Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hunghom, Hong Kong.
Soc Psychiatry Psychiatr Epidemiol. 2010 May;45(5):561-8. doi: 10.1007/s00127-009-0098-1. Epub 2009 Aug 2.
Mental illness stigma is one of the key causes for poor psychosocial treatment adherence. The objective of this study was to explore the link between self-stigmatization and adherence via path analysis with insight and readiness for change conceptualized as the possible mediators. The direct effects of psychopathology causing non-adherence were also tested.
One hundred and five participants with schizophrenia were recruited from five psychiatric settings in Hong Kong. Data concerning their level of stigma, insight, stages of change, psychopathology, and psychosocial treatment adherence were collected. Path analysis was used to test two hypothetical models.
The findings supported the direct effects of self-stigma on reducing psychosocial treatment adherence, and its indirect influences mediated by insight and stages of change on treatment adherence. Psychopathology was also found to have a direct effect on undermining adherence. This model showed better model fit than the one which did not consider the direct effects of self-stigmatization and psychopathology.
To conclude, this study deepened our understanding on the mechanism explaining how self-stigmatization undermines psychosocial treatment adherence. The findings provide direct implications on ways of formulating a self-stigma reduction program to combat self-stigma and its negative consequences.
精神疾病污名是导致社会心理治疗依从性差的主要原因之一。本研究旨在通过路径分析探讨自我污名化与依从性之间的联系，将洞察和改变准备视为可能的中介因素。还测试了导致不依从的精神病理学的直接影响。
从香港五家精神病院招募了 105 名精神分裂症患者。收集了他们的污名程度、洞察力、改变阶段、精神病理学和社会心理治疗依从性的数据。采用路径分析检验了两个假设模型。
研究结果支持自我污名化对降低社会心理治疗依从性的直接影响，以及洞察和改变阶段对治疗依从性的间接影响。还发现精神病理学对破坏依从性有直接影响。与不考虑自我污名化和精神病理学直接影响的模型相比，该模型显示出更好的模型拟合度。
综上所述，本研究深化了我们对解释自我污名化如何破坏社会心理治疗依从性的机制的理解。研究结果为制定自我污名化减少计划以对抗自我污名化及其负面影响提供了直接启示。
