Flourishing, psychological distress and internalized stigma among parents of an adult son or daughter with schizophrenia

Background: Parents of adults diagnosed with schizophrenia, have been reported to have higher levels of psychological distress than the general population, and parents whose offspring have other mental or physical illnesses. Aim: This study examines the comparatively new construct of flourishing, and its relationship to internalized stigma and psychological distress. Method: A cross-sectional survey was conducted between July 2021 and March 2022, with an international sample of 200 parents of adult sons or daughters diagnosed with schizophrenia. Participants completed a demographic questionnaire and three standardized inventories. These were the PERMA Profiler, which measures flourishing, the CORE-10, which measures psychological distress, and a new parental Internalized Stigma Scale. Sample characteristics of individuals of schizophrenia and their parents were examined using descriptive statistics, and the contributing factors affecting stigma were assessed through regression analysis. Results: The initial hypothesis that parents scoring high on internalized stigma, would have significantly higher levels of psychological distress and lower levels of flourishing, than parents with low- level internalized stigma, was confirmed. Overall, the flourishing levels were lower and psychological distress higher in these parents, than those of the general population. Regression analysis identified psychological distress and hopefulness as the two major predictors of flourishing, though in different directions. Interestingly, stigma did not determine flourishing, in spite of their close relationship. Conclusions: Researchers have long been aware of internalized stigma in persons with schizophrenia. Yet this study is one of the few that linked it with parents of adults with schizophrenia and flourishing and psychological distress. Implications were discussed in the light of the findings.