Prevalence and correlates of self-stigma in Post-Traumatic Stress Disorder (PTSD)

BACKGROUND: Self-stigma refers to the internalisation of negative societal views and stereotypes. Self-stigma has been well-characterised in the context of mental disorders such as schizophrenia but has received little attention in relation to post-traumatic stress disorder (PTSD).

OBJECTIVE: This work aimed to determine the prevalence of self-stigma in a sample of adults with PTSD and to establish factors associated with the internalisation of stigma in this population.

METHOD: Participants were 194 adults (mean age 46.07 (SD = 12.39); 64.4% female; 96.6% white Caucasian; residing in the UK), who self-reported a diagnosis of PTSD and currently screened positive for the disorder according to the PTSD Checklist for DSM-5 (PCL-5). Structured interviews and validated self-report questionnaires were used to ascertain clinical and sociodemographic information for analysis.

RESULTS: The prevalence of self-stigma measured by the Internalized Stigma of Mental Illness Scale (ISMIS) was 41.2% (95% CI 34.24–48.22). There was no evidence of an association between self-stigma and gender (β = −2.975 (95% CI −7.046–1.097) p = .151), age (β = 0.007 (95% CI −0.152–0.165) p = .953), sexual trauma (β = 0.904 (95% CI −3.668–5.476) p = .697), military trauma (β = −0.571 (95% CI −4.027–7.287) p = .571). Self-stigma was associated with lower income and higher levels of anxiety (β = 5.722 (95% CI 2.922–8.522) p = <.001), depression (β = 6.937 (95% CI 4.287–9.588) p = <.000), and traumatic stress symptoms (β = 3.880 (95% CI 1.401–6.359) p = .002).

CONCLUSIONS: The results indicate that self-stigma may be a significant issue among people with a diagnosis of PTSD. Further work is needed to understand the long-term impact and to develop interventions to address the internalisation of stigma in this population.

•  The prevalence of self-stigma among a sample of participants with PTSD was 41.2%.

•  There was no evidence of an association between self-stigma and gender, age or sexual / military trauma.

•  Self-stigma was associated with lower income and higher levels of anxiety, depression, and traumatic stress symptoms.