Conner Kyaien O, Koeske Gary, Brown Charlotte
Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
J Gerontol Soc Work. 2009 Oct;52(7):695-712. doi: 10.1080/01634370902914372.
Stigma associated with mental illness continues to be a pervasive barrier to mental health treatment, leading to negative attitudes about treatment and deterring appropriate care seeking. Empirical research suggests that the stigma of mental illness may exert an adverse influence on attitudes toward mental health treatment and service utilization patterns by individuals with a mental illness, particularly African Americans. However, little research has examined the impact of stigma on racial differences in attitudes toward seeking mental health treatment. This study examined the hypothesis that stigma partially mediates the relationship between race and attitudes towards mental health treatment in a community-based sample of 101 African American and White older adults. Multiple regression analyses and classic path analysis was utilized to test the partial mediation model. Controlling for socio-demographic factors, African American older adults were more likely to have negative attitudes toward mental health treatment, and they also reported more public and internalized stigma than their White counterparts. As hypothesized, the relationship between race and attitudes toward mental health treatment was partially mediated by internalized stigma, suggesting that internalized stigma may cause older adults to develop negative attitudes about mental health treatment. The partial mediation model was not significant for public stigma, however. Implications for social work research and practice are discussed.
与精神疾病相关的污名仍然是心理健康治疗的一个普遍障碍，导致对治疗的负面态度，并阻碍人们寻求适当的治疗。实证研究表明，精神疾病的污名可能会对患有精神疾病的人，尤其是非裔美国人，对心理健康治疗的态度和服务利用模式产生不利影响。然而，很少有研究探讨污名对寻求心理健康治疗态度上种族差异的影响。本研究检验了这样一个假设：在一个由101名非裔美国人和白人老年人组成的社区样本中，污名部分介导了种族与对心理健康治疗态度之间的关系。采用多元回归分析和经典路径分析来检验部分中介模型。在控制了社会人口因素后，非裔美国老年人对心理健康治疗更有可能持负面态度，而且他们报告的公众污名和内化污名也比白人同龄人更多。正如所假设的那样，种族与对心理健康治疗态度之间的关系部分由内化污名介导，这表明内化污名可能导致老年人对心理健康治疗产生负面态度。然而，部分中介模型对公众污名并不显著。本文还讨论了对社会工作研究和实践的启示。
