media portrayals were analyzed. Binary logistic regression analysis was also performed, adjusting for treatment duration. Results: The mean treatment duration was 23.6 ± 13.2 years. Internalized stigma was significantly associated with "negative reactions when disclosing illness or symptoms to others" (adjusted odds ratio: 3.88, 95% confidence interval: 1.27-11.87; P=0.018) and "perceived discrepancy between media portrayals of schizophrenia and reality" (adjusted odds ratio: 5.62, 95% confidence interval: 1.78-17.76, P=0.003). The adjusted odds ratio for perceived discrepancy between media portrayals and reality was numerically higher than that for negative interpersonal experiences after adjustment for treatment duration. Conclusion: Internalized stigma in community-dwelling patients with schizophrenia is associated with negative interpersonal experiences and media-driven stereotypes. The strong link to media portrayal suggests that information dissemination in the digital age may exacerbate self-stigma. Support strategies in rural and local communities should focus on improving media literacy and collaborative efforts with residents to reconstruct social roles for individuals with schizophrenia.