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Self-stigma and suicide risk mediates the associations of inattention/impulsivity symptoms with psychological distress and quality of life among people with schizophrenia.

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Title: Self-stigma and suicide risk mediates the associations of inattention/impulsivity symptoms with psychological distress and quality of life among people with schizophrenia.
Authors: Nguyen, Thao Thanh Thi (AUTHOR), Soraci, Paolo (AUTHOR), Huang, Hsiao-Wei (AUTHOR), Chen, Yun-Ling (AUTHOR), Huang, Yu-Ting (AUTHOR), Pisanti, Renato (AUTHOR), Chang, Kun-Chia (AUTHOR), Griffiths, Mark D. (AUTHOR), Lin, Chung-Ying (AUTHOR)
Source: Quality of Life Research. May2026, Vol. 35 Issue 5, p1-17. 17p.
Subjects: Schizophrenia, Social stigma, Distraction, Human behavior, Psychological distress, Suicide risk factors, Quality of life
Geographic Terms: Taiwan
Abstract: Purpose: The present study examined whether self-stigma mediated the associations from inattention/impulsivity symptoms and suicide risk to psychological distress and quality of life (QoL) among individuals with schizophrenia. Methods: A longitudinal study was conducted comprising 241 individuals with schizophrenia who were recruited from daycare and outpatient units in Southern Taiwan. Eligible participants were adults (≥ 20 years) diagnosed with schizophrenia and enrolled in a daycare program or receiving regular outpatient follow-up. After providing informed consent, participants were interviewed to assess self-stigma, inattention and impulsivity symptoms, suicide risk, psychological distress, and QoL. Individuals with a history of moderate to severe substance use disorder (except tobacco use disorder) or head injury were excluded. Results: Self-stigma mediated the relationships between inattention and impulsivity symptoms and both psychological distress and QoL among Taiwanese individuals with schizophrenia. More specifically, the indirect effect of inattention and impulsivity symptoms at Time 1 (T1) on each QoL domain (physical, psychological, social, and environment QoL at T3 through self-stigma at T2 was significant (β = − 0.05 to − 0.03, p < 0.05). The indirect effect on psychological distress at T3 was also significant (β = 0.06, 95% CI [0.01, 0.12], p = 0.019). In addition, self-stigma at T1 significantly predicted each QoL domain (β = − 0.19 to − 0.13, p < 0.001) and psychological distress at T3 (β = 0.24, 95% CI [1.94, 4.10], p < 0.001) through self-stigma at T2. Conclusion: The present study demonstrated the robust influence of self-stigma in increasing psychological distress and poor QoL in each specific domain, suggesting clinical approaches are needed for managing self-stigma, inattention and impulsivity symptoms, and suicide risk among individuals with schizophrenia. Plain English summary: People with schizophrenia are likely to have inattention and impulsive behavior problems, which might cause difficulties in daily living because inattention and impulsive behavior problems may increase their self-stigma levels. However, no empirical evidence, especially longitudinal evidence, has been documented regarding the mediating roles of self-stigma in psychological distress and quality of life (QoL). Moreover, it is unclear if QoL is better to be examined using a global score or specific QoL domain score. Therefore, this study addressed the literature gap by testing the mediating role of self-stigma in the association of inattention/impulsivity with psychological distress and QoL (with global and specific domain scores comparison) over time. Employing a longitudinal design across three timepoints (3 months apart between each timepoint), people with schizophrenia completed questionnaires assessing their inattention/impulsivity, self-stigma, psychological distress, suicidality, and specific domains of QoL (including physical, psychological, social, and environmental QoL). Using robust analytical methods (i.e., structural equation modeling), higher levels of inattention and impulsivity led to stronger self-stigma, which in turn contributed to greater psychological distress and poorer QoL (in both global score and specific domains of QoL) later. Moreover, treating QoL using specific domains performed a better fit than treating QoL as a whole in the structural equation modeling, indicating that QoL needs to be considered for individual domain scores instead of summing them up. These findings suggest that reducing self-stigma may be a helpful way to improve psychological distress and specific domains of QoL for people living with schizophrenia. [ABSTRACT FROM AUTHOR]
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Database: Psychology and Behavioral Sciences Collection
Description
Abstract:Purpose: The present study examined whether self-stigma mediated the associations from inattention/impulsivity symptoms and suicide risk to psychological distress and quality of life (QoL) among individuals with schizophrenia. Methods: A longitudinal study was conducted comprising 241 individuals with schizophrenia who were recruited from daycare and outpatient units in Southern Taiwan. Eligible participants were adults (≥ 20 years) diagnosed with schizophrenia and enrolled in a daycare program or receiving regular outpatient follow-up. After providing informed consent, participants were interviewed to assess self-stigma, inattention and impulsivity symptoms, suicide risk, psychological distress, and QoL. Individuals with a history of moderate to severe substance use disorder (except tobacco use disorder) or head injury were excluded. Results: Self-stigma mediated the relationships between inattention and impulsivity symptoms and both psychological distress and QoL among Taiwanese individuals with schizophrenia. More specifically, the indirect effect of inattention and impulsivity symptoms at Time 1 (T1) on each QoL domain (physical, psychological, social, and environment QoL at T3 through self-stigma at T2 was significant (β = − 0.05 to − 0.03, p < 0.05). The indirect effect on psychological distress at T3 was also significant (β = 0.06, 95% CI [0.01, 0.12], p = 0.019). In addition, self-stigma at T1 significantly predicted each QoL domain (β = − 0.19 to − 0.13, p < 0.001) and psychological distress at T3 (β = 0.24, 95% CI [1.94, 4.10], p < 0.001) through self-stigma at T2. Conclusion: The present study demonstrated the robust influence of self-stigma in increasing psychological distress and poor QoL in each specific domain, suggesting clinical approaches are needed for managing self-stigma, inattention and impulsivity symptoms, and suicide risk among individuals with schizophrenia. Plain English summary: People with schizophrenia are likely to have inattention and impulsive behavior problems, which might cause difficulties in daily living because inattention and impulsive behavior problems may increase their self-stigma levels. However, no empirical evidence, especially longitudinal evidence, has been documented regarding the mediating roles of self-stigma in psychological distress and quality of life (QoL). Moreover, it is unclear if QoL is better to be examined using a global score or specific QoL domain score. Therefore, this study addressed the literature gap by testing the mediating role of self-stigma in the association of inattention/impulsivity with psychological distress and QoL (with global and specific domain scores comparison) over time. Employing a longitudinal design across three timepoints (3 months apart between each timepoint), people with schizophrenia completed questionnaires assessing their inattention/impulsivity, self-stigma, psychological distress, suicidality, and specific domains of QoL (including physical, psychological, social, and environmental QoL). Using robust analytical methods (i.e., structural equation modeling), higher levels of inattention and impulsivity led to stronger self-stigma, which in turn contributed to greater psychological distress and poorer QoL (in both global score and specific domains of QoL) later. Moreover, treating QoL using specific domains performed a better fit than treating QoL as a whole in the structural equation modeling, indicating that QoL needs to be considered for individual domain scores instead of summing them up. These findings suggest that reducing self-stigma may be a helpful way to improve psychological distress and specific domains of QoL for people living with schizophrenia. [ABSTRACT FROM AUTHOR]
ISSN:09629343
DOI:10.1007/s11136-026-04240-w