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.     

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.     

Mental Illness and Psychiatric Treatment Among Women: A Rejoinder to Johnson

In this reply to Johnson, it is suggested that her response to my paper is largely on ideological grounds. Johnson totally ignores the theoretical and empirical basis for the definition of mental illness that is used. She appears not to have read my paper carefully, for all the issues she raises have been dealt with in the paper. She does not seem to comprehend the problematic aspects of both feminist and traditional theory. Johnson does not appear to understand that traditional therapists do not blame the victim and that they also see the therapeutic process as resulting in maturation and growth. Her ideology also apparently makes her unable to see that she and I are in substantial agreement on many issues regarding the role of women.     

Expanding Roles: A Survey of Public Health Genetic Counselors

According to the 2008 National Society of Genetic Counselors (NSGC) Professional Status Survey (PSS), 31 genetic counselor respondents reported spending at least 50% of their time in the area of public health. The NSGC Public Health Special Interest Group (PHSIG) had 49 dues-paying members in 2009. The purpose of this study was to identify the work settings and public health activities in which genetic counselors participate. A novel online survey was disseminated over the NSGC PHSIG Listserv. Forty-one percent (n = 13) of public health genetic counselor respondents worked in a university medical system, while 53% (n = 17) were grant-funded and held a non-clinical appointment. The most common public health activities included educating healthcare professionals (82%) and community members (61%), research (55%), grant writing (55%) and grant administration (36%). Most respondents (82%) reported learning certain public health skills outside of their genetic counseling training programs. Differences in work settings were found, with a significantly greater percentage of public health genetic counselors working in government agencies. Genetic counselors have opportunities to become involved in public health activities as the scope of public health genetics grows. Furthermore, genetic counseling competencies are compatible with the Institute of Medicine’s “10 Essential Public Health Services.” The NSGC and genetic counseling training programs are encouraged to offer more public health learning opportunities for genetic counselors and genetic counseling students interested in this specialty area.     

Employability of Genetic Counselors with a PhD in Genetic Counseling

The development of a PhD in genetic counseling has been discussed for more than 20 years, yet the perspectives of employers have not been assessed. The goal of this qualitative study was to gain an understanding of the employability of genetic counselors with a PhD in genetic counseling by conducting interviews with United States employers of genetic counselors. Study participants were categorized according to one of the following practice areas: academic, clinical, government, industry, laboratory, or research. All participants were responsible for hiring genetic counselors in their institutions. Of the 30 employers interviewed, 23 envisioned opportunities for individuals with a PhD degree in genetic counseling, particularly in academic and research settings. Performing research and having the ability to be a principal investigator on a grant was the primary role envisioned for these individuals by 22/30 participants. Employers expect individuals with a PhD in genetic counseling to perform different roles than MS genetic counselors with a master's degree. This study suggests there is an employment niche for individuals who have a PhD in genetic counseling that complements, and does not compete with, master's prepared genetic counselors.     

Caregiving Attitudes,Personal Loss,and Stress-Related Growth Among Siblings of Adults with Mental Illness

As parents age, well siblings are often asked to assume caregiving responsibilities for their brother or sister with mental illness. However, relatively little is known about how well siblings prioritize sibling caregiving responsibilities with other life demands. We examined well siblings’ attitudes toward self-care and caregiving for their sibling with mental illness (self- and sibling-care) using two cross-sectional samples. The first sample of well siblings (N?=?242) was used to examine the psychometric properties of the self- and sibling-care measure (SSCM), designed to assess the degree to which siblings prioritize their own needs and the needs of their sibling with mental illness. A second sample (N?=?103) was used to determine the relative contribution of self- and sibling-care attitudes in accounting for variation in well siblings’ reports of personal loss and stress-related personal growth. Results support the psychometric validity of the SSCM and suggest that self- and sibling-care attitudes account for greater variance in scores on perceived personal loss and stress-related growth than demographic or caregiving factors. Our findings support the need to address family care responsibilities and resource limitations through recovery-oriented mental health policies, services, and programs.     

Examining Factors Associated with Primary Care and Continuity of Care Among Adults with Severe Mental Illness

A number of studies have consistently reported that there is a greater prevalence of mental illness among the most socioeconomically disadvantaged. At the same time, there is evidence that services are not optimally accessed by the most socioeconomically disadvantaged; the most in need of care are also the most likely to have unmet healthcare needs. Of people with mental illnesses, those with severe mental illnesses (SMI) are the most at risk of poverty and the least likely to have optimal care. In the past, specialized community mental health services have been identified as the primary provider for people with SMI. However, there is growing interest in using the primary care setting as the main source of mental health care where both medical treatment and psychotherapy can be accessed. In this paper, we examine factors related to primary care use (and in turn, pharmacologic and psychotherapies) for people who are socioeconomically disadvantaged and who have a SMI.     

From Campers to Counselors: a Resource for Prospective Genetic Counseling Students

When thinking about the future of the genetic counseling field, one place to start is with prospective genetic counseling graduate school applicants. Although resources and mentorship opportunities exist for genetic counselors entering the field, the process of deciding on a career, applying to graduate programs, and being admitted can be daunting. As members of the profession, we should take responsibility for ensuring that individuals have the information and resources necessary to make an educated decision about whether genetic counseling is the correct path for them and to take the initial steps along this path. In this article, we present our Genetic Counseling Boot Camp as a model for other genetic counselors to use in developing their own local programs. This type of program can benefit prospective genetic counselors as they begin their professional journeys and can also provide value for the organizers and presenters who are already seasoned in the field.     

