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Coping strategies and self-stigma among adolescents discharged from psychiatric hospitalization: A 6-month follow-up study

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  • Tally Moses

Abstract

Background: The effects of mental illness stigma on adolescents receiving psychiatric treatment may largely be determined by their coping strategies. Yet, little is known about adolescents’ use of stigma-coping strategies, or how helpful these are for addressing stigma-related stress. Aims: This study explores how adolescents discharged from psychiatric hospitalization anticipate coping with a hypothetical social stigma event related to hospitalization. We examine how well anticipated coping strategies predict adolescents’ self-stigma ratings following 6 months. To evaluate the direction of causality, the reverse order of effects, the influence of self-stigma on coping strategies, is also assessed. Methods: A voluntary sample of 80 adolescents participated in two face-to-face interviews that assessed coping and self-stigma. Anticipated (baseline) and actual (follow-up) coping strategies were measured with a modified Response to Stress Questionnaire (primary and secondary control engagement coping, disengagement) and two stigma-specific strategies developed for this study (disconfirming stereotypes and aggression/confrontation). Relationships between anticipated coping strategies and self-stigma were assessed with ordinary least squares (OLS) regression; multivariate general linear modeling (GLM) and structural equation modeling (SEM) explored the reverse associations. Results: Youth reporting higher self-stigma ratings at follow-up anticipated using more disengagement and effort to disconfirm stereotypes and less secondary control engagement coping at baseline. Anticipated use of secondary control engagement coping was uniquely significant in predicting participants’ self-stigma when controlling for baseline self-stigma. At the same time, higher baseline self-stigma ratings predicted less adaptive coping (disengagement and effort to disconfirm stereotypes) at follow-up. Conclusions: The results point to the particular importance of secondary control engagement coping for helping to mitigate the impact of peer prejudice or discrimination on self-stigma among youth receiving psychiatric services. At the same time, higher initial levels of self-stigma likely drive less adaptive coping with peer stigma. These bidirectional influences point to a vicious cycle between internalizing negative stereotypes and coping in ways that perpetuate negative outcomes.

Suggested Citation

  • Tally Moses, 2015. "Coping strategies and self-stigma among adolescents discharged from psychiatric hospitalization: A 6-month follow-up study," International Journal of Social Psychiatry, , vol. 61(2), pages 188-197, March.
    • Handle: RePEc:sae:socpsy:v:61:y:2015:i:2:p:188-197
    DOI: 10.1177/0020764014540146
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    References listed on IDEAS

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    1. Moses, Tally, 2010. "Being treated differently: Stigma experiences with family, peers, and school staff among adolescents with mental health disorders," Social Science & Medicine, Elsevier, vol. 70(7), pages 985-993, April.
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    1. Tally Moses, 2015. "What helps or undermines adolescents’ anticipated capacity to cope with mental illness stigma following psychiatric hospitalization," International Journal of Social Psychiatry, , vol. 61(3), pages 215-224, May.
    2. Rice, Jessica L. & Tan, Tony Xing, 2017. "Youth psychiatrically hospitalized for suicidality: Changes in familial structure, exposure to familial trauma, family conflict, and parental instability as precipitating factors," Children and Youth Services Review, Elsevier, vol. 73(C), pages 79-87.
    3. Ferrie, Jamie & Miller, Hannah & Hunter, Simon C., 2020. "Psychosocial outcomes of mental illness stigma in children and adolescents: A mixed-methods systematic review," Children and Youth Services Review, Elsevier, vol. 113(C).

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