The Role of Self-Stigma, Optimism, and Coping in Psychosocial Adaptation to Serious Mental Illness: A Parallel Mediation Analysis Through a Disability Centrality Lens

This study examined the relationship between psychiatric symptom severity and psychosocial adaptation to serious mental illness (SMI) and investigated the mediating role of optimism, self-stigma, and coping within the framework of the Disability Centrality Model (DCM). A Qualtrics survey consisting of measures of psychosocial adaptation to SMI, psychiatric symptom severity, coping, self-stigma, and optimism was disseminated through identified community entities. A total sample of 300 adults with SMI completed the survey. Correlational analyses and parallel mediation analysis were conducted. Results indicated that optimism, self-stigma, and coping collectively fully mediate the relationship between symptom severity and psychosocial adaptation to SMI, with the full model accounting for 62.4% of the variance. Among the mediators, self-stigma demonstrated the strongest indirect effect. Findings underscore the importance of DCM-informed mechanisms, namely, maladaptive identity centrality, positive expectancies, and behavioral coping strategies, in shaping psychosocial adaptation outcomes. Rehabilitation professionals should target self-stigma, cultivate optimism, and strengthen adaptive coping to support successful psychosocial adaptation to SMI.