心理疾病污名社会表征公众影响初探

在中国文化背景下对心理疾病污名社会表征的公众影响进行了初步探讨。在全国12个省市对1028名普通公众进行问卷调查。结果发现,心理疾病污名社会表征的不同维度分别对公众接近、帮助心理疾病患者的意愿和专业心理求助意愿产生正面或负面的影响。公众污名感知在社会表征影响行为意愿过程中起中介作用。     

国外心理疾病烙印影响研究概述

心理疾病污名足加诸在心理疾病患者身上的耻辱标记,世界卫生组织2001年指出"心理和行为障碍患者康复的最大阻碍就是社会对他们的污名和与之相连的歧视".作者对国外污名领域的研究进行了回顾,论述了心理疾病污名的概念、有关其影响机制的理论和实证研究.从公众污名和自我污名两方面论述了污名对心理疾病患者的影响以及消除污名的方法.     

心理疾病内隐污名述评

心理疾病内隐污名是个体无法内省或精确识别的与心理疾病有关的痕迹, 它潜在地调节着个体对心理疾病患者的观念和行为。心理疾病内隐污名的主要测量方法包括内隐联想测验、简式内隐联想测验、启动任务和生理心理测量。当前该研究领域集中在内隐污名的成分、公众内隐污名、自我内隐污名、去污名化评估等方面。未来研究可从心理疾病内隐污名的构成与结构、认知神经基础、测量整合和本土化等角度做进一步探讨。     

心理疾病自我污名:心理康复的一个高危因子

心理疾病自我污名是心理疾病患者内化公众的消极刻板印象、偏见和歧视,形成自我偏见和歧视的现象.心理疾病自我污名会给患者带来一系列的负面影响,是心理康复过程中的一个高危因子.自我污名可能是通过引发患者的消极认知、负面情感和自我歧视行为来危及心理康复过程的.对自我污名的干预应针对患者和社会公众分别加以实施.未来可以从理论构建、测量工具和干预措施的改进,以及去污名与心理康复的融合等方面展开自我污名本土化的研究.     

群体认同、自尊和心理疾病污名的关系

通过对620位在校大学生进行问卷施测,探讨大学生群体认同、自尊和心理疾病污名之间的内在关系,并使用LISREL 8.70建构了彼此之间的关系模型,进行了中介效应分析.结果发现:(1)群体认同显著地负向预测自我污名,且通过自尊和公众污名这两个中介变量影响自我污名;(2)自尊显著负向预测自我污名,公众污名显著正向预测自我污名.结论:三个变量之间相关非常显著;所建构的模型具有较高的拟合度.     

心理疾病污名形成理论述评

心理疾病污名是加诸于患者身上的耻辱标记,妨碍患者的治疗和康复。心理疾病污名的成因理论包括功能主义和生物文化两个派别,污名的发展模型解释了污名的形成过程,身份威胁模型对污名的作用机制进行了阐述。通过抗议、教育和接触可以有效地减少污名。在中国开展相关研究应注重分析传统文化、心理疾病类型与污名的关系,探讨各种减少污名策略的可行性     

基于语义差异量表的心理疾病外显与内隐污名的结构及关系

采用语义差异法编制心理疾病污名语义差异量表,用于测量外显污名,并用语义差异量表的词对作为单类内隐联想测验的材料,测量内隐污名,用这两类材料研究外显污名与内隐污名的结构及关系。结果表明：外显污名的三维度模型具有良好的拟合度（χ²/df=2.99, RMSEA=0.075, CFI=0.918, TLI=0.902）;内隐污名的三维度模型也具有良好的拟合度（χ²/df=2.272, RMSEA=0.071, CFI=0.857, TLI=0.833）,且与外显污名的结构相同,都由认知评价、情感体验、行为反应三维度构成;心理疾病污名的外显认知评价与内隐认知评价存在显著相关（r=0.436）,外显污名与内隐污名的其它维度之间均不存在显著相关。     

