Varni Susan E, Miller Carol T, McCuin Tara, Solomon Sondra E
University of Vermont.
J Soc Clin Psychol. 2012 Feb 1;31(2):123-150. doi: 10.1521/jscp.2012.31.2.123.
The stigma associated with HIV/AIDS poses a psychological challenge to people living with HIV/AIDS. We hypothesized that that the consequences of stigma-related stressors on psychological well-being would depend on how people cope with the stress of HIV/AIDS stigma. Two hundred participants with HIV/AIDS completed a self-report measure of enacted stigma and felt stigma, a measure of how they coped with HIV/AIDS stigma, and measures of depression and anxiety, and self-esteem. In general, increases in felt stigma (concerns with public attitudes, negative self-image, and disclosure concerns) coupled with how participants reported coping with stigma (by disengaging from or engaging with the stigma stressor) predicted self-reported depression, anxiety, and self-esteem. Increases in felt stigma were associated with increases in anxiety and depression among participants who reported relatively high levels of disengagement coping compared to participants who reported relatively low levels of disengagement coping. Increases in felt stigma were associated with decreased self-esteem, but this association was attenuated among participants who reported relatively high levels of engagement control coping. The data also suggested a trend that increases in enacted stigma predicted increases in anxiety, but not depression, among participants who reported using more disengagement coping. Mental health professionals working with people who are HIV positive should consider how their clients cope with HIV/AIDS stigma and consider tailoring current therapies to address the relationship between stigma, coping, and psychological well-being.
与艾滋病毒/艾滋病相关的污名给艾滋病毒/艾滋病感染者带来了心理挑战。我们假设，与污名相关的压力源对心理健康的影响将取决于人们如何应对艾滋病毒/艾滋病污名带来的压力。200名艾滋病毒/艾滋病感染者完成了一份关于实际污名和感知污名的自我报告测量、一份关于他们如何应对艾滋病毒/艾滋病污名的测量，以及抑郁、焦虑和自尊的测量。总体而言，感知污名的增加（对公众态度、负面自我形象和披露问题的担忧）以及参与者报告的应对污名的方式（通过脱离或参与污名压力源）预测了自我报告的抑郁、焦虑和自尊。与报告脱离应对水平相对较低的参与者相比，报告脱离应对水平相对较高的参与者中，感知污名的增加与焦虑和抑郁的增加有关。感知污名的增加与自尊的降低有关，但在报告参与控制应对水平相对较高的参与者中，这种关联减弱。数据还表明了一种趋势，即在报告使用更多脱离应对方式的参与者中，实际污名的增加预测了焦虑的增加，但不是抑郁的增加。与艾滋病毒呈阳性的人打交道的心理健康专业人员应考虑他们的客户如何应对艾滋病毒/艾滋病污名，并考虑调整当前的治疗方法，以解决污名、应对方式和心理健康之间的关系。
