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Evidence Basis for Psychodynamic Self-Psychology in Eating Disorders - A Review Paper. 饮食失调心理动力自我心理学的证据基础——综述。
IF 0.4 4区 医学 Q4 Medicine Pub Date : 2020-11-24 DOI: 10.4324/9781003000280-4
E. Bachar
The purpose of the present study is to present the empirical basis for the capability of the theory of psychodynamic self-psychology to predict in crosssectional and prospective longitudinal studies, both the development of and the remission from eating disorders. In addition, we present the effectiveness of psychodynamic self-psychological treatment in a randomized control study over two other techniques. Theoretical constructs of the theory and technique suggestions will be weaved into the empirical data.
本研究的目的是为心理动力学自我心理学理论在横断面和前瞻性纵向研究中预测饮食失调的发展和缓解的能力提供实证基础。此外,我们在一项随机对照研究中提出了心理动力学自我心理治疗的有效性,而不是其他两种技术。理论建构和技术建议将被编织到实证数据中。
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引用次数: 4
Perversion and the universal law. 变态和宇宙法则。
IF 0.4 4区 医学 Q4 Medicine Pub Date : 2018-11-09 DOI: 10.4324/9780429473777-11
J. Chasseguet-smirgel
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引用次数: 39
Violating Clan and Kinship Roles as Risk Factors for Suicide and Stigma among Lao Refugees: An Application of the Cultural Model of Suicide and "What Matters Most" Frameworks. 违反氏族和亲属角色是老挝难民自杀和耻辱的风险因素:自杀文化模型和“最重要的”框架的应用。
IF 0.4 4区 医学 Q4 Medicine Pub Date : 2017-01-01
Amar Mandavia, Debbie Huang, Jeffrey Wong, Bernalyn Ruiz, Francesca Crump, Jenny Shen, Monica Martinez, Luba Botcheva, Eduardo Vega, Joyce Chu, Sara Lewis, Lawrence H Yang

Background: While Asian groups have immigrated worldwide, suicide risk models have neglected to integrate cultural components. This study incorporates how stigma associated with failure to uphold clan/kinship roles can increase suicide risk in highly-marginalized Lao-Americans.

Methods: One focus group with five Lao participants and 21 individual semi-structured interviews with community family members were conducted. Transcripts were coded via directed content analysis using the "What Matters Most" and Cultural Theory of Suicide frameworks.

Results: Violating role-expectations associated with youth, adults and older adults appears to be associated with risk for suicide. This suggests that the failure of adults to fulfill their roles might potentially threaten loss of "full personhood" and trigger stigma, thus potentially evoking greater suicide risk.

Conclusion: Interventions would benefit from cultural considerations of fulfilling role-expectations and "personhood" to combat suicide and stigma within cultural communities.

背景:当亚洲群体移民到世界各地时,自杀风险模型忽略了文化因素的整合。本研究结合了与未能维护家族/亲属角色相关的耻辱如何增加高度边缘化的美籍老挝人的自杀风险。方法:进行了5名老挝人的焦点小组和21名社区家庭成员的半结构化访谈。使用“最重要的是什么”和自杀的文化理论框架,通过直接内容分析对成绩单进行编码。结果:违反角色期望与青少年、成年人和老年人的自杀风险有关。这表明,成年人未能履行自己的角色可能会潜在地威胁到“完整人格”的丧失,并引发耻辱感,从而可能引发更大的自杀风险。结论:干预措施将受益于实现角色期望和“人格”的文化考虑,以打击文化社区内的自杀和耻辱。
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引用次数: 0
Self-Stigma, Identity, and Co-Occurring Disorders. 自我耻辱感、身份认同和共发性疾病。
IF 0.4 4区 医学 Q4 Medicine Pub Date : 2017-01-01
Maya A Al-Khouja, Patrick W Corrigan

Background: A four stage regressive model that links public stigma to self-stigma is applied to mental illness and substance use disorder. We assess this four stage model in those with co-occurring disorders versus those who have mental illness or substance use disorder alone.

Method: 366 people who self-identified as having either a mental illness or co-occurring mental illness with substance use disorder were recruited from MTurk and completed measures on identity and self-stigma.

Results: Higher group identity predicted lower selfstigma in those with mental illness while this effect was not present for participants with co-occurring disorders. Limitations include that this study only looked at mental illness identity for those with both mental illness and substance use disorder; sample limitations are also discussed.

Conclusions: Those with co-occurring disorders may identify more with certain groups over others.