心理疾病内隐污名：来自单类内隐联想测验的证据

以61名大学生为被试,采用三个独立的单类内隐联想测验（SC-IAT）考察心理疾病内隐污名的构成及其内隐效应。结果发现：（1）在认知评价、情感反应、行为倾向及其三者合并的4个SC-IATs中,被试在相容任务上的反应时均显著快于不相容任务;（2）总的SC-IAT和三个独立SC-IAT的内隐效应显著;（3）65.27%的被试的内隐效应值大于0,表现出对心理疾病患者负面的内隐态度;（4）研究采用的心理疾病内隐污名SC-IAT具有较好的信、效度指标。研究表明,被试倾向于将心理疾病与消极词联结在一起,心理疾病污名的内隐效应显著;心理疾病内隐污名包括自动化的负面认知、消极情感反应和歧视倾向。     

污名现象及其心理效应

污名本质上是一种消极的刻板印象,是社会对某些个体或群体贬低性的、侮辱性的标签,对被污名者有着深刻的影响。文章从三个方面对污名的相关研究做了简要的回顾。首先介绍了几种污名的相关定义;然后介绍了污名的心理效应,包括污名他人的功能,污名对群体和个体的影响,以及社会公众对污名的态度和应对过程;第三介绍了两个污名研究的主要领域：一个是污名群体知觉、应对歧视规律的污名歧视研究,另一个是可隐匿污名的相关研究,如隐匿污名的心理过程,隐匿的情绪反应以及揭示污名的心理意义等。最后,提出了未来研究的几点展望,可隐匿污名的相关研究,内隐社会认知研究和消除污名消极影响的干预研究     

依恋与孤儿初中生心理健康的关系:自我污名和心理韧性的并行中介作用

采用问卷测量法对某省立孤儿学校520名在校孤儿初中生进行调查,探讨师生依恋、同伴依恋与孤儿初中生心理健康的关系,以及自我污名和心理韧性在其中的并行中介作用。结果表明：（1）师生依恋、同伴依恋均可以正向预测孤儿初中生心理健康,但师生依恋预测作用更大,因而更重要;（2）自我污名和心理韧性是依恋预测孤儿初中生心理健康的并行中介变量,自我污名负向中介作用大于心理韧性正向中介作用;（3）师生依恋对孤儿初中生心理健康的预测作用完全以自我污名和心理韧性为中介,同伴依恋对孤儿初中生心理健康的预测作用部分以自我污名和心理韧性为中介。研究结果可为我国福利性集中供养制孤儿学校开展孤儿心理健康教育实践提供依据。     

Knowing so much,yet knowing so little: a scoping review of interventions that address the stigma of mental illness in the Canadian context

Stigma can have detrimental effects on the health and wellbeing of individuals living with a mental illness. This scoping review describes the nature, range, and extent of intervention research aimed at reducing public and self-stigma of mental illness in the Canadian context. The review was guided by Arksey and O’Malley’s framework. A search of databases and relevant websites identified 35 primary studies. Most studies used quantitative research methods and included predominantly youth or middle-aged adults, women, and white Canadian-born people. Guided by different conceptualizations of stigma, direct or indirect contact, education, and advocacy-focused interventions, aimed to provide information, and/or develop skills to address self and public stigma. Most studies evaluated interventions’ effectiveness short-term. Of the few studies that followed-up participants long-term, some were able to reduce stigmatizing attitudes post-intervention, however, these targeted only specific groups such as students or health care professionals. Lack of diversity among the samples, and limited evidence of long-term effectiveness of interventions, were some of the studies’ limitations. What is currently known about interventions aimed at reducing the stigma of mental illness in the Canadian context is not informed by research among vulnerable groups, such as people living with a mental illness, older adults, immigrants, and people of diverse ethnic backgrounds. Interventions that are informed by clear conceptualizations of stigma and rigorously evaluated in a range of ethno-cultural groups would create a knowledge base that is useful for policy-makers, community leaders, and agencies serving various ethnic communities in Canada.     

