Cluster faculty member, Lawrence Yang and colleagues, just completed the first study to compare the stigmatizing effects of symptoms of schizophrenia and related psychotic disorders to the stigmatizing effects of being labelled “at-risk” for these conditions and seeking help at a specialized clinic. While the identification of the clinical “at-risk” state is an important psychiatric tool that allows for earlier evaluation and treatment, fewer than one in three young people identified as “at-risk” actually develop psychosis. Therefore it is important to consider the impacts of “false positives” when the “at-risk” label is applied to young people; there is concern that stigma may be a damaging effect of this label. Yang and colleagues found however that young people experienced more stigma from the symptoms that led them to seek help, than from being labelled “at-risk” or from attending a specialized clinic.
Yang and colleagues conducted this research at the Center of Prevention and Evaluation, or COPE, a comprehensive program at the New York State Psychiatric Institute at Columbia University that offers treatment and resources to participants about early symptoms and risk of schizophrenia. Young people referred to COPE are told that while they are at increased risk for psychosis as compared with the general population, it is likely that they will not develop psychosis. They are also told that if they do develop psychosis, they will receive immediate treatment, which tends to be effective. In Yang’s study, young people participating in COPE were asked about their stigma experiences on average about 11 months after they entered the program. With these survey data the researchers were able to distinguish feelings of stigma due to attending a specialized high-risk clinic from the stigma of having symptoms and experiences.
Yang is also the principal investigator of a multi-site five-year project currently funded by the National Institutes of Health that is building upon the current study to understand stigma better in the clinical high risk state for psychosis. This project, which is being conducted at New York State Psychiatric Institute, Beth Israel Deaconess-Harvard Medical Center, and Maine Medical Center, will enable Yang to corroborate these initial findings, as well as to examine whether vulnerability to stigma is affected by social cognition, like recognizing others’ intents and emotions in their facial expressions and in what they say.
