Veterans Affairs (VA) Capitol Network (Veterans Integrated Service Network 5) Mental Illness Research, Education and Clinical Center (MIRECC), VA Maryland Healthcare System, MIRECC, Baltimore, MD 21201, USA.
Psychiatr Serv. 2013 Mar 1;64(3):264-9. doi: 10.1176/appi.ps.001322012.
The investigators aimed to examine the prevalence of internalized stigma among individuals with serious mental illness and to construct and test a hypothesized model of the interrelationships among internalized stigma, self-concept, and psychiatric symptoms.
One hundred individuals, most of whom were African American and had a diagnosis of serious mental illness, were receiving mental health services from one of three community outpatient mental health programs or one Veterans Affairsmedical center. They completed an interview that included measures of internalized stigma, psychiatric symptoms, self-esteem, selfefficacy, and recovery orientation. Structural equation modeling (SEM) was used to examine the interrelationships among these variables.
Thirty-five percent of participants reported moderate to severe levels of internalized stigma, which was not significantly associated with any demographic variable or diagnosis. However, greater internalized stigma was associated with lower levels of self-esteem, self-efficacy, and recovery orientation, as well as with more severe psychiatric symptoms. The SEM produced a nonsignificant chi square statistic and other fit indices indicative of a good model fit (goodness-of-fit index=.96, root mean square error of approximation=.011).
Results suggest that internalized stigma was prevalent and problematic among individuals with serious mental illness. There may be multiple pathways through which stigma and discrimination lead to negative outcomes, suggesting that interventions to reduce internalized stigma need to target multiple points along these pathways in order to be effective.
研究者旨在调查严重精神疾病患者内化污名的普遍程度，并构建和检验内化污名、自我概念和精神症状之间相互关系的假设模型。
100 名参与者，其中大多数为非裔美国人，患有严重精神疾病，正在接受来自三个社区门诊心理健康计划或一个退伍军人事务医疗中心之一的心理健康服务。他们完成了一项访谈，其中包括内化污名、精神症状、自尊、自我效能和康复取向的测量。结构方程模型（SEM）用于检验这些变量之间的相互关系。
35%的参与者报告了中度到重度的内化污名，与任何人口统计学变量或诊断均无显著关联。然而，更高的内化污名与更低的自尊、自我效能和康复取向以及更严重的精神症状相关。SEM 产生了非显著的卡方统计量和其他拟合指数，表明模型拟合良好（拟合优度指数=.96，均方根误差近似值=.011）。
结果表明，严重精神疾病患者中内化污名普遍存在且存在问题。污名和歧视可能通过多种途径导致负面后果，这表明为减少内化污名而进行的干预需要针对这些途径的多个点，才能有效。
