Date Approved

1-31-2024

Embargo Period

1-31-2024

Document Type

Dissertation

Degree Name

Doctor of Philosophy (Ph.D.) in Clinical Psychology

Department

Psychology

College

College of Science & Mathematics

Advisor

Thomas Dinzeo, Ph.D.

Committee Member 1

Meredith Jones, Ph.D.

Committee Member 2

Dylan Klein, Ph.D.

Committee Member 3

Monica Calkins, Ph.D.

Keywords

clinical high-risk for psychosis, cognitive behavioral therapy, early psychosis, first episode psychosis, group, stigma

Subject(s)

Psychoses--Treatment

Disciplines

Clinical Psychology | Psychology | Social and Behavioral Sciences

Abstract

The clinical high-risk state for psychosis (CHR-P) was created to help identify individuals experiencing early signs of psychosis to help forestall worsening symptoms. CHR-P individuals may experience stigma that may stem from internal or external processes, including from receiving specialized care. Research has demonstrated associations between internalized stigma and psychosocial and functional outcomes, which underscores the need for interventions to help mitigate the impact of stigma while balancing the need for treatment. To date, there is only one stigma intervention specifically designed for individuals designated as CHR-P, which is psychoeducational in nature. Based on the recent call to action that highlights the need for specialized stigma interventions for CHR-P groups, this study piloted the first manualized, cognitive-behaviorally based stigma intervention designed for early psychosis, including those at risk. The study took place at the University of Pennsylvania’s Psychosis Evaluation and Recovery Center and recruited 9 CHR-P and first episode psychosis subjects to participate in two simultaneously run groups. Psychosocial and functional outcomes were assessed at baseline and follow-up and demonstrated reductions in stigma and depression and elevations in sense of purpose, self-esteem, and social cognitive performance. Qualitative interviews showed acceptability, feasibility, and ideas for manual refinement.

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