Botha Ulla A, Koen Liezl, Niehaus Dana J H
Department of Psychiatry, University of Stellenbosch, PO Box 19063, Tygerberg, 7505, South Africa.
Soc Psychiatry Psychiatr Epidemiol. 2006 Aug;41(8):619-23. doi: 10.1007/s00127-006-0071-1. Epub 2006 May 29.
With the worldwide shift towards a more community-based psychiatric service delivery approach, stigma and the issues surrounding it have received much attention. However, very little South African data exist and the aim of our study was therefore to investigate the experience of internalized stigma in a South African schizophrenia population with specific emphasis on abuse as a form of stigmatization.
A total of 100 subjects at various stages of schizophrenic illness were subjected to a the Internalized Stigma of Mental Illness scale (ISMI) that was modified to include six items focusing specifically on investigating the experience of stigmatization within the South African context.
A high overall degree of stigmatization was perceived by most subjects, but not equally so for all ISMI areas. When looking at the modified items, 29% felt media-influence to be negative, this seemed to be specifically true for those with matriculation and higher as well as a home-language other than Afrikaans. Thirty nine percent indicated that they had been victims of physical abuse due to their mental illness, with the data suggesting that especially Xhosa-speaking patients, male subjects and those with more admissions and a longer duration of illness experienced this excessively.
Our study confirmed a high overall degree of perceived stigmatization as well as suggesting some evidence for cultural influences on stigma. It was the first to provide South African data and as such can be regarded as central to our efforts in restructuring psychiatric services and clinical practices in a way that would minimize the effects of stigma and ultimately benefit our clients.
随着全球范围内向更基于社区的精神科服务提供方式转变，耻辱感及其相关问题受到了广泛关注。然而，南非的数据非常少，因此我们研究的目的是调查南非精神分裂症患者群体内化耻辱感的经历，特别强调将虐待作为一种耻辱形式。
共有100名处于精神分裂症疾病不同阶段的受试者接受了精神疾病内化耻辱感量表（ISMI）测试，该量表经过修改，包含六个专门针对调查南非背景下耻辱感经历的项目。
大多数受试者都感受到了较高程度的耻辱感，但在ISMI的所有领域并非均等。查看修改后的项目时，29%的人认为媒体影响是负面的，这似乎对那些拥有大学入学资格及以上学历以及母语不是南非荷兰语的人尤为如此。39%的人表示他们曾因精神疾病而遭受身体虐待，数据表明，尤其是说科萨语的患者、男性受试者以及那些住院次数更多、患病时间更长的人遭受这种情况的比例过高。
我们的研究证实了总体上较高程度的耻辱感，并表明了文化对耻辱感有影响的一些证据。它首次提供了南非的数据，因此可以被视为我们以尽量减少耻辱感影响并最终使我们的客户受益的方式重组精神科服务和临床实践努力的核心。