背景:将公共耻辱与自我耻辱联系起来的四阶段回归模型应用于精神疾病和物质使用障碍。我们评估了这四阶段模型在那些同时发生的疾病与那些单独有精神疾病或物质使用障碍。方法:从MTurk招募了366名自认为患有精神疾病或精神疾病伴物质使用障碍的患者,并完成了身份和自我耻辱感的测量。结果:较高的群体认同预示着精神疾病患者较低的自我耻辱感,而这一效应并不存在于共患性疾病的参与者中。局限性包括,这项研究只关注那些同时患有精神疾病和物质使用障碍的人的精神疾病身份;还讨论了样本限制。结论:那些同时出现疾病的患者可能更倾向于认同某些群体。
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引用次数: 0
'People with Problems, Not Patients with Illnesses': Using Psychosocial Frameworks to Reduce the Stigma of Psychosis. “有问题的人,而不是病人”:使用社会心理框架减少精神病的耻辱。
IF 0.4 4区 医学 Q4 Medicine Pub Date : 2017-01-01
Eleanor Longdon, John Read

Background: Stigma and discrimination are major difficulties for people with psychosis. However, despite the dominance of biomedical ideology in public education and de-stigmatization efforts, there is substantial evidence that campaigns based on the "medical model" (such as the "mental illness is an illness like any other" approach) are not only ineffective, but can actually compound the problem. This paper considers the alternative role of psychosocial explanatory frameworks in promoting more tolerant and enlightened approaches to, and attitudes about, psychosis.

Data: A summary of theoretical and empirical research on the effectiveness of mental health anti-stigma campaigns is presented.

Conclusions: There is a reasonably substantial evidencebase supporting the hypothesis that anti-stigma campaigns which frame psychosis as a meaningful response to adversity are effective. They are a more promising approach to "humanizing" people with complex mental health problems than strategies based on models of disease and disability.

背景:污名和歧视是精神病患者面临的主要困难。然而,尽管生物医学意识形态在公共教育和去污名化工作中占主导地位,但有大量证据表明,基于“医学模式”(如“精神疾病和其他任何疾病一样”的方法)的运动不仅无效,而且实际上可能使问题复杂化。本文考虑了社会心理解释框架在促进对精神病更宽容和开明的方法和态度方面的替代作用。数据:对心理健康反污名运动有效性的理论和实证研究进行了总结。结论:有相当大量的证据支持这一假设,即将精神病视为对逆境有意义的反应的反污名运动是有效的。与基于疾病和残疾模型的策略相比,它们是使有复杂心理健康问题的人“人性化”的更有希望的方法。
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引用次数: 0
Explicit and Implicit Stigma of Mental Illness as Predictors of the Recovery Attitudes of Assertive Community Treatment Practitioners. 精神疾病的显性和隐性污名对协助性社区治疗从业者康复态度的预测作用。
IF 0.4 4区 医学 Q4 Medicine Pub Date : 2017-01-01
Laura G Stull, Haley McConnell, John McGrew, Michelle P Salyers

Background: While explicit negative stereotypes of mental illness are well established as barriers to recovery, implicit attitudes also may negatively impact outcomes. The current study is unique in its focus on both explicit and implicit stigma as predictors of recovery attitudes of mental health practitioners.

Method: Assertive Community Treatment practitioners (n = 154) from 55 teams completed online measures of stigma, recovery attitudes, and an Implicit Association Test (IAT).

Results: Three of four explicit stigma variables (perceptions of blameworthiness, helplessness, and dangerousness) and all three implicit stigma variables were associated with lower recovery attitudes. In a multivariate, hierarchical model, however, implicit stigma did not explain additional variance in recovery attitudes. In the overall model, perceptions of dangerousness and implicitly associating mental illness with "bad" were significant individual predictors of lower recovery attitudes.

Conclusions: The current study demonstrates a need for interventions to lower explicit stigma, particularly perceptions of dangerousness, to increase mental health providers' expectations for recovery. The extent to which implicit and explicit stigma differentially predict outcomes, including recovery attitudes, needs further research.