The Impact of Exercise on Hormones Is Related to Autonomic Reactivity to a Mental Task

This study examined the effects of an acute physical stressor on salivary testosterone (Tsal) and cortisol (Csal) and their relationship with the autonomic responsiveness to a mental task in fit young men (n = 30). Salivary testosterone (Tsal) and cortisol (Csal) levels were determined before and after a maximal bicycle exercise. Heart rate (HR) and skin conductance levels (SCL) were continuously recorded before, during, and after a Stroop task. Tsal and Csal levels diminished while HR and SCL increased in response to stressors in all the sample. When subjects were distributed in function of their endocrine response to the physical stressor, high Tsal responders showed higher HR reactivity than low responders, and high Csal responders showed higher SCL reactivity and lower reaction time in the Stroop task. These results show that the influence of an acute physical stressor on hormones is associated with the autonomic responses to a mental task.     

Stigma Towards Homosexuality and AIDS Among Students of a Large Hispanic-Serving University

Homosexuality and AIDS-related stigma lead to failures in testing, disclosure of HIV status, and treatment for HIV. This study explored stigma towards AIDS and homosexuality among students of a large Hispanic-serving university in the southeastern United States (US). An online anonymous survey was emailed to 8000 randomly selected students. Two multiple choice questions about attitudes towards a professor with AIDS and a gay classmate were analyzed using Chi-square tests, simple and multivariable logistic regression to examine the association of stigma with other factors. Most (60%) of the 632 respondents were women. Only 7.8% of study participants reported stigmatizing attitudes of wanting to drop a class, sitting further away from, or feeling less comfortable in a class with a professor diagnosed with AIDS. Similarly, 7.8% of respondents would stigmatize a gay classmate by trying to avoid social contact or feeling uncomfortable talking with him. Males (adjusted odds ratio [AOR] 3.71, 95% confidence interval [CI] 1.95, 7.04) and non-Hispanic students (AOR 2.03, 95% CI 1.08, 3.81) had a higher—and those born in the US had a lower (AOR 0.43, 95% CI 0.23, 0.81)—odds of stigmatizing a gay classmate. No variables were significantly associated with stigmatizing attitudes towards a professor with AIDS. Stigmatizing attitudes towards a faculty member with AIDS or a gay classmate do not appear to be a major problem among students at this Hispanic-serving university. Interventions designed to further reduce gay-related stigma might focus on non-Hispanic young men who are born outside of the United States.     

Patient Responsiveness to a Sleep and Circadian Intervention in a Sample of Adults With Serious Mental Illness

Understanding patient responsiveness, a component of fidelity, is essential as it impacts treatment outcome and ongoing use of treatment elements. This study evaluated patient responsiveness—operationalized as receptivity to treatment modules and ratings of the usefulness and the utilization of treatment elements—to the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) in a sample of adults with serious mental illness (SMI) and sleep/circadian dysfunction. Adults with SMI and sleep/circadian dysfunction (N = 104) received TranS-C in a community mental health setting. Independent raters rated TranS-C sessions to assess receptivity. At posttreatment and 6-month follow-up, participants completed a usefulness scale, utilization scale, the PROMIS Sleep Disturbance (PROMIS-SD) and Sleep-Related Impairment (PROMIS-SRI) scales, DSM-5 Cross-Cutting Measure (DSM-5-CC), and Sheehan Disability Scale (SDS). Receptivity was rated as somewhat to fully understood, and predicted a reduction on the DSM-5-CC. On average, participants rated TranS-C as moderately useful and utilized treatment elements occasionally. Ratings of usefulness were associated with the PROMIS-SD, PROMIS-SRI, and DSM-5-CC at posttreatment, but not with the SDS. Ratings of utilization were not associated with outcome. The findings add to the literature on patient responsiveness, an implementation outcome, and provide data on the utility of TranS-C within a community mental health setting.     

Enriching the Genetic Counseling Recruitment Pipeline: A National Cross-Sectional Study of Public High School Counselors

Early awareness of careers is helpful in recruiting students into a career pipeline. School counselors are among the top resources that students turn to when seeking advice about choosing their career. Studies show that high school is the ideal time to generate interest in the genetic counseling career, especially for minorities. This novel study of 291 high school counselors working in ethnically diverse public school districts in the United States examined to what extent members of this important group discuss genetic counseling as a career option with their students. The findings indicate that the majority of school counselors in this study (83%) did not discuss genetic counseling with their students, citing a lack of resources and lack of student interest as the major barriers. Suggestions of ways to increase high school counselors’ awareness of the genetic counseling career in order to enhance the goal of enriching recruitment of ethnic minorities into the genetic counseling pipeline are presented.     

Family Matters: The Role of Mental Health Stigma and Social Support on Depressive Symptoms and Subsequent Help Seeking Among African American Boys

African American adolescent boys underutilize mental health service due to stigma associated with depression. Gaining an increased understanding of how depressed, African American adolescent boys perceive their mental health needs and engage in help-seeking behaviors might play an essential role in efforts to improve their symptoms and access to care. Using a mixed-methods design, this study examined the influence of mental health stigma and social support on depressive symptoms among African American adolescent boys. Findings indicated the protective effects of social support in decreasing depressive symptoms, especially when participants experienced mental health stigma. Results also revealed the pivotal role of family social support over both professional and peer support for participants who struggled with depressive symptoms. The primacy of family support among the sample, combined with the frequent distrust of professionals and peer networks, would indicate that working with families may improve initial identification of depression among African American adolescent boys and decrease their barriers to care.