Coker Elizabeth M
Department of Sociology, Anthropology, Psychology and Egyptology, The American University in Cairo, 113 Sharia Kasr el Aini, P.O. Box 2511, 11511 Cairo, Egypt.
Soc Sci Med. 2005 Sep;61(5):920-30. doi: 10.1016/j.socscimed.2005.01.009. Epub 2005 Mar 3.
Psychiatric stigma is a concept that is often used uncritically by policy-makers to explain the underutilization of professional psychiatric services in non-Western societies. Stigma, however, is a multi-determined process manifestations and effects of which cannot be viewed separately from the larger social and cultural context. The present paper presents the results of a qualitative study of psychiatric stigma in Egypt from the perspective of lay respondents. A vignette method was used to elicit judgments of social distance and qualitative responses to stories depicting psychosis, depression, alcohol abuse and a 'possession state' from 208 respondents recruited through their places of work. The results indicated that while stigma does exist in Egypt, the form that it takes must be understood with reference to Egyptian notions of selfhood that locate behavioral disturbances in the intersubjective rather than intrapsychic realm. On the one hand, individual blame is diffused as responsibility for the illness and its cure is placed in the social, not personal (or biological) realm. On the other, behavioral disorders that threaten the social fabric of society are particularly stigmatized and often met with social rejection.
精神病耻辱感是一个概念，政策制定者经常不加批判地用它来解释非西方社会中专业精神科服务利用不足的现象。然而，耻辱感是一个由多种因素决定的过程，其表现和影响不能脱离更广泛的社会和文化背景来单独看待。本文从普通受访者的角度呈现了一项关于埃及精神病耻辱感的定性研究结果。采用了一种小品文方法，从通过工作场所招募的208名受访者那里引出对社会距离的判断以及对描述精神病、抑郁症、酗酒和“附身状态”故事的定性回应。结果表明，虽然耻辱感在埃及确实存在，但必须参照埃及关于自我的观念来理解其表现形式，这种观念将行为障碍定位在主体间而非心理内部领域。一方面，个人责任被分散，因为疾病及其治愈的责任被置于社会而非个人（或生物学）领域。另一方面，威胁社会结构的行为障碍尤其受到污名化，并且常常遭到社会排斥。
