Birchwood Max, Trower Peter, Brunet Kat, Gilbert Paul, Iqbal Zaffer, Jackson Chris
School of Psychology, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
Behav Res Ther. 2007 May;45(5):1025-37. doi: 10.1016/j.brat.2006.07.011. Epub 2006 Sep 26.
Social anxiety disorder (SaD) or social phobia is a co-morbid affective disorder in schizophrenia, present in up to one in three individuals. We employ 'social rank' theory to predict that one pathway to social anxiety in schizophrenia is triggered by the anticipation of a catastrophic loss of social status that the stigma of schizophrenia can entail. A group of 79 people with a first episode of psychosis were assessed for social anxiety: hypotheses were tested comparing 23 socially anxious and 56 non-anxious patients on measures of cognitive appraisals of shame/stigma of psychosis and perceived social status, controlling for depression, psychotic symptoms and general psychopathology. Participants with social anxiety experienced greater shame attached to their diagnosis and felt that the diagnosis placed them apart from others, i.e., socially marginalised them and incurred low social status. We propose a stigma model of social anxiety that makes testable predictions about how the shame beliefs may contaminate social interaction and thereby exacerbate and maintain social phobia.
社交焦虑障碍（SaD）或社交恐惧症是精神分裂症中的一种共病情感障碍，在多达三分之一的个体中存在。我们运用“社会等级”理论来预测，精神分裂症患者社交焦虑的一条途径是由对精神分裂症污名可能带来的社会地位灾难性丧失的预期所触发的。对一组79名首次发作精神病的患者进行社交焦虑评估：通过比较23名社交焦虑患者和56名非焦虑患者在对精神病羞耻/污名的认知评估和感知社会地位方面的测量结果来检验假设，同时控制抑郁、精神病症状和一般精神病理学因素。有社交焦虑的参与者对自己的诊断感到更大的羞耻，并觉得诊断使他们与他人不同，即社会上使他们边缘化并导致社会地位低下。我们提出了一个社交焦虑的污名模型，该模型对羞耻信念如何可能污染社会互动从而加剧和维持社交恐惧症做出了可检验的预测。
