“自豪出柜”减少精神疾病患者耻辱感影响的效果：随机对照试验试点
Efficacy of Coming Out Proud to reduce stigma's impact among people with mental illness: pilot randomised controlled trial.
作者信息
Rüsch Nicolas, Abbruzzese Elvira, Hagedorn Eva, Hartenhauer Daniel, Kaufmann Ilias, Curschellas Jan, Ventling Stephanie, Zuaboni Gianfranco, Bridler René, Olschewski Manfred, Kawohl Wolfram, Rössler Wulf, Kleim Birgit, Corrigan Patrick W
机构信息
Nicolas Rüsch, MD, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zürich, Switzerland, and Department of Psychiatry II, University of Ulm, Germany; Elvira Abbruzzese, PhD, Eva Hagedorn, MA, Daniel Hartenhauer, MA, Ilias Kaufmann, MA, Department of Clinical Psychology and Psychotherapy, University of Zürich, Switzerland; Jan Curschellas, BA, Stephanie Ventling, MSc, Gianfranco Zuaboni, MScN, René Bridler, MD, Sanatorium Kilchberg, Switzerland; Manfred Olschewski, MSc, Department of Medical Biometry and Statistics, University of Freiburg, Germany; Wolfram Kawohl, MD, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zürich, Switzerland; Wulf Rössler, MD, MSc, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zürich, Switzerland, and Institute of Psychiatry, Laboratory of Neuroscience (LIM 27), University of São Paulo, Brazil; Birgit Kleim, PhD, Department of Clinical Psychology and Psychotherapy, University of Zürich, Switzerland; Patrick W. Corrigan, PsyD, Illinois Institute of Technology, Chicago, USA.
出版信息
Br J Psychiatry. 2014;204(5):391-7. doi: 10.1192/bjp.bp.113.135772. Epub 2014 Jan 16.
BACKGROUND
Facing frequent stigma and discrimination, many people with mental illness have to choose between secrecy and disclosure in different settings. Coming Out Proud (COP), a 3-week peer-led group intervention, offers support in this domain in order to reduce stigma's negative impact.
AIMS
To examine COP's efficacy to reduce negative stigma-related outcomes and to promote adaptive coping styles (Current Controlled Trials number: ISRCTN43516734).
METHOD
In a pilot randomised controlled trial, 100 participants with mental illness were assigned to COP or a treatment-as-usual control condition. Outcomes included self-stigma, empowerment, stigma stress, secrecy and perceived benefits of disclosure.
RESULTS
Intention-to-treat analyses found no effect of COP on self-stigma or empowerment, but positive effects on stigma stress, disclosure-related distress, secrecy and perceived benefits of disclosure. Some effects diminished during the 3-week follow-up period.
CONCLUSIONS
Coming Out Proud has immediate positive effects on disclosure- and stigma stress-related variables and may thus alleviate stigma's negative impact.
背景
面对频繁的污名化和歧视，许多患有精神疾病的人不得不在不同场合下在保密和公开之间做出选择。“自豪地公开”（COP）是一项为期3周的由同伴主导的团体干预项目，在这方面提供支持，以减少污名化的负面影响。
目的
检验COP在减少与污名相关的负面结果以及促进适应性应对方式方面的效果（当前对照试验编号：ISRCTN43516734）。
方法
在一项试点随机对照试验中，100名患有精神疾病的参与者被分配到COP组或常规治疗对照组。结果包括自我污名化、赋权、污名压力、保密情况以及公开的感知益处。
结果
意向性分析发现，COP对自我污名化或赋权没有影响，但对污名压力、与公开相关的痛苦、保密情况以及公开的感知益处有积极影响。在3周的随访期内，一些影响有所减弱。
结论
“自豪地公开”对与公开和污名压力相关的变量有即时积极影响，因此可能减轻污名化的负面影响。
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