Social support modifies perceived stigmatization in the first years of mental illness: a longitudinal approach.

Perceived stigmatization of mentally ill people impairs their social relations and well-being. While perceived stigmatization theoretically and empirically has been accounted for as an independent and unalterable factor, this longitudinal study focuses on reciprocal effects between stigmatization and social ties. The duration of mental illness is included as a grouping variable to extend the longitudinal perspective. A sample of severely mentally ill persons (n=165) in two psychiatric hospitals in Zurich took part in a structured interview during their admission and 1 year later. Cross-lagged path models were designed to test the interrelations of (1) perceived stigmatization, (2) a defensive stigma coping orientation, (3) concrete stigmatizing experiences, and either (4) social network, or (5) perceived social support as dependent variables. Contrary to previous findings, neither of the three components of stigmatization tested has any influence on social network or support. Social support, though, strongly predicts perceived stigmatization 1 year later, but only in the group with a more recent onset of illness. This finding suggests that the perception of stigma is subject to modification in the course of new life circumstances and underlines the importance of activating social resources in the first years of mental illness. Duration of illness should be included as a central variable in future research, as it influences the nature of the relation between stigmatization and social ties.