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 (beta = -2.975 (95% CI -7.046-1.097) p = .151), age (beta = 0.007 (95% CI -0.152-0.165) p = .953), sexual trauma (beta = 0.904 (95% CI -3.668-5.476) p = .697), military trauma (beta = -0.571 (95% CI -4.027-7.287) p = .571). Self-stigma was associated with lower income and higher levels of anxiety (beta = 5.722 (95% CI 2.922-8.522) p = < .001), depression (beta = 6.937 (95% CI 4.287-9.588) p = < .000), and traumatic stress symptoms (beta = 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.