丹麦精神病学》中 "抑郁症患者 "和 "焦虑症患者 "治疗师对抑郁症和焦虑症患者的话语表述。

IF 1.9 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Health Pub Date : 2024-05-01 Epub Date: 2023-05-16 DOI:10.1177/13634593231173802
Anne Bryde Bryde Christensen, Karoline Dyrloev, Michaela Hoej, Stig Poulsen, Nina Reinholt, Sidse Arnfred
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引用次数: 0

摘要

心理健康护理中的污名化现象以前就已被发现,一些诊断尤其容易受到负面态度和污名化的影响。然而,此前还没有研究探讨过从业人员在跨诊断群体背景下对不同诊断患者的话语建构。我们对丹麦心理健康从业者的 12 个访谈进行了话语分析,他们对焦虑症或重度抑郁症患者进行了跨诊断心理治疗(统一协议)或标准团体认知行为治疗(CBT)。本研究的目的是确定焦虑症和抑郁症患者在治疗师心目中的形象。我们发现了一种 "培训话语",在这种话语中,患者通过感知到的动机、责任感、积极参与和进步得到评价。我们认为,这种培训话语与更广泛的新自由主义话语秩序有关,新自由主义话语重视效率和能动性。分析表明,焦虑症患者有时比抑郁症患者更受 "青睐",我们认为,新自由主义的话语秩序以及与诊断相关的预先假定是造成这种情况的原因。访谈表明,在描述病人时使用了多种话语,而且经常可以发现矛盾的情绪。我们将结合治疗师对精神病治疗系统的普遍批判态度以及更广泛的社会趋势来讨论分析结果。
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"The Depressed" and "People with Anxiety" therapists' discursive representations of patients with depression and anxiety in Danish Psychiatry.

Stigmatization within mental health care has previously been identified, and some diagnoses have been shown to be particularly exposed to negative attitudes and stigma. However, no previous studies have explored practitioners' discursive construction of patients with different diagnoses within a transdiagnostic group context. We performed discourse analysis on 12 interviews with Danish mental health practitioners, who had been conducting either transdiagnostic psychotherapy (The Unified Protocol) or standard group cognitive behavioral therapy (CBT) with patients treated for anxiety disorders or major depressive disorder. The purpose of this study was to identify how patients with anxiety and depression were represented by therapists. We identified a "training discourse," within which patients were evaluated through perceived motivation, responsibility, active participation, and progression. We argue that this training discourse can be related to a broader neoliberal order of discourse valuing efficiency and agency. The analysis indicated that patients with anxiety were sometimes "favorized" over patients with depression, and it is argued that the neoliberal order of discourse and pre-assumptions related to the diagnoses are contributing to this. The interviews indicate that multiple discourses were applied when describing patients, and ambivalence was often detectable. We discuss the findings of the analysis in relation to therapists' general critical attitudes toward the psychiatric system and in relation to broader societal tendencies.

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来源期刊
Health
Health Multiple-
CiteScore
4.90
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0
期刊介绍: Health: is published four times per year and attempts in each number to offer a mix of articles that inform or that provoke debate. The readership of the journal is wide and drawn from different disciplines and from workers both inside and outside the health care professions. Widely abstracted, Health: ensures authors an extensive and informed readership for their work. It also seeks to offer authors as short a delay as possible between submission and publication. Most articles are reviewed within 4-6 weeks of submission and those accepted are published within a year of that decision.
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