We propose the first study to systematically examine any potential effects of stigma associated with the new 'high risk for psychosis'('HRP') designation, a groundbreaking development in the earliest identification of psychotic signs that enables efforts to prevent psychosis. Concerns of stigma towards the new HRP status have been expressed because this designation has the potential to activate the same severe social ramifications known to be associated with an identification of 'psychosis'. Stigma may be an unnecessary risk especially because the majority of those identified as HRP even in the absence of intervention do not go on to develop psychosis. Further, the HRP designation is being used in over 6 countries (including the U.S.) and there is current debate to include it officially within the DSM 5 in 2013. Because no evidence exists regarding stigma of the HRP, we bring together expertise from two well-established research teams that have experience in treating and following HRP individuals and their family members with that of recognized researchers in stigma and the early course of psychosis. We propose a comprehensive approach to assessing stigma experiences among a HRP group (n= 196) and associated 'family attitudes'among family members (n= 155) at initial HRP identification and then at 6 months follow-up. We compare the stigma experiences of the HRP group with that of a first episode non-affective psychosis group (FEP;n= 100) who act as a benchmark for severe stigma. We examine stigma of the HRP designation at baseline, how any stigma may increase or decrease over time, and how this stigma compares with that of an FEP group. We further assess longitudinal impacts of HRP stigma and 'family attitudes'upon changes in psychological, social, and developmental outcomes in the HRP group. This research promises to greatly inform interventions to counter stigma at its earliest stages and maximize opportunities for people at HRP to attain developmental goals leading to adulthood. Further, removing or ameliorating this concern of stigma is crucial, as HRP identification is a potentially transformative means of preventing and treating schizophrenia, thus reducing burden for psychosis worldwide.

Public Health Relevance

Concerns of stigma towards the new 'high risk for psychosis'('HRP') identification have been expressed because this designation has the potential to activate the severe social ramifications known to be associated with an identification of 'psychosis'. Stigma may be an unnecessary risk especially because the majority of those identified as HRP do not go on to develop psychosis and the HRP designation is being increasingly used worldwide. We propose the first study to systematically examine any effects of stigma associated with the HRP designation, thus contributing to strategies for early detection of psychoses and reducing the burden of psychosis globally.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
1R01MH096027-01
Application #
8222135
Study Section
Special Emphasis Panel (ZRG1-RPHB-P (02))
Program Officer
Friedman-Hill, Stacia
Project Start
2012-05-22
Project End
2017-03-31
Budget Start
2012-05-22
Budget End
2013-03-31
Support Year
1
Fiscal Year
2012
Total Cost
$514,751
Indirect Cost
$88,897
Name
Columbia University (N.Y.)
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
621889815
City
New York
State
NY
Country
United States
Zip Code
10032
Seidman, Larry J (2014) Stigma and mental illness. Asian J Psychiatr 9:1-2
Walder, Deborah J; Holtzman, Carrie W; Addington, Jean et al. (2013) Sexual dimorphisms and prediction of conversion in the NAPLS psychosis prodrome. Schizophr Res 144:43-50
Yang, Lawrence H; Anglin, Deidre M; Wonpat-Borja, Ahtoy J et al. (2013) Public stigma associated with psychosis risk syndrome in a college population: implications for peer intervention. Psychiatr Serv 64:284-8