The clinical high risk for psychosis (CHR-p) syndrome enables early identification of individuals at risk of schizophrenia and related disorders. We differentiate between the stigma associated with the at-risk identification itself (‘labelling-related’ stigma) versus stigma attributed to experiencing mental health symptoms (‘symptom-related’ stigma) and examine their relationships with key psychosocial variables.

We compare labelling- and symptom-related stigma in rates of endorsement and associations with self-esteem, social support loss and quality of life.

We assessed stigma domains of shame-related emotions, secrecy and experienced discrimination for both types of stigma. Individuals at CHR-p were recruited across three sites (N = 150); primary analyses included those who endorsed awareness of psychosis risk (n = 113). Paired-sample t-tests examined differences in labelling- versus symptom-related stigma; regressions examined associations with psychosocial variables, controlling for covariates, including CHR-p symptoms.

Respondents reported greater symptom-related shame, but more labelling-related secrecy. Of the nine significant associations between stigma and psychosocial variables, eight were attributable to symptom-related stigma, even after adjusting for CHR-p symptoms.

Stigma attributed to symptoms had a stronger negative association with psychosocial variables than did labelling-related stigma among individuals recently identified as CHR-p. That secrecy related to the CHR-p designation was greater than its symptom-related counterpart suggests that labelling-related stigma may still be problematic for some CHR-p participants. To optimise this pivotal early intervention effort, interventions should address the holistic ‘stigmatising experience’ of having symptoms, namely any harmful reactions received as well as participants’ socially influenced concerns about what their experiences mean, in addition to the symptoms themselves.

精神病临床高危 （CHR-p） 综合征能够及早识别有精神分裂症和相关疾病风险的个体。我们区分了与风险识别本身相关的耻辱感（“标签相关”耻辱感）与归因于经历心理健康症状的耻辱感（“症状相关”耻辱感），并检查它们与关键社会心理变量的关系。

我们比较了标签和症状相关的耻辱感在认可率和相关性方面与自尊、社会支持丧失和生活质量的关联。

我们评估了羞耻相关情绪、保密和经历歧视的耻辱领域。CHR-p 的个体是在三个地点招募的 （N = 150）;主要分析包括那些支持对精神病风险的认识的人 （n = 113）。配对样本 t 检验检查了标签与症状相关耻辱感的差异;回归分析了与社会心理变量的关联，控制了协变量，包括 CHR-p 症状。

受访者报告了与症状相关的羞耻感更大，但与标签相关的保密性更多。在耻辱感与社会心理变量之间的 9 项显著关联中，即使调整了 CHR-p 症状后，8 项归因于与症状相关的耻辱感。

在最近被确定为 CHR-p 的个体中，归因于症状的耻辱感与社会心理变量的负相关性比标签相关耻辱感更强。与 CHR-p 名称相关的保密性大于与症状相关的保密性，这表明与标签相关的耻辱感对于一些 CHR-p 参与者来说可能仍然存在问题。为了优化这一关键的早期干预工作，干预措施应解决出现症状的整体“污名化体验”，即收到的任何有害反应以及参与者对他们的经历意味着什么的社会影响的担忧，以及症状本身。