The mediating role of self-compassion in the relationship between internalized stigma and psychological resilience in bipolar disorder.
bipolar disorder
internalized stigma
resilience
self-compassion
self-judgement
self-kindness
Journal
Psychology and psychotherapy
ISSN: 2044-8341
Titre abrégé: Psychol Psychother
Pays: England
ID NLM: 101135751
Informations de publication
Date de publication:
12 2023
12 2023
Historique:
revised:
24
06
2023
received:
12
04
2023
accepted:
19
07
2023
medline:
7
11
2023
pubmed:
31
7
2023
entrez:
31
7
2023
Statut:
ppublish
Résumé
Internalized stigma is known to be high in bipolar disorder (BD). Concepts such as self-compassion and psychological resilience have recently begun to be studied as protective factors for BD. The aim of the current study was to examine the relationships between internalized stigma, self-compassion and resilience among individuals with BD. One hundred and thirty-two male and female (18-65 years of age) participants with a DSM 5 diagnosis of BD (BD- I & BD- II) were included. The remission criteria (YMRS< 5 and HDRS< 7) was evaluated using clinician-administered measures and all participants were found to be remitted. Correlation and mediation analyses were performed. Participants completed the Internalized Stigma in Mental Illness Scale (ISMI), the Self-Compassion Scale (SCS) and the Resilience Scale for Adults (RSA). Significant correlations were found between internalized stigma, sub-dimensions of self-compassion (self-kindness, self-judgement, common humanity, isolation, mindfulness, and over-identification), and resilience in the expected directions like negative correlations between internalized stigma and positive dimensions of self-compassion (self-kindness, common humanity and mindfulness). Self-judgement and self-kindness mediated the relationship between internalized stigma and psychological resilience. The findings of the study shed light on which dimensions of self-compassion might be more beneficial to work with in order to increase resilience when working with internalized stigma in BD. This strengths-based investigation would be valuable to enrich psycho-social interventions for the prevention of relapse in BD.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
952-966Informations de copyright
© 2023 The Authors. Psychology and Psychotherapy: Theory, Research and Practice published by John Wiley & Sons Ltd on behalf of The British Psychological Society.
Références
Akdemir, A., Örsel, D. S., Dağ, İ., Türkçapar, M. H., İşcan, N., & Özbay, H. (1996). Hamilton depresyon derecelendirme ölçeği (HDDÖ)' nin geçerliliği-güvenirliliği ve klinikte kullanımı. Psikiyatri Psikoloji Psikofarmakoloji Dergisi, 4, 251-259.
Akin, U., Akin, A., & Abaci, R. (2007). Self-compassion scale: The study of validity and reliability. Hacettepe Unıversıty Journal of Educatıon, 33, 1-10.
Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic and statistical considerations. Journal of Personality and Social Psychology, 51, 1173-1182. https://doi.org/10.1037//0022-3514.51.6.1173
Basim, H. N., & Cetin, F. (2011). The reliability and validity of the resilience scale for adults-Turkish version. Turkish Journal of Pschiatry, 22, 104-114.
Bonanno, G. A. (2004). Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? American Psychologist, 59, 20-28. https://doi.org/10.1037/0003-066X.59.1.20
Brohan, E., Gauci, D., Sartorius, N., & Thornicroft, G. (2011). Self-stigma, empowerment and perceived discrimination among people with bipolar disorder or depression in 13 European countries: The GAMIAN-Europe study. Journal of Affective Disorders, 129, 56-63. https://doi.org/10.1016/j.jad.2010.09.001
Choi, J. W., Cha, B., Jang, J., Park, C. S., Kim, B. J., Lee, C. S., & Lee, S. J. (2015). Resilience and impulsivity in euthymic patients with bipolar disorder. Journal of Affective Disorders, 170, 172-177. https://doi.org/10.1016/j.jad.2014.08.056
Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155-159. https://doi.org/10.1037//0033-2909.112.1.155
Corrigan, P. W. (1998). The impact of stigma on severe mental illness. Cognitive and Behavioral Practice, 5, 201-222. https://doi.org/10.1016/S1077-7229(98)80006-0
Davydov, D. M., Stewart, R., Ritchie, K., & Chaudieu, I. (2010). Resilience and mental health. Clinical Psychology Review, 30, 479-495. https://doi.org/10.1016/j.cpr.2010.03.003
Døssing, M., Nilsson, K. K., Svejstrup, S. R., Sørensen, V. V., Straarup, K. N., & Hansen, T. B. (2015). Low self-compassion in patients with bipolar disorder. Comprehensive Psychiatry, 60, 53-58.
