(PS7-B42) Internalized Stigma of Mental Illness: Relationship to Personality Traits, and Influence on Therapist Preference

Given extensive support for the therapeutic alliance as a robust predictor of treatment outcomes (Castonguay et al., 2006), research on factors that influence the formation of this alliance, such as preferences related to therapist traits and factors that influence these preferences,  is warranted. One potential factor impacting both alliance and therapist preference, is internalized sigma of mental illness. Internalized stigma refers to the application of stigmatizing attitudes or beliefs about mental illness towards oneself. This self-stigma has been associated with poor alliance as rated by therapists (Nakash et al., 2013) and clients (Owen et al., 2013), and poor self-esteem, efficacy, and recovery orientation (Drapalski et al., 2013). Thus, internalized stigma may have implications for both personal traits, and traits desired in a therapist. Exploring the relationships between internalized stigma, personality, and therapist preference outside the context of active therapy may produce data without the confounding influence of current therapy dynamics or social desirability. This project aims to examine the influence of internalized stigma on traits desired in a hypothetical therapist and on personality traits.

In the ongoing study, participants (current n=21; target n=100) were recruited from a database of individuals who expressed interest in research participation. Participants were eligible if they had either never received therapy or had had fewer than 9 sessions of therapy. Participants completed a survey with a variety of measures: Internalized Stigma of Mental Illness (ISMIS; Ritsher et al., 2003), NEO-PI III 60-item, and a 90-item adjective list derived from the NEO-PI III asking them to indicate preferred traits in their hypothetical therapist. Four sub-scales of the ISMIS were included: Alienation, Social Withdrawal, Stereotype Endorsement, and Discrimination Experience.

            Preliminary findings indicated that stereotype endorsement uniquely predicted desire for a therapist high in openness after controlling for all other ISMIS sub-scales. Additionally significant correlations between desire for extraversion in a therapist, and social withdrawal and alienation were indicated. Finally significant positive relationships between self-rated neuroticism and alienation, discrimination experience, and social withdrawal, and a significant negative relationship between social withdrawal and self-rated extraversion were found.

Initial findings suggest specific domains of internalized stigma may have connections to one’s personality presentation and influence traits desired in a therapist. This line of research may have implications for improving the therapeutic alliance and subsequently enhancing outcomes when working with individuals who endorse stigmatized beliefs about having a mental illness.