Authors (including presenting author) :
Leung KS(1)(3), Chan SKW(2)(3), Chang WC(2)(3), LAM SBB(1), Cheung AK(3)
Affiliation :
(1) Department of Clinical Psychology, Queen Mary Hospital, (2) Department of Psychiatry, Queen Mary Hospital, (3) The University of Hong Kong
Introduction :
Psychotic disorders are a group of severe mental disorders that have a detrimental effect on cognitive and psychosocial functioning for patients and their families. The current state of psychosis services in Hong Kong places a focus on early intervention and the goal of achieving both clinical remission and functional recovery. Research indicates the issue of self-stigma, which involves the internalization of negative experiences related to mental illness and its associated mental health problems. It is suggested that interventions aiming at reducing self-stigmatization are necessary to promote recovery. In the proposed research, Acceptance and Commitment Therapy (ACT) was selected as a potential intervention for reducing self-stigma in people with psychosis. The proposed study consists of two parts, including a cross-sectional study for investigating the association between self-stigma and psychological flexibility, and the mediation model between psychological flexibility, self-stigma, and psychiatric symptoms in patients with early psychosis. In the second part of the research, an intervention study was conducted to evaluate the effect of ACT on stigma and psychological flexibility among patients with psychosis.
Objectives :
1. To study the association between self-stigma and psychological flexibility.
2. To study the association between self-stigma and the core processes of flexibility and inflexibility in the ACT Hexaflex model.
3. To explore the relationships among psychological flexibility, self-stigma, and psychiatric symptoms in patients with mental illnesses.
4. To examine and identify potential ACT processes that could be emphasized in future stigma reduction programs.
5. To examine the effectiveness of ACT intervention in reducing psychiatric symptoms by changing self-stigma.
Methodology :
Recruitment has taken place at the Department of Clinical Psychology and the Department of Psychiatry under the Hospital Authority, as well as through open recruitment at universities and mental health service centers in the community. Potential participants were screened based on inclusion and exclusion criteria.
Inclusion criteria: Participants with a DSM-5 diagnosis of schizophrenia or nonaffective psychosis, including diagnoses such as schizophreniform disorder, schizoaffective disorder, brief psychotic disorder, delusional disorder, or unspecified schizophrenia spectrum and other psychotic disorders will be recruited. Only participants between the ages of 18 and 64 will be recruited. Participants are also required to have proficient Chinese reading and writing abilities, as well as proficiency in Cantonese.
Exclusion criteria: Individuals will be excluded if they have a diagnosis of drug-induced psychosis, manic episode, intellectual disability, or dementia. Additionally, individuals with a history of severe physical or neurological illnesses will be excluded. Participants with active psychosis, active manic symptoms, or suicidal risk will also be excluded.
Demographic data and outcome measures were summarized using descriptive statistics. Correlation analyses were conducted to investigate the association among psychological flexibility, self-stigma, and psychiatric symptoms. Mediation analyses were conducted to examine the mediating effects of self-stigma on the relationship between psychological flexibility and the severity of psychiatric symptoms.
Result & Outcome :
Preliminary data suggested a significant correlation between psychological flexibility, self-stigma, and psychiatric symptoms. A trend of indirect effect in self-stigma was observed. A pilot Acceptance and Commitment Therapy (ACT) group was conducted at the Department of Clinical Psychology at QMH for patients with a history of psychosis. It is a four-week, 1.5-hour group intervention covering the topics of psycho-education on self-stigma and the six core processes in ACT. Preliminary data were reviewed.