Edwards, L. (2022). Reducing internalized stigma with self-compassion: Integrating self-compassion framework to address stigma internalization [ProQuest Information & Learning]. In Dissertation abstracts international: Section B: The sciences and engineering (Vol. 83, Issue 9-B). Widener University ProQuest Dissertations Publishing.
Ellison, N., Mason, O., & Scior, K. (2013). Bipolar disorder and stigma: A systematic review of the literature. Journal of Affective Disorders, 151, 805-820. https://doi.org/10.1016/j.jad.2013.08.014
Ersoy, M. A., & Varan, A. (2007). Reliability and validity of the Turkish version of the internalized stigma of mental illness scale. Turkish Journal of Psychiatry, 18, 163-171.
Ferrari, A. J., Stockings, E., Khoo, J. P., Erskine, H. E., Degenhardt, L., Vos, T., & Whiteford, H. A. (2016). The prevalence and burden of bipolar disorder: Findings from the global burden of disease study 2013. Bipolar Disorders, 18, 440-450. https://doi.org/10.1111/bdi.12423
Fletcher, K., Yang, Y., Johnson, S. L., Berk, M., Perich, T., Cotton, S., & Murray, G. (2019). Buffering against maladaptive perfectionism in bipolar disorder: The role of self-compassion. Journal of Affective Disorders, 250, 132-139. https://doi.org/10.1016/j.jad.2019.03.003
Friborg, O., Hjemdal, O., Rosenvinge, J. H., & Martinussen, M. (2003). A new rating scale for adult resilience: What are the central protective resources behind healthy adjustment? International Journal of Methods in Psychiatric Research, 12, 65-76. https://doi.org/10.1002/mpr.143
Gilbert, P. (2009). Introducing compassion-focused therapy. Advances in Psychiatric Treatment, 15, 199-208. https://doi.org/10.1192/apt.bp.107.005264
Goodwin, F. K., & Jamison, K. R. (2007). Manic-depressive illness. Oxford University Press.
Grover, S., Mehra, A., Dogra, S., Hazari, N., Malhora, N., Narang, T., Sahoo, S., Sharma, S., Handa, S., & Avasthi, A. (2020). Internalized stigma and psychiatric morbidity among patients with psoriasis: A study from North India. Indian Dermatology Online Journal, 12, 97-104. https://doi.org/10.4103/idoj.IDOJ_345_20
Hawke, L. D., Parikh, S. V., & Michalak, E. E. (2013). Stigma and bipolar disorder: A review of the literature. Journal of Affective Disorders, 150, 181-191. https://doi.org/10.1016/j.jad.2013.05.030
Heath, P. J., Brenner, R. E., Lannin, D. G., & Vogel, D. L. (2018). Self-compassion moderates the relationship of perceived public and anticipated self-stigma of seeking help. Stigma and Health, 3, 65-68. https://doi.org/10.1037/sah0000072
Hofer, A., Mizuno, Y., Wartelsteiner, F., Fleischhacker, W. W., Frajo-Apor, B., Kemmler, G., & Uchida, H. (2017). Quality of life in schizophrenia and bipolar disorder: The impact of symptomatic remission and resilience. European Psychiatry, 46, 42-47. https://doi.org/10.1016/j.eurpsy.2017.08.005
Johnson, J., Wood, A. M., Gooding, P., Taylor, P. J., & Tarrier, N. (2011). Resilience to suicidality: The buffering hypothesis. Clinical Psychology Review, 31, 563-591. https://doi.org/10.1016/j.cpr.2010.12.007
Karadağ, F., Oral, E. T., Aran Yalçın, F., & Erten, E. (2001). Reliability and validity of Turkish translation of Young mania rating scale. Turkish Journal of Psychiatry, 13, 107-114.
