Trial of Treatment for Internalized Stigma in Schizophrenia
- Conditions
- Schizophrenia
- Interventions
- Behavioral: Narrative Enhancement and Cognitive TherapyBehavioral: Supportive Group Therapy
- Registration Number
- NCT02421237
- Lead Sponsor
- John Jay College of Criminal Justice, City University of New York
- Brief Summary
The purpose of the present study is to build upon the investigators' previous exploratory intervention development study by conducting an adequately-powered, randomized controlled trial of the Narrative Enhancement/Cognitive Therapy (NECT) intervention among persons with schizophrenia-spectrum disorders.
- Detailed Description
Internalized (or self) stigma develops when people with mental illness become aware of stigmatizing attitudes held by many in society about mental illness (e.g., dangerousness, incompetence, inability to work), perceive these attitudes as being legitimate, and apply them to themselves. There is substantial evidence that internalized stigma is strongly negatively linked to both the objective (e.g., social functioning) and subjective (e.g., self-esteem and well-being) components of recovery for persons with schizophrenia, and that these effects operate independent of symptom-related disability. Nevertheless, few efforts have been made to develop treatment to address this issue. Previously, the investigators were funded to develop a group-based intervention (R34MH082161) combining cognitive-behavioral therapy and narrative psychotherapy to address internalized stigma among people with severe mental illness. The purpose of the present study is to build upon the investigators' previous exploratory intervention development study by conducting an adequately-powered, randomized controlled trial of the Narrative Enhancement/Cognitive Therapy (NECT) intervention among persons with schizophrenia-spectrum disorders. The investigators will screen 500 persons at two sites (Newark, New Jersey and Indianapolis, IN) for evidence of moderate or elevated internalized stigma. They will conduct a randomized study of NECT versus supportive group therapy in a sample of 175 individuals meeting Structured Clinical Interview criteria for schizophrenia-spectrum disorders. Randomization will be stratified by baseline self-stigma severity (moderate or elevated), to ensure roughly equal numbers of participants for each stratum. Participants will complete baseline, post-treatment, 3-month post treatment and 6-month post treatment assessments of internalized stigma, psychiatric symptoms, insight, self-esteem, hopelessness, coping, narrative coherence and social functioning. The specific aims of the project are: 1) Conduct a randomized study of the effectiveness of NECT, comparing outcomes for 175 persons with schizophrenia-spectrum disorder randomly assigned to NECT or supportive group therapy, 2) Examine the mediating impact of changes in narrative coherence and in the use of problem-centered coping strategies on outcomes for persons assigned to the NECT treatment. The intervention can have important implications for enhancing usual care services to reduce disability for people with schizophrenia, and therefore has potentially important implications for improving the public health.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 170
- Schizophrenia-spectrum disorder (schizophrenia or schizoaffective)
- Elevated internalized stigma
- Current substance dependence
- Inability to speak English
- Inability to provide informed consent
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Experimental condition Narrative Enhancement and Cognitive Therapy Narrative enhancement and cognitive therapy (NECT) groups. Structured psychoeducational and skills-training groups focused on self-stigma and its impact on people with schizophrenia Control condition Supportive Group Therapy Supportive group therapy groups. Unstructured supportive groups not focused on self-stigma.
- Primary Outcome Measures
Name Time Method Change in Internalized Stigma of Mental Illness Scale Up to 11 months post baseline Change in Beck Hopelessness Scale Up to 11 months post baseline Change in Rosenberg Self-Esteem Scale Up to 11 months post baseline
- Secondary Outcome Measures
Name Time Method Change in Heinrichs Quality of Life Scale Up to 11 months post baseline
Trial Locations
- Locations (1)
John Jay College, City University of New York
🇺🇸New York, New York, United States