Self-stigma, stages of change and psychosocial treatment adherence among chinese people with schizophrenia: A path analysis

Kelvin M.T. Fung, Wing Hong Hector Tsang, Fong Chan

Research output: Journal article publicationJournal articleAcademic researchpeer-review

71 Citations (Scopus)


Objectives: Mental illness stigma is one of the key causes for poor psychosocial treatment adherence. The: objective of this study was to explore the link between self-stigmatization and adherence via path analysis with insight and readiness for change conceptualized as the possible mediators. The direct effects of psychopathology causing nonadherence were also tested. Method: One hundred and five participants with schizophrenia were recruited from five psychiatric settings in Hong Kong. Data concerning their level of stigma, insight, stages of change, psychopathology, and psychosocial treatment adherence were collected. Path analysis was used to test two hypothetical models. Results: The findings supported the direct effects of selfstigma on reducing psychosocial treatment adherence, and its indirect influences mediated by insight and stages of change on treatment adherence. Psychopathology was also found to have a direct effect on undermining adherence. This model showed better model fit than the one which did not consider the direct effects of self-stigmatization and psychopathology. Conclusion: To conclude, this study deepened our understanding on the mechanism explaining how selfstigmatization undermines psychosocial treatment adherence. The findings provide direct implications on ways of formulating a self-stigma reduction program to combat self-stigma and its negative consequences.
Original languageEnglish
Pages (from-to)561-568
Number of pages8
JournalSocial Psychiatry and Psychiatric Epidemiology
Issue number5
Publication statusPublished - 1 May 2010


  • Insight
  • Schizophrenia
  • Self-stigma
  • Stages of change
  • Treatment adherence

ASJC Scopus subject areas

  • Epidemiology
  • Health(social science)
  • Social Psychology
  • Psychiatry and Mental health


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