Kazdin, A. E. (2007). Mediators and mechanisms of change in psychotherapy research. Annual Review of Clinical Psychology, 3, 1-27. https://doi.org/10.1146/annurev.clinpsy.3.022806.091432
Keyes, C. L. M. (2005). Mental illness and/or mental health? Investigating axioms of the complete state model of health. Journal of Consulting and Clinical Psychology, 73, 539-548. https://doi.org/10.1037/0022-006X.73.3.539
Lee, D., Cha, B., Park, C. S., Kim, B. J., Lee, C. S., Lee, S. J., & Choi, J. W. (2017). Effects of resilience on quality of life in patients with bipolar disorder. Journal of Affective Disorders, 207, 434-441. https://doi.org/10.1016/j.jad.2016.08.075
Lowens, I. (2010). Compassion focused therapy for people with bipolar disorder. International Journal of Cognitive Therapy, 3, 172-185. https://doi.org/10.1521/ijct.2010.3.2.172
Luthar, S. S., & Cicchetti, D. (2000). The construct of resilience: Implications for interventions and social policies. Development and Psychopathology, 12, 857-885. https://doi.org/10.1017/s0954579400004156
Mansell, W., Morrison, A. P., Reid, G., Lowens, I., & Tai, S. (2007). The interpretation of, and responses to, changes in internal states: An integrative cognitive model of mood swings and bipolar disorders. Behavioural and Cognitive Psychotherapy, 35, 515-539.
Masten, A. S. (2011). Resilience in children threatened by extreme adversity: Frameworks for research, practice, and translational synergy. Development and Psychopathology, 23, 493-506. https://doi.org/10.1017/S0954579411000198
Mateer, E. M., Jin, J., Taone, T., Duffield, C., & Foster, M. (2023). Does self-compassion buffer against stigma among Asian Americans? Stigma and Health. https://doi.org/10.1037/sah0000455
Mizuno, Y., Hofer, A., Suzuki, T., & Frajo-Apor, B. (2016). Clinical and biological correlates of resilience in patients with schizophrenia and bipolar disorder: A cross-sectional study. Schzophrenia Research, 175(1-3), 148-153. https://doi.org/10.1016/j.schres.2016.04.047
Mooney, K. A., & Padesky, C. A. (2000). Applying client creativity to recurrent problems: Constructing possibilities and tolerating doubt. Journal of Cognitive Psychotherapy, 14, 149-161. https://doi.org/10.1891/0889-8391.14.2.149
Neff, K. D. (2003). The development and validation of a scale to measure self-compassion. Self and Identity, 2, 223-250. https://doi.org/10.1080/15298860390209035
Neff, K. D. (2022a). The differential effects fallacy in the study of self-compassion: Misunderstanding the nature of bipolar continuums. Mindfulness, 13, 572-576.
Neff, K. D. (2022b). Self-compassion: Theory, method, research, and intervention. Annual Review of Psychology, 74, 193-218. https://doi.org/10.1146/annurev-psych-032420-031047
Neff, K. D., Kirkpatrick, K. L., & Rude, S. S. (2007). Self compassion and adaptive psychological functioning. Journal of Research in Personality, 41, 139-154. https://doi.org/10.1016/j.jrp.2006.03.004
Post, F., Buchta, M., Kemmler, G., Pardeller, S., Frajo-Apor, B., & Hofer, A. (2021). Resilience predicts self-stigma and stigma resistance in stabilized patients with bipolar I disorder. Frontiers in Psychiatry, 12, 678807. https://doi.org/10.3389/fpsyt.2021.678807
Post, F., Pardeller, S., Frajo-Apor, B., Kemmler, G., Sondermann, C., Hausmann, A., & Hofer, A. (2018). Quality of life in stabilized outpatients with bipolar I disorder: Associations with resilience, internalized stigma, and residual symptoms. Journal of Affective Disorders, 238, 399-404. https://doi.org/10.1016/j.jad.2018.05.055
Potter, N. N. (2013). Narrative selves, relations of trust, and bipolar disorder. Philosophy, Psychiatry, & Psychology, 20, 57-65.
