People with mental illness often internalize negative stereotypes, resulting in self-stigma and low self-esteem (“People with mental illness are bad and therefore I am bad, too”). Despite strong evidence for self-stigma's negative impact as assessed by self-report measures, it is unclear whether self-stigma operates in an automatic, implicit manner, potentially outside conscious awareness and control. We therefore assessed (i) negative implicit attitudes toward mental illness and (ii) low implicit self-esteem using 2 Brief Implicit Association Tests in 85 people with mental illness. Implicit self-stigma was operationalized as the product of both implicit measures. Explicit self-stigma and quality of life were assessed by self-report. Greater implicit and explicit self-stigma independently predicted lower quality of life after controlling for depressive symptoms, diagnosis, and demographic variables. Our results suggest that implicit self-stigma is a measurable construct and is associated with negative outcomes. Attempts to reduce self-stigma should take implicit processes into account.
*Joint Research Programs in Psychiatric Rehabilitation, Illinois Institute of Technology, Chicago, IL; †Department of Psychiatry and Psychotherapy, University of Freiburg, Germany; and ‡Department of Psychology, Northwestern University, Evanston, IL.
Supported by a Marie Curie Outgoing International Fellowship of the European Union to Nicolas Rüsch and by funding from NIAAA, NIMH and the Fogarty International Center (to Patrick W. Corrigan).
Send reprint requests to Nicolas Rüsch, MD, Department of Psychiatry and Psychotherapy, University of Freiburg, Hauptstr. 5, 79104 Freiburg, Germany. E-mail: email@example.com.