Prevalence of Self-stigma and Its Association with Coping Strategies among Psychiatric Outpatients
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Abstract
Objective: This study aimed to examine the prevalence of self-stigma and its association with coping strategies among psychiatric outpatients in Thailand.
Methods: A cross-sectional descriptive study was conducted among 387 psychiatric outpatients at the psychiatric clinic of Ramathibodi Hospital. The Thai version of the Internalized Stigma of Mental Illness Scale (ISMI) was used to assess self-stigma, and the Thai version of the Brief COPE inventory was used to assess coping strategies. Data were analyzed using descriptive statistics, correlation analysis, and multiple regression analysis.
Results: Of the 387 participants, 355 (91.73%) provided valid responses. The majority were female (71.8%) with median age of 35 years. The prevalence of high self-stigma was 13.52%. Self-stigma correlated negatively with adaptive coping strategies, particularly positive reframing (r = -0.357, p < 0.001), acceptance (r = -0.320, p < 0.001), and humor (r = -0.279, p < 0.001), and positively correlated with maladaptive coping strategies, especially self-blame (r = 0.558, p < 0.001) and behavioral disengagement (r = 0.477, p < 0.001). Multiple regression analysis revealed that humor, self-blame, and behavioral disengagement remained significantly associated with self-stigma, after adjusting for sociodemographic and clinical variables.
Conclusion: This study found that the prevalence of self-stigma among psychiatric patients was lower than that reported in international studies. However, certain coping strategies were significantly associated with levels of self-stigma. These findings underscore the importance of promoting adaptive coping and reducing maladaptive coping, which may help mitigate self-stigma and enhance patients’ coping capacity.
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