This meta-analytic study synthesized findings from 108 independent data sets across 22 cultures to investigate whether the stigma internalization model (the internalization of experienced stigma and perceived stigma to self-stigma) is associated with well-being and recovery of people with mental illness. We also examined the moderating role of collectivism in the internalization process. Results of the meta-analytic structural equation modeling suggested that self-stigma is a significant mediator in the relationships between experienced stigma and perceived stigma with well-being and recovery variables (indirect effects = 0.02 to −0.16). Experienced and perceived stigma had significant direct effects on well-being and recovery variables (Bs = 0.07 to −0.21, p < 0.05), suggesting that both external (e.g., public stigma) and internal (i.e., self-stigma) influences of stigma work concurrently to affect recovery and well-being of people with mental illness. The results of the mixed effect three-level meta-analytic models showed that collectivism significantly moderated the relationship between experienced and perceived stigma with self-stigma (Bs = 0.06 to 0.11, p < 0.05). This implied that the more collectivistic a culture is, the stronger the correlation between experienced and perceived stigma with self-stigma. Implications to stigma reduction approaches were discussed.

这项元分析研究综合了来自 22 种文化的 108 个独立数据集的结果，以调查污名内化模型（将体验到的污名和感知到的污名内化为自我污名）是否与精神疾病患者的福祉和康复有关。我们还研究了集体主义在内化过程中的调节作用。元分析结构方程模型的结果表明，自我污名是经历污名和感知污名与幸福和恢复变量之间关系的重要中介（间接影响 = 0.02 至 -0.16）。经历和感知的耻辱感对幸福感和恢复变量有显着的直接影响（Bs = 0.07 到 -0.21，p < 0.05)，表明污名的外部（例如，公共污名）和内部（即，自我污名）影响同时影响精神疾病患者的康复和福祉。混合效应三级元分析模型的结果表明，集体主义显着调节了体验和感知的污名与自我污名之间的关系（Bs = 0.06 至 0.11，p  < 0.05）。这意味着文化越集体主义，体验和感知的污名与自我污名之间的相关性就越强。讨论了对减少污名化方法的影响。