论污名化经历的描述与改变

Bruce G. Link, E. Struening, S. Neese-Todd, S. Asmussen, J. Phelan
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引用次数: 212

摘要

精神疾病的耻辱感已被证明是许多精神疾病患者及其家庭生活中的一个强烈的负面特征。因此,努力减少污名化对患者生活的负面影响是有意义的。为了与这个想法保持一致,我们开始开发和评估旨在鼓励成功应对耻辱的干预措施。具体而言,我们构建了旨在评估耻辱感体验的措施,并开发了旨在中断耻辱感的一些负面后果的试点干预措施。为了实现这一目标,我们研究了参加俱乐部项目的人,在测试前-测试后设计的背景下,随机将参与者分配到干预组和对照组。在一个独特的特征中,我们还在预测试后随访了参与者两年,当时所有参与者都有机会体验干预。我们发现人们感知和经历耻辱,这些感知和经历与低自尊和抑郁症状有关。然而,我们发现很少有证据表明,我们进行的试点干预对我们评估的任何污名测量、自尊或抑郁症状都有积极影响。我们的研究通过提供对耻辱感体验的精确测量,为有关耻辱感的文献做出了贡献,但在以一种可以用我们的测量方法检测到的方式改变这种体验方面失败了。加大努力减少污名化后果的挑战仍然十分紧迫。
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On Describing and Seeking to Change the Experience of Stigma
Abstract The stigma of mental illness has been shown to be a strong negative feature in the lives of many people with mental illnesses and their families. As a consequence it makes sense to undertake efforts to reduce the negative impact of stigma on the lives of people who experience it. In keeping with this idea we set out to develop and evaluate an intervention designed to encourage successful coping with stigma. Specifically, we constructed measures designed to assess the experience of stigma and to develop a pilot intervention designed to interrupt some of the negative consequences of stigma. To achieve this goal we studied people attending a clubhouse program, randomly assigning participants to intervention and control groups in the context of pretest-postest design. In a unique feature we also followed up the participants two year following the pre-test when all participants had the opportunity to experience the intervention. We found that people perceive and experience stigma and that these perceptions and experiences are associated low self-esteem and depressive symptoms. However, we found little evidence to suggest that the pilot intervention we mounted had a positive impact on any of the stigma measures we assessed, or on self-esteem or depressive symptoms. Our study contributes to the literature on stigma by providing refined measurement of the stigma experience but fails in terms of changing that experience in a manner that can be detected with our measures. The challenge of mounting efforts to reduce the consequences of stigma remains pressing.
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