27th National Clinical Education Symposium Presentation Abstracts
29 APRIL 2025, TUESDAY
08:45-10:00 ORAL PRESENTATION SESSION - 4
PRISM-RII as a Visual Measurement Tool for Internalized Stigmatization in Patients with Schizophrenia
Yusuf Ezel Yıldırım1
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Show more (Affiliations)
1. Department of Psychiatry, University of Health Sciences, Bakirkoy Prof. Dr. Mazhar Osman Training and Research Hospital for Psychiatric, Neurologic and Neurosurgical Diseases, Istanbul, Türkiye
DOI: 10.5080/kes27.abs42 Page 65
BACKGROUND AND AIM: Stigmatization in schizophrenia negatively impacts quality of life and disease progression. Internalized stigma, wherein patients incorporate societal prejudices into their self-concept, can exacerbate symptoms, hinder treatment adherence, and reduce social functioning. Traditional assessments may not fully capture these subjective experiences. The Pictorial Representation of Illness and Self Measure Revised II (PRISM-RII) offers a visual, easy-to-apply, and practical tool to assess both perceived illness burden and internalized stigma. This study aims to evaluate the effectiveness of PRISM-RII in measuring internalized stigmatization among patients with schizophrenia.
METHODS: Fifty-three patients with schizophrenia were recruited from the outpatient clinic of Bakırköy Prof.Dr. Mazhar Osman Training and Research Hospital. Participants provided informed consent and completed a sociodemographic form, PANSS, the Internalized Stigma of Mental Illness Inventory(ISMI), and PRISM-RII. Ethical approval was obtained from the Bakırköy Dr. Sadi Konuk Training and Research Hospital Ethics Committee(decision number 2020-14-14).
RESULTS: Of 53 participants, 16 were women(30.2%), with a mean age of 38.7±11.5 and illness duration of 14.8±9.6 years. Regarding disc size selection representing illness, 24 participants (45.3%) chose the small disc, 14(26.4%) the medium disc, and 15(28.3%) the large disc. Total ISMI scores differed significantly across disc sizes(Kruskal-Wallis-H(2)=15.44,p<0.001). Post-hoc analyses showed that those selecting the small disc had lower ISMI scores compared to medium and large disc groups, with no significant difference between the latter two. A negative correlation was found between Self-Illness Separation(SIS) values and ISMI(r=-0,39,p=0.004).
CONCLUSIONS: PRISM-RII effectively assesses internalized stigma in schizophrenia. The correlation between disc size selection and ISMI scores suggests that patients with higher stigma levels perceive their illness as more central to their identity. The negative correlation between SIS values and stigma levels highlights PRISM-RIIs potential to capture the nuanced relationship between self-perception and illness. Visual tools like PRISM-RII may enhance clinicians' understanding of stigma's psychological impact, aiding in more personalized treatment strategies.