Power, M. J. (2005). Psychological approaches to bipolar disorders: A theoretical critique. Clinical Psychology Review., 25, 1101-1122. https://doi.org/10.1016/j.cpr.2005.06.008
Ranjbar, M., Seyed Fatemi, N., Mardani Hamooleh, M., & Esmaeeli, N. (2020). Correlation of stigma with self-compassion in patients with bipolar disorder. Iran Journal of Nursing, 32, 1-13. https://doi.org/10.29252/ijn.32.122.1
Ritsher, J. B., & Phelan, J. C. (2004). Internalized stigma predicts erosion of morale among psychiatric outpatients. Psychiatry Research, 129, 257-265. https://doi.org/10.1016/j.psychres.2004.08.003
Shapero, B. G., Stange, J. P., Goldstein, K. E., Black, C. L., Molz, A. R., Hamlat, E. J., Black, S. K., Boccia, A. S., Abramson, L. Y., & Alloy, L. B. (2015). Cognitive styles in mood disorders: Discriminative ability of unipolar and bipolar cognitive profiles. International Journal of Cognitive Therapy, 8, 35-60. https://doi.org/10.1521/ijct.2015.8.1.35
Shipley, B. (2002). Cause and correlation in biology: A user's guide to path analysis, structural equations and causal inference. Cambridge University Press. https://doi.org/10.1017/CBO9781139979573
Tabachnick, B. G., & Fidell, L. S. (2013). Using multivariate statistics (6th ed.). Pearson.
Trompetter, H. R., De Kleine, E., & Bohlmeijer, E. T. (2017). Why does positive mental health buffer against psychopathology? An exploratory study on self-compassion as a resilience mechanism and adaptive emotion regulation strategy. Cognitive Therapy and Research, 41, 459-468.
Unal, G. O., Bektas, O., Iscan, G., & Inci, A. (2022). The relationship between internalized stigma, perceived social support and self-efficacy in bipolar disorder. General Medicine Journal, 32, 344-351. https://doi.org/10.54005/geneltip.1104022
Wong, C. C. Y., Knee, C. R., Neighbors, C., & Zvolensky, M. J. (2019). Hacking stigma by loving yourself: A mediated-moderation model of self-compassion and stigma. Mindfulness, 10, 415-433. https://doi.org/10.1007/s12671-018-0984-2
Wood, A. M., & Johnson, J. (Eds). (2016). The Wiley handbook of positive clinical psychology. John Wiley & Sons, Ltd.
Wood, A. M., & Tarrier, N. (2010). Positive clinical psychology: A new vision and strategy for integrated research and practice. Clinical Psychology Review, 30, 819-829. https://doi.org/10.1016/j.cpr.2010.06.003
Yang, Y., Fletcher, K., Whitehead, R., & Murray, G. (2018). Toward new therapeutic mechanisms in bipolar disorder: Analog investigation of self-compassion and nonattachment to self. Frontiers in Psychology, 9, 1848. https://doi.org/10.3389/fpsyg.2018.01848
Yanos, P. T., Lucksted, A., Drapalski, A. L., Roe, D., & Lysaker, P. (2015). Interventions targeting mental health self-stigma: A review and comparison. Psychiatric Rehabilitation Journal, 38(2), 171-178. https://doi.org/10.1037/prj0000100
Yates, T. M., Egeland, B., & Sroufe, L. A. (2003). Rethinking resilience: A developmental process perspective. In S. Luthar (Ed.), Resilience and vulnerability: Adaptation in the context of childhood adversities (pp. 243-266). Cambridge University Press. https://doi.org/10.1017/CBO9780511615788.012
Young, R. C., Biggs, J. T., Ziegler, V. E., & Meyer, D. A. (1978). A rating scale for mania: Reliability, validity and sensitivity. British Journal of Psychiatry, 133, 429-435. https://doi.org/10.1192/bjp.133.5.429