Stigma by Association Among Family Members of People with a Mental Illness: A Qualitative Analysis

People with mental illness are not the sole recipients of stigmatisation; their immediate family members may be subjected to stigma by association. Through semi‐structured interviews, we investigated experiences of stigma by association among 23 immediate family members of people with mental illness. Participants reported experiencing stigma by association from community members, mental health professionals, and civil servants. Familial relationship, co‐residence, and the gender of participants appeared to play a role in their stigma experiences; parents and spouses reported different manifestations of stigma by association than siblings and children, participants who lived together with their family member with mental illness reported increased experiences of stigma by association, and in contrast to male participants, female participants reported others thinking they are overprotective and as such perpetuated, maintained, or sustained their family members' mental illness. The relevance of these factors points to the need for tailored education and emotional support provision to family members of people with mental illness. Moreover, in‐service training for mental health professionals should include the development of relevant social skills that enable the recognition of familial relationships and roles, and family members' fears, concerns, and problems. Copyright © 2014 John Wiley & Sons, Ltd.     

Psychological stigma costs as barriers to healthcare use in former soldiers of the German Armed Forces: A qualitative analysis

Individuals decide to use healthcare when the expected benefits outweigh the perceived costs. One of these cost factors in this decision can be stigma. So far, it has not been researched how former soldiers of the German Armed Forces with a service-induced mental illness perceive stigma and how it influences their healthcare use. As stigma is shaped by the socio-cultural context, the setting of the potential healthcare use must be considered. Narrative interviews were conducted with 33 former soldiers with mental health problems. The data were analyzed using a thematic analysis approach, in which codes were formed and emerging themes were systemized. The relationship between stigma and healthcare use was analyzed. Occupational discrimination and social exclusion were experienced in both in the military and civilian context, but stigma functioned differently in each context. In the military context, former soldiers’ self-stigma of mentally ill individuals being weak was in stark contrast to their internalized military standards. This contrast let them avoid disclosure and subsequent healthcare use. In civilian context, the participants perceived 2 different stigma costs: mental illness stigma and former soldier stigma (i.e., stigmatization because of their military past). Both were perceived as barriers to healthcare use. A model, illustrating these different stigma costs in the different contexts, was developed. Further research on the link between stigma and healthcare use of this group is urgently needed.     

心理疾病污名内隐测评的类别标签初探

采用单一类型内隐联想测验,考察以往研究中常用的概括化心理疾病词和具体心理疾病词作为心理疾病内隐污名间接测量概念词或类别标签的有效性。结果发现,相较于与积极词配对的任务,两类概念词与消极词（心理疾病态度词）配对的任务反应时更快,正确率更高。研究表明概括化概念和具体疾病与反映人们对心理疾病患者真实态度的消极词存在更紧密的自动联结,是人们头脑中表征心理疾病的概念词或类别标签,可作为内隐测量中的心理疾病概念词用于污名评估。     

Self‐Stigma,Mental Health Literacy,and Health Outcomes in Integrated Care

The authors describe research on the self‐stigma of mental illness and help seeking, mental health literacy, and health outcomes in an integrated care medical center. Results revealed that self‐stigma of mental illness and self‐stigma of seeking help had an inverse relationship with mental health literacy. No statistically significant relationships were found between health outcomes, either type of self‐stigma, and mental health literacy. The authors discuss these and other findings and offer research and counseling implications.     

Stigma and Mental Health in Japanese Unemployed Individuals

An Internet‐based survey was administered in Japan to compare mental health of and stigma toward unemployed individuals, workers with regular employment, and workers with irregular employment. Unemployed individuals showed higher scores for both anxiety/depression and disturbance of activities, as well as faced more stigma than did employed individuals. In addition, the factor structure of stigma that unemployed individuals have toward the unemployed was the same as that previously found for university students and employed individuals. Financial strain and stigma were the factors with the greatest influence on the mental health of unemployed individuals.