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被区别对待:心理健康障碍青少年在家庭、同伴和学校工作人员中经历的污名化。

Being treated differently: stigma experiences with family, peers, and school staff among adolescents with mental health disorders.

机构信息

University of Wisconsin-Madison, School of Social Work, 1350 University Avenue, Madison, WI 53706, USA.

出版信息

Soc Sci Med. 2010 Apr;70(7):985-93. doi: 10.1016/j.socscimed.2009.12.022. Epub 2010 Feb 1.

DOI:10.1016/j.socscimed.2009.12.022
PMID:20122768
Abstract

Stigma directed at adolescents diagnosed with emotional and behavioral disorders by individuals in their interpersonal network likely undermines their wellbeing, yet little is known about their subjective stigma experiences. In particular, the prospect of diagnosed youth experiencing prejudice and discrimination by family members has not previously been examined. This study examines adolescents' perceptions of being treated 'differently' because of mental health problems by family members, peers, and school staff. Qualitative analysis of narratives from mixed method interviews with 56 adolescents in a mid-western US city demonstrated variation in the perceived extent and nature of stigma and in contextual factors perceived as promoting or protecting from stigmatization, depending on the interpersonal domain. The greatest number of participants experienced stigmatization in relationships with peers (62%); this often led to friendship losses and transitions. Participants reporting no peer stigmatization often reported socializing with others "in the same boat" or concealing problems--methods of avoiding potentially stigmatizing interactions. Close to half (46%) described experiencing stigmatization by family members, which often took the form of unwarranted assumptions, distrust, avoidance, pity, and gossip. About one third (35%) of participants reported stigma perpetrated by school staff, who expressed fear, dislike, avoidance, and under-estimation of their abilities. Fortunately, 22% reported "different" treatment by school staff, but this treatment was interpreted as positive and supportive. Results showed that perceived stigmatization in one domain was associated with perceived stigma in other domains. The results suggest that efforts to combat stigmatization of youth with mental health disorders must help family members, peers, and school staff overcome their inclinations to make negative assumptions and discriminate against these youth.

摘要

针对人际关系网络中个体对被诊断患有情绪和行为障碍的青少年的污名化,可能会破坏他们的幸福感,但人们对他们主观污名化的体验知之甚少。特别是,以前没有研究过被诊断的年轻人可能会受到家庭成员的偏见和歧视。本研究考察了青少年对因心理健康问题而受到家庭成员、同龄人、学校工作人员“不同对待”的看法。通过对美国中西部一个城市的 56 名青少年进行混合方法访谈的叙述进行定性分析,研究表明,根据人际关系领域的不同,感知到的污名化程度和性质以及促进或保护免受污名化的背景因素存在差异。最多的参与者在与同伴的关系中经历了污名化(62%);这往往导致友谊的丧失和转变。没有经历过同伴污名化的参与者通常会报告与其他“同病相怜”的人交往,或者隐瞒问题——这些都是避免潜在污名化互动的方法。近一半(46%)的参与者描述了来自家庭成员的污名化,这种污名化通常表现为无端的假设、不信任、回避、怜悯和八卦。约三分之一(35%)的参与者报告了来自学校工作人员的污名化,他们表达了对这些学生的恐惧、厌恶、回避和低估。幸运的是,22%的参与者报告了学校工作人员的“不同”待遇,但这种待遇被解释为积极和支持性的。结果表明,一个领域的感知污名化与其他领域的感知污名化有关。结果表明,为打击对有心理健康障碍的年轻人的污名化而做出的努力,必须帮助家庭成员、同龄人、和学校工作人员克服对这些年轻人产生负面假设和歧视的倾向。

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