Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD 21201, USA.
Psychiatr Serv. 2010 Aug;61(8):811-6. doi: 10.1176/ps.2010.61.8.811.
The experiences of parents of a child who received an initial diagnosis of attention-deficit hyperactivity disorder (ADHD) were examined to determine the ways in which they may have encountered stigmatizing situations.
Forty-eight parents of children aged six to 18 years were interviewed about their experiences leading up to their child's ADHD diagnosis, including their decisions to seek treatment. All interviews were recorded, transcribed, and analyzed using grounded theory methods. Codes were identified using a constant comparative approach, which led to theoretically defined thematic constructs of stigma.
Stigmatizing experiences were noted by 77% of the sample. Nearly half (N=21, 44%) were concerned about how society would label their child, 40% (N=19) felt social isolation and rejection, and 21% (N=10) perceived health care professionals and school personnel as being dismissive of their concerns. Parents' own attitudes about ADHD treatment were shaped by their exposure to negative media (N=10, 21%), their mistrust of medical assessments (N=8, 17%), and the influence of general public views (N=3, 6%). These stigmatizing views were related to parental concerns about the impact that diagnosis and treatment would have on their child's self-esteem and opportunities for future success.
The range of ways in which parents in the study experienced stigma highlights the need for multiple perspectives for community outreach and public health programs that are aimed at addressing and eliminating mental health stigma. Even though stigma is a well-established barrier to mental health service use, the anticipated benefits of treatment may outweigh parents' experiences with stigma.
本研究旨在探讨父母在孩子被首次诊断为注意缺陷多动障碍（ADHD）时的经历，以确定他们可能遇到污名化情况的方式。
对 48 名 6 至 18 岁儿童的父母进行了访谈，内容涉及他们在孩子被诊断为 ADHD 之前的经历，包括他们决定寻求治疗的情况。所有访谈均进行了录音、转录，并采用扎根理论方法进行分析。使用恒定性比较方法识别代码，这导致了理论上定义的污名主题结构。
77%的样本中出现了污名化经历。近一半（N=21，44%）的父母担心社会会如何给孩子贴上标签，40%（N=19）感到社会孤立和排斥，21%（N=10）认为医疗保健专业人员和学校人员对他们的担忧不屑一顾。父母对 ADHD 治疗的态度受到他们接触负面媒体（N=10，21%）、对医疗评估的不信任（N=8，17%）以及公众观点的影响（N=3，6%）的影响。这些污名化观点与父母对诊断和治疗对孩子自尊心和未来成功机会的影响的担忧有关。
本研究中父母经历污名化的方式多种多样，这凸显了需要采取多种方法进行社区外联和公共卫生计划，以解决和消除心理健康污名。尽管污名是使用心理健康服务的一个既定障碍，但治疗的预期益处可能超过父母的污名化经历。
