Corrigan Patrick W, Lurie Barbara Demming, Goldman Howard H, Slopen Natalie, Medasani Krishna, Phelan Sean
Evanston Northwestern Healthcare, 1033 University Place, Evanston, IL 60201, USA.
Psychiatr Serv. 2005 May;56(5):544-50. doi: 10.1176/appi.ps.56.5.544.
Research among adults has yielded three sets of conclusions about the stigma of mental illness. First, people with mental illness are stigmatized more severely than those with physical health conditions; those who abuse alcohol are viewed more harshly than those with mental illness. Second, stereotypes of mental illness related to responsibility and dangerousness lead to negative emotional reactions and discriminatory behaviors. Third, familiarity with people with mental illness tends to diminish stigma. This study attempted to validate these findings with a large and diverse sample of adolescents.
A total of 303 adolescents completed a revised version of the Attribution Questionnaire (rAQ) that presented four vignettes, each describing a different type of peer: a peer with mental illness, with mental illness caused by a brain tumor, with alcohol abuse problems, and with leukemia. The rAQ comprises seven Likert scale items of agreement that research participants rated for each vignette. Items included pity, danger, fear, responsibility, anger, help, and avoidance. Participants also completed a revised Level of Contact Report to assess their familiarity with mental illness.
As with adults, adolescents stigmatized peers who abuse alcohol most severely, followed by those with mental illness. Peers with leukemia were treated more benignly than the other groups. Having a brain tumor mediated the stigmatizing effect of mental illness. Adolescents who agreed that persons with mental illness are responsible for their illness and are dangerous demonstrated more discrimination toward these persons. However, this finding was not supported for alcohol abuse. Familiarity yielded an unexpected effect among adolescents; those who reported more familiarity with mental illness were more likely to endorse stigma of mental illness.
Adolescents tended to discriminate among conditions, viewing substance abuse more harshly than the other disorders. Blame and dangerousness were important variables leading to discrimination, and contact with persons with mental illness led to more discrimination.
针对成年人的研究得出了关于精神疾病污名化的三组结论。第一,患有精神疾病的人比身体健康问题患者受到更严重的污名化;酗酒者比患有精神疾病的人受到更严厉的看待。第二,与责任和危险性相关的精神疾病刻板印象会导致负面情绪反应和歧视行为。第三,对患有精神疾病的人的熟悉程度往往会减少污名。本研究试图通过一个规模庞大且多样化的青少年样本验证这些发现。
共有303名青少年完成了归因问卷(rAQ)的修订版,该问卷呈现了四个 vignette,每个 vignette 描述了一种不同类型的同龄人:患有精神疾病的同龄人、因脑瘤导致精神疾病的同龄人、有酗酒问题的同龄人以及患有白血病的同龄人。rAQ 由七个李克特量表同意项目组成,研究参与者对每个 vignette 进行评分。项目包括怜悯、危险、恐惧、责任、愤怒、帮助和回避。参与者还完成了一份修订后的接触程度报告,以评估他们对精神疾病的熟悉程度。
与成年人一样,青少年对酗酒的同龄人污名化最为严重,其次是患有精神疾病的同龄人。患有白血病的同龄人比其他组受到更温和的对待。患有脑瘤介导了精神疾病的污名化效应。那些认为患有精神疾病的人应对自己的疾病负责且具有危险性的青少年,对这些人表现出更多的歧视。然而,这一发现对于酗酒并不成立。熟悉程度在青少年中产生了意想不到的效果;那些报告对精神疾病更熟悉的人更有可能认可对精神疾病的污名化。
青少年倾向于对不同情况进行区分,对药物滥用的看法比其他疾病更为严厉。指责和危险性是导致歧视的重要变量,与患有精神疾病的人接触会导致更多的歧视。