Relations among Attenuated Psychosis Symptoms, Internalized Stigma, and Help-Seeking Intentions in a Community Sample of Youth

Abstract

Attenuated psychosis symptoms often emerge during adolescence and young adulthood and, for some youth may be distressing, impairing, and/or increase in severity over time. Early identification of these youth combined with early intervention efforts can prevent or mitigate a host of negative outcomes traditionally associated with full-threshold psychotic disorders. Internalized mental health stigma has been widely established as a significant barrier to help-seeking among youth with mental health concerns, particularly those with attenuated psychosis symptoms. In addition to stigma, various symptom-related factors (e.g., symptom type, severity, and related distress) can also influence help-seeking among this group. Although positive symptom severity is thought to be positively associated with help-seeking among youth in the general population, relations between other types of symptoms – e.g., negative symptoms or affective symptoms – and help-seeking remain somewhat unclear. The current study examined relations among self-reported mental health symptoms, internalized stigma, and intent to seek mental health treatment in a community sample of youth who were not currently engaged in treatment (N = 601, M age = 21.24). Participants were categorized into two clinical groups – those who scored at or above threshold, and those who scored below threshold on psychosis risk screening tools. Internalized stigma partially mediated the relation between positive symptom severity and intent to seek treatment and was positively associated with intent to seek treatment in the sample. Negative symptoms and general symptoms were each positively associated with internalized stigma and intent, controlling for positive symptoms. The relation between internalized stigma and intent did not appear to differ by clinical group. Among different types of internalized stigma, alienation was uniquely associated with intent to seek treatment in the full sample, with higher levels of alienation predicting greater intent. Findings highlight the complex interplay between symptoms, stigma, and help-seeking experiences among community youth and may inform early intervention efforts for this population.