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精神分裂症个体的自我污名减少计划随机对照试验。

Randomized controlled trial of the self-stigma reduction program among individuals with schizophrenia.

机构信息

Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.

出版信息

Psychiatry Res. 2011 Sep 30;189(2):208-14. doi: 10.1016/j.psychres.2011.02.013. Epub 2011 Mar 5.

Abstract

Research evidence suggests that individuals with schizophrenia are prone to self-stigmatization, which reduces their psychosocial treatment adherence. A self-stigma reduction program was developed based on a theoretical framework proposed by our team. The effectiveness of such program to reduce self-stigma, enhance readiness for change, and promote adherent behaviors among individuals with schizophrenia was investigated. This program consisted of 12 group and four individual follow-up sessions. An integrative approach including psychoeductaion, cognitive behavioral therapy, motivational interviewing, social skills training, and goal attainment program was adopted. Sixty-six self-stigmatized individuals with schizophrenia were recruited. They were randomly allocated to the self-stigma reduction program (N=34; experimental protocol) or the newspaper reading group (N=32; comparison protocol). Measures on participants' level of self-stigma, readiness for change, insight, general self-efficacy, and treatment adherence were taken for six assessment intervals. The findings suggested that the self-stigma reduction program has potential to reduce self-esteem decrement, promote readiness for changing own problematic behaviors, and enhance psychosocial treatment adherence among the self-stigmatized individuals with schizophrenia during the active interventional stage. However, there was a lack of therapeutic maintenance effects during the 6-month follow-up period. Recommendations for further improving the effectiveness of self-stigma reduction program are suggested.

摘要

研究证据表明,精神分裂症患者容易出现自我污名化,从而降低其接受心理社会治疗的依从性。我们团队基于理论框架制定了一项自我污名化减少计划。该计划旨在调查其减少自我污名、增强改变意愿以及促进精神分裂症患者依从性行为的有效性。该计划包括 12 次小组和 4 次个体随访。采用了一种综合方法,包括心理教育、认知行为疗法、动机性访谈、社交技能训练和目标达成计划。招募了 66 名自我污名化的精神分裂症患者。他们被随机分配到自我污名化减少计划组(N=34;实验组)或报纸阅读组(N=32;对照组)。在六个评估时间点测量参与者的自我污名程度、改变意愿、洞察力、一般自我效能感和治疗依从性。研究结果表明,在积极的干预阶段,自我污名化减少计划有潜力降低自尊下降、促进改变自身问题行为的意愿,并增强精神分裂症自我污名化个体的心理社会治疗依从性。然而,在 6 个月的随访期间缺乏治疗维持效果。建议进一步提高自我污名化减少计划的效果。

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