Abstract

Background

Internalised stigma in young people meeting criteria for at-risk mental states (ARMS) has been highlighted as an important
issue, and it has been suggested that provision of cognitive therapy may increase such stigma.

Aims

To investigate the effects of cognitive therapy on internalised stigma using a secondary analysis of data from the EDIE-2
trial.

Method

Participants meeting criteria for ARMS were recruited as part of a multisite randomised controlled trial of cognitive therapy
for prevention and amelioration of psychosis. Participants were assessed at baseline and at 6, 12, 18 and 24 months using
measures of psychotic experiences, symptoms and internalised stigma.

Results

Negative appraisals of experiences were significantly reduced in the group assigned to cognitive therapy (estimated difference
at 12 months was –1.36 (95% CI –2.69 to –0.02), P = 0.047). There was no difference in social acceptability of experiences (estimated difference at 12 months was 0.46, 95%
CI –0.05 to 0.98, P = 0.079).

Conclusions

These findings suggest that, rather than increasing internalised stigma, cognitive therapy decreases negative appraisals of
unusual experiences in young people at risk of psychosis; as such, it is a non-stigmatising intervention for this population.