Intergenerational burden: deconstructing the dual impact of familial suicide in a specialized bipolar clinic, from clinical risk to internalized stigma
4 affiliations
- 1Department of Psychiatry, Kocaeli University Research and Application Hospital
- 2Department of Psychiatry, Kocaeli City Hospital
- 3Department of Psychiatry, Derince Training and Research Hospital
- 4Department of Psychiatry, Eyüpsultan State Hospital
Abstract
Background: This study aimed to assess the level of internalized stigma in individuals with bipolar disorder (BD) during the euthymic phase and to examine its individual, familial, and clinical predictors.
Method: Ninety-seven euthymic participants with BD, diagnosed according to DSM-5 criteria, were administered the Internalized Stigma of Mental Illness Scale (ISMI), Resilience Scale for Adults (RSA), and Rosenberg Self-Esteem Scale (RSES).
Results: High levels of internalized stigma (ISMI mean ≥ 2.5) were found in 13.4% of participants. Multiple linear regression analysis showed that higher resilience (β = –0.39, p <.001) and higher educational attainment (β = –0.18, p = .029) were associated with lower internalized stigma, whereas a family history of death by suicide was associated with higher stigma (β = 0.20, p = .019). A greater number of mood episodes showed a borderline association with higher stigma (β = 0.18, p = .050). The overall model explained 52% of the variance in stigma scores.
Limitations: The cross-sectional design and relatively small sample size are the primary limitations.
Conclusions: Internalized stigma in BD was associated with a combination of individual, familial, and educational factors. The independent association of a family history of suicide underscores the importance of a systematic evaluation of such a family history in a clinical interview, suggesting that strengthening resilience and health literacy may represent vital targets for intervention.
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BibTeX
@article{kocaayan2026intergenerational,
title = {{Intergenerational burden: deconstructing the dual impact of familial suicide in a specialized bipolar clinic, from clinical risk to internalized stigma}},
author = {Fatma Seher Kocaayan and Ezgi Şişman and Havva Atasoy Kaplan and İlay Dalkıran and Hanife Yılmaz Abaylı and Aslıhan Polat},
journal = {Frontiers in Psychiatry},
year = {2026},
month = oct,
doi = {10.3389/fpsyt.2026.1931254},
url = {https://www.frontiersin.org/articles/10.3389/fpsyt.2026.1931254/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Intergenerational burden: deconstructing the dual impact of familial suicide in a specialized bipolar clinic, from clinical risk to internalized stigma
AU - Fatma Seher Kocaayan
AU - Ezgi Şişman
AU - Havva Atasoy Kaplan
AU - İlay Dalkıran
AU - Hanife Yılmaz Abaylı
AU - Aslıhan Polat
PY - 2026
DA - 2026/10/20
JO - Frontiers in Psychiatry
DO - 10.3389/fpsyt.2026.1931254
UR - https://www.frontiersin.org/articles/10.3389/fpsyt.2026.1931254/full
AB - Background: This study aimed to assess the level of internalized stigma in individuals with bipolar disorder (BD) during the euthymic phase and to examine its individual, familial, and clinical predictors. Method: Ninety-seven euthymic participants with BD, diagnosed according to DSM-5 criteria, were administered the Internalized Stigma of Mental Illness Scale (ISMI), Resilience Scale for Adults (RSA), and Rosenberg Self-Esteem Scale (RSES). Results: High levels of internalized stigma (ISMI mean ≥ 2.5) were found in 13.4% of participants. Multiple linear regression analysis showed that higher resilience (β = –0.39, p <.001) and higher educational attainment (β = –0.18, p = .029) were associated with lower internalized stigma, whereas a family history of death by suicide was associated with higher stigma (β = 0.20, p = .019). A greater number of mood episodes showed a borderline association with higher stigma (β = 0.18, p = .050). The overall model explained 52% of the variance in stigma scores. Limitations: The cross-sectional design and relatively small sample size are the primary limitations. Conclusions: Internalized stigma in BD was associated with a combination of individual, familial, and educational factors. The independent association of a family history of suicide underscores the importance of a systematic evaluation of such a family history in a clinical interview, suggesting that strengthening resilience and health literacy may represent vital targets for intervention.
SN - 1664-0640
ER -