Self-stigma profiles in schizophrenia: a Latent Class Analysis approach^*

Objective: this study aimed at analyzing the internalized stigma latent profiles and the covariates that predict variations in their levels considering antecedent variables such as ethnicity, gender and some relevant clinical characteristics like premorbid adjustment, Duration of Untreated Psychosis and symptoms.

Method: Latent Class Analysis (LCA) was used to devise a solution with three internalized stigma profiles in a sample comprised by 227 patients diagnosed with schizophrenia from the Public Mental Health Centers of the city of Arica, Chile.

Results: the results showed that premorbid adjustment is a significant predictor of class belonging for the latent stigma profiles. When analyzing the sociodemographic characteristics and contrary to what was hypothesized, ethnicity was not a relevant predictor of internalized stigma profiles.

Conclusion: the latent classification model is suitable for assessing stigma profiles in order to target future interventions in specific foci and at-risk populations.

Descriptors:
Schizophrenia; Social Stigma; Latent Class Analysis; Mental Health Services; Sociodemographic Factors; Psychiatric Status Rating Scales

Highlights:

(1) Latent Class Analysis revealed different internalized stigma profiles in schizophrenia: high, moderate and low. (2) Ethnic identity was not a significant predictor: contrary to common assumptions, belonging to any given ethnic group did not exacerbate internalized stigma in individuals with schizophrenia. (3) Premorbid adjustment was a key factor: poor psychosocial functioning before psychosis onset was a significant predictor of high and moderate stigma profiles. (4) Severity of the symptoms was irrelevant: severity of the psychotic symptoms was not correlated with internalized stigma, suggesting that the psychosocial factors are more influential. (5) Targeted interventions are required: individuals with poor premorbid adjustment may benefit from stigma-reduction programs focused on improving their social and coping skills.