Stigma resistance is positively associated with psychiatric and psychosocial outcomes: A meta-analysis

To better understand how stigma resistance impacts functioning-related domains, we examined mean effect sizes between stigma resistance and: 1) symptoms (overall, positive, negative, and mood symptoms); 2) self-stigma; 3) self-efficacy; 4) quality of life; 5) recovery; 6) hope; 7) insight, and 8) overall outcomes (the average effect size across the constructs examined in each study). The mean effect size between stigma resistance and overall outcomes was significant and positive (r = 0.46, p < 0.001, k = 48). A large, negative effect size was found between stigma resistance and self-stigma (r = -0.57, p < 0.001, k = 40). Large, positive effect sizes were found with self-efficacy (r = 0.60, p < 0.001, k = 25), quality of life (r = 0.51, p < 0.001, k = 17), hope (r = 0.54, p < 0.001, k = 8), and recovery (r = 0.60, p < 0.001, k = 7). Stigma resistance had a significant medium and small relationship with insight and symptoms, respectively. Race significantly moderated overall outcomes, self-stigma, mood symptoms, functioning, and hope associations. Education significantly moderated symptoms, functioning, and mood symptoms associations, and age significantly moderated self-stigma and negative symptom associations. Stigma resistance may be a key requirement for recovery. Individual characteristics influence resisting stigma and future work should prioritize cultural factors surrounding stigma resistance. (C) 2016 Elsevier B.V. All rights reserved.