Self-Stigma Patterns in Cannabis-Induced Versus Non-Cannabis-Induced First-Episode Psychosis

J Dual Diagn. 2026 Mar 5:1-7. doi: 10.1080/15504263.2026.2638185. Online ahead of print.

Abstract

Objective: This study examined differences in self-stigma between patients with cannabis-induced first-episode psychosis (C-FEP, n = 10) and non-cannabis-induced first-episode psychosis (NC-FEP, n = 10).

Methods: We used three core measures: the Self-Stigma of Mental Illness Scale (SSMIS), the Rosenberg Self-Esteem Scale (RSES), and qualitative interviews.

Results: Despite similar levels of stereotype awareness, C-FEP patients showed significantly lower stereotype concurrence (p < .01) and self-application (p < .05) than NC-FEP patients. C-FEP patients attributed their symptoms to cannabis use rather than inherent vulnerability, potentially buffering against internalized stigma, but expressed greater disclosure concerns. Self-esteem was higher in the C-FEP group (p < .05).

Conclusions: These findings suggest that causal attribution influences self-stigma manifestation, with important implications for tailored stigma interventions in early psychosis.

Keywords: Self-stigma; cannabis; first episode psychosis; psychosis.