Family Affiliate Stigma and Patient Internalized/Anticipated Stigma in Bipolar Disorder: A Multicenter Dyadic Study
International Journal of Social Psychiatry, 2026 (SSCI, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1177/00207640261468240
- Dergi Adı: International Journal of Social Psychiatry
- Derginin Tarandığı İndeksler: Social Sciences Citation Index (SSCI), Scopus, Periodicals Index Online, CINAHL, EMBASE, Index Islamicus, MEDLINE, MLA - Modern Language Association Database, Psycinfo, Public Affairs Index, MLA International Bibliography, Social Sciences Abstracts, Academic Search Ultimate (EBSCO), Social Science Premium Collection (ProQuest), Health Research Premium Collection (ProQuest), Sociology Source Ultimate (EBSCO)
- Anahtar Kelimeler: affiliate stigma, bipolar disorder, dyadic associations, illness burden, stigma
- Çukurova Üniversitesi Adresli: Evet
Özet
Background: Stigma in bipolar disorder is commonly conceptualized as an individual-level experience, but it may also be embedded within family systems. Family members may develop affiliate stigma, and patient–relative stigma dimensions may co-occur within dyads. Dyadic studies assessing these dimensions concurrently remain limited. Aims: This multicenter dyadic study examined the association between relatives 'affiliate/family stigma and patients' internalized/anticipated stigma in bipolar disorder, and explored associations between stigma-related dimensions and illness-burden indicators. Methods: The sample comprised 184 adults with bipolar disorder in remission and one adult relative per patient, recruited from seven centers across Türkiye. Diagnoses were confirmed using the SCID-5-CV. Stigma was assessed using parallel patient and relative forms of the newly developed Turkish-language Patient–Relative Stigma Questionnaire for Bipolar Disorder (PRSQ-BD). Psychometric analyses included internal consistency, exploratory and confirmatory factor analyses, and discriminant-separability indices. Dyadic associations were examined using linear mixed-effects models with random intercepts for center. Lifetime episode count and bipolar episode–related hospitalizations were analyzed using negative binomial regression models. Results: Higher relatives' affiliate/family stigma was associated with higher patient internalized/anticipated stigma after adjustment for sociodemographic and clinical variables. Patients' public stigma beliefs showed a strong statistical association with internalized/anticipated stigma. Patient internalized/anticipated stigma was statistically associated with lifetime episode count and hospitalization count. In dyadic hospitalization models, relatives' internalized/anticipated stigma was also statistically associated with hospitalization count. Conclusions: These exploratory findings indicate that patient and relative stigma-related dimensions are associated within dyads and are statistically related to illness-burden indicators. Given the preliminary psychometric status of the PRSQ-BD and the cross-sectional design, findings should be interpreted as dyadic associations among theoretically specified mean-item indices, not as evidence of validated mechanisms, temporal pathways, or causal effects.