背景:虽然对精神疾病的显性负面刻板印象已被公认为是康复的障碍,但隐性态度也可能对康复结果产生负面影响。本研究的独特之处在于,它同时关注了显性和隐性成见对心理健康从业者康复态度的预测作用:方法:来自 55 个团队的支持性社区治疗从业人员(n = 154)完成了关于成见、康复态度和内隐关联测试(IAT)的在线测量:结果:四个显性成见变量中的三个(自责感、无助感和危险感)以及所有三个隐性成见变量都与较低的康复态度有关。然而,在一个多变量分层模型中,内隐成见并不能解释康复态度的额外差异。在整体模型中,对危险性的感知和将精神疾病与 "坏 "联系在一起的隐性成见是较低康复态度的重要个体预测因素:当前的研究表明,有必要采取干预措施来降低显性成见,尤其是对危险性的认知,以提高心理健康服务提供者对康复的期望。至于内隐成见和外显成见在多大程度上会对包括康复态度在内的结果产生不同的预测作用,还需要进一步的研究。
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引用次数: 0
Greater Metacognition and Lower Fear of Negative Evaluation: Potential Factors Contributing to Improved Stigma Resistance among Individuals Diagnosed with Schizophrenia. 更高的元认知能力和更低的负面评价恐惧:精神分裂症患者抗污名化能力提高的潜在因素
IF 0.4 4区 医学 Q4 Medicine Pub Date : 2017-01-01
Ruth L Firmin, Lauren Luther, Michelle P Salyers, Kelly D Buck, Paul H Lysaker

Background: Stigma resistance, one's ability to block the internalization of stigma, appears to be a key domain of recovery. However, the conditions in which one is most likely to resist stigma have not been identified, and models of stigma resistance have yet to incorporate one's ability to consider the mind of others. The present study investigated the impact of the interaction between metacognition, or one's ability to form an integrated representation of oneself, others, and the world, and fear of negative evaluation on one's ability to resist stigma.

Methods: Narratives of encounters with stigma shared by 41 persons with schizophrenia or schizoaffective disorders were first coded for spontaneous expressions of fear of negative evaluation from others. Two-step cluster analyses were then conducted in order to test the hypothesis that metacognition and fearing negative evaluation from others are important, interacting pathways which contribute to resisting stigma.

Results: Those with high (n = 11; 26.8%), intermediate (n = 9; 22.0%), and low metacognition (n = 21; 51.2%) significantly differed on stigma resistance (F = 9.49, p<0.001) and the high metacognition group was most likely to resist stigma. Those with high and low metacognition did not express fear of negative evaluation, while those with intermediate metacognition did express fear of negative evaluation.

背景:污名抵抗,一个人阻止污名内化的能力,似乎是恢复的关键领域。然而,一个人最有可能抵抗耻辱的条件尚未被确定,并且耻辱抵抗的模型尚未纳入一个人考虑他人思想的能力。本研究调查了元认知(或一个人对自己、他人和世界形成综合表征的能力)与对负面评价的恐惧之间的相互作用对一个人抵抗污名的能力的影响。方法:对41例精神分裂症或分裂情感性障碍患者所分享的遭遇耻辱的叙述进行编码,以确定他们对他人负面评价的恐惧的自发表达。然后进行了两步聚类分析,以验证元认知和害怕他人的负面评价是重要的,相互作用的途径,有助于抵抗耻辱的假设。结果:高(n = 11;26.8%),中级(n = 9;22.0%),元认知能力低(n = 21;51.2%)的柱头抗性差异显著(F = 9.49, p
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引用次数: 0
Does Individual Stigma Predict Mental Health Funding Attitudes? Toward an Understanding of Resource Allocation and Social Climate. 个人病耻感能预测心理健康资助态度吗?对资源配置与社会气候的理解。
IF 0.4 4区 医学 Q4 Medicine Pub Date : 2017-01-01
Joseph S DeLuca, Timothy W Clement, Philip T Yanos

Background: The uneven progression of mental health funding in the United States, and the way that the funding climate seems to be influenced by local and regional differences, raises the issue of what factors, including stigma, may impact mental health funding decisions. Criticisms that mental health stigma research is too individually-focused have led researchers to consider how broader, macro-level forms of stigma - such as structural stigma - intersect with micro-level forms of individual stigma. While some studies suggest that macro and micro stigma levels are distinct processes, other studies suggest a more synergistic relationship between structural and individual stigma.

Method: Participants in the current study (N = 951; national, convenience sample of the U.S.) completed a hypothetical mental health resource allocation task (a measure of structural discrimination). We then compared participants' allocation of resources to mental health to participants' endorsement of negative stereotypes, beliefs about recovery and treatment, negative attributions, intended social distancing, microaggressions, and help-seeking (measures of individual stigma).

Results: Negative stereotyping, help-seeking self-stigma, and intended social distancing behaviors were weakly but significantly negatively correlated with allocating funds to mental health programs. More specifically, attributions of blame and anger were positively correlated to funding for vocational rehabilitation; attributions of dangerousness and fear were negatively correlated to funding for supported housing and court supervision and outpatient commitment; and attributions of anger were negatively correlated to funding for inpatient commitment and hospitalization.

