Mandel School of Applied Social Sciences, Case Western Reserve University, 11235 Bellflower Rd., Cleveland, OH 44106, USA.
Psychiatr Serv. 2011 Aug;62(8):893-9. doi: 10.1176/ps.62.8.pss6208_0893.
The extant literature describes stigma in two forms, public stigma and self-stigma. Public stigma pertains to negative social behaviors, reactions, attitudes, and beliefs directed toward people with mental illness and among persons with mental illness. Self-stigma concerns the internalized effects of public stigma. Although both types of stigma have negative impacts on people with mental illness, they produce different effects. In particular, self-stigma can negatively affect self-esteem, social relationships, willingness to engage in life opportunities, and adherence to psychiatric services. Few adult stigma models represent self-stigma, and no models exist that examine self-stigma among adolescents with a mental illness. Because of developmental differences, adolescent self-stigma may be distinct from that of adults. This study aimed to develop a self-stigma model to elucidate youths' responses to mental illness labels and how psychiatric services affect self-image and self-efficacy.
The qualitative study included a sample of 27 adolescents between the ages of 12 and 17 who took psychiatric medication for a mental illness diagnosis. A semistructured interview, the Teen Subjective Experience Medication Interview, was used to query adolescents about their perceptions of having a psychiatric diagnosis and of taking psychiatric medication. The analytic strategy identified a sequence of narrative plot components that illustrated a self-stigma process among adolescents.
The findings revealed a self-stigma model comprising three narrative components: stereotype, differentiate, and protect.
The adolescent model was similar to yet distinct from the adult model, and developmental differences may contribute to the variation. The need for future research to validate an adolescent self-stigma model is discussed.
现有文献将污名分为两种形式，即公众污名和自我污名。公众污名是指针对精神疾病患者和精神疾病患者的负面社会行为、反应、态度和信念。自我污名涉及公众污名的内化影响。尽管这两种类型的污名都对精神疾病患者产生负面影响，但它们产生的影响不同。特别是，自我污名会对自尊心、社会关系、参与生活机会的意愿以及对精神科服务的坚持产生负面影响。很少有成人污名模型代表自我污名，也没有模型可以检验患有精神疾病的青少年的自我污名。由于发育差异，青少年的自我污名可能与成年人的自我污名不同。本研究旨在开发一个自我污名模型，以阐明青少年对精神疾病标签的反应，以及精神科服务如何影响自我形象和自我效能。
这项定性研究包括 27 名 12 至 17 岁的青少年，他们因精神疾病诊断而服用精神科药物。采用半结构式访谈，即青少年主观体验药物访谈，询问青少年对自己有精神科诊断和服用精神科药物的看法。分析策略确定了一系列叙事情节成分，这些成分说明了青少年自我污名的过程。
研究结果揭示了一个由三个叙事成分组成的自我污名模型：刻板印象、区分和保护。
青少年模型与成人模型相似但又不同，发育差异可能导致这种差异。需要进一步研究来验证青少年自我污名模型。