Conclusions: Individual stigma and sociodemographic factors appear to only partially explain structural stigma decisions. Future research should assess broader social and contextual factors, in addition to other beliefs and worldviews (e.g., allocation preference questionnaire, economic beliefs).

背景:美国精神卫生资助进展不平衡,以及资助环境似乎受到地方和地区差异影响的方式,提出了包括污名在内的哪些因素可能影响精神卫生资助决策的问题。对精神健康病耻感研究过于关注个人的批评导致研究人员考虑更广泛的、宏观层面的病耻感形式——如结构性病耻感——如何与微观层面的个人病耻感形式交叉。虽然一些研究表明宏观和微观柱头水平是不同的过程,但其他研究表明结构柱头和个体柱头之间存在更多的协同关系。方法:本研究的参与者(N = 951;(美国的便利样本)完成了一个假设的心理健康资源分配任务(一种结构性歧视的测量)。然后,我们比较了参与者在心理健康方面的资源分配与参与者对负面刻板印象的认可、对康复和治疗的信念、负面归因、有意的社会距离、微侵犯和寻求帮助(个体耻辱的衡量标准)。结果:负面刻板印象、寻求帮助的自我耻辱感和有意的社会距离行为与心理健康项目的资金分配呈微弱但显著的负相关。更具体地说,责备和愤怒的归因与职业康复的资金正相关;危险和恐惧的归因与支持住房、法院监督和门诊承诺的资金负相关;愤怒的归因与住院费用和住院费用呈负相关。结论:个体病耻感和社会人口学因素似乎只能部分解释结构性病耻感决定。未来的研究应评估更广泛的社会和背景因素,以及其他信仰和世界观(例如,分配偏好问卷,经济信仰)。
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引用次数: 0
Mental Health Stigma: so much progress and yet a long way to go - Introduction to special issue on stigma. 精神卫生污名化:如此多的进展,但仍有很长的路要走-污名化特刊导言。
IF 0.4 4区 医学 Q4 Medicine Pub Date : 2017-01-01
David Roe, Patrick W Corrigan, Bruce G Link
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引用次数: 0
Different Roads Lead to Rome: Exploring Patterns of Change among Narrative Enhancement and Cognitive Therapy (NECT) Participants. 不同的道路通往罗马:探索叙事增强和认知治疗(NECT)参与者的变化模式。
IF 0.4 4区 医学 Q4 Medicine Pub Date : 2017-01-01
David Roe, Ilanit Hasson-Ohayon, Michal Mashiach-Eizenberg, Amit Yamin, Paul H Lysaker

Background: Narrative enhancement and cognitive therapy (NECT) is aimed at decreasing self-stigma and promoting recovery. The current study used a mixed-methods approach to explore the process and mechanisms by which NECT affects self-stigma and recovery.

Method: Sixty-two participants with serious mental illness (SMI) and enrolled in NECT completed questionnaires assessing self-clarity, recovery, self-stigma, and hope before and after the intervention, and the two latter questionnaires also after completing two defined parts of the intervention. In addition, one group's transcriptions were qualitatively analyzed and compared with changes in quantitative measures.

Results: Quantitative analysis revealed a significant increase in self-clarity and a decrease in self-stigma, which occurred early in the intervention. Qualitative analysis identified factors contributing to such changes. Limitations include lack of a comparison group, bias selection in the qualitative analysis and case record diagnoses.

Conclusions: NECT was found to be effective in reducing self-stigma and improving self clarity and the mechanisms and process were identified.

背景:叙事增强和认知疗法(NECT)旨在减少自我耻辱感和促进康复。目前的研究采用混合方法来探索NECT影响自我耻辱和恢复的过程和机制。方法:62名重度精神疾病(SMI)被试在干预前后分别完成自我清晰度、康复、自我污名和希望量表,并在完成干预的两个特定部分后分别完成后两份问卷。此外,对其中一组的转录进行定性分析,并与定量测量的变化进行比较。结果:定量分析显示,在干预早期,自我清晰度显著提高,自我羞耻感显著降低。定性分析确定了导致这些变化的因素。局限性包括缺乏比较组、定性分析中的偏倚选择和病例记录诊断。结论:NECT在减少自我污名感和提高自我清晰度方面具有有效的作用,并明确了其机制和过程。
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引用次数: 0
期刊
Israel Journal of Psychiatry and Related Sciences
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