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将精神疾病和药物成瘾描述为可治疗的健康状况:一项随机实验对耻辱感和歧视的影响。

Portraying mental illness and drug addiction as treatable health conditions: effects of a randomized experiment on stigma and discrimination.

作者信息

McGinty Emma E, Goldman Howard H, Pescosolido Bernice, Barry Colleen L

机构信息

Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Room 359, Baltimore, MD 21205, USA.

Department of Psychiatry, University of Maryland School of Medicine, USA.

出版信息

Soc Sci Med. 2015 Feb;126:73-85. doi: 10.1016/j.socscimed.2014.12.010. Epub 2014 Dec 5.

Abstract

Despite significant advances in treatment, stigma and discrimination toward persons with mental illness and drug addiction have remained constant in past decades. Prior work suggests that portraying other stigmatized health conditions (i.e., HIV/AIDS) as treatable can improve public attitudes toward those affected. Our study compared the effects of vignettes portraying persons with untreated and symptomatic versus successfully treated and asymptomatic mental illness and drug addiction on several dimensions of public attitudes about these conditions. We conducted a survey-embedded randomized experiment using a national sample (N = 3940) from an online panel. Respondents were randomly assigned to read one of ten vignettes. Vignette one was a control vignette, vignettes 2-5 portrayed individuals with untreated schizophrenia, depression, prescription pain medication addiction and heroin addiction, and vignettes 6-10 portrayed successfully treated individuals with the same conditions. After reading the randomly assigned vignette, respondents answered questions about their attitudes related to mental illness or drug addiction. Portrayals of untreated and symptomatic schizophrenia, depression, and heroin addiction heightened negative public attitudes toward persons with mental illness and drug addiction. In contrast, portrayals of successfully treated schizophrenia, prescription painkiller addiction, and heroin addiction led to less desire for social distance, greater belief in the effectiveness of treatment, and less willingness to discriminate against persons with these conditions. Portrayal of persons with successfully treated mental illness and drug addiction is a promising strategy for reducing stigma and discrimination toward persons with these conditions and improving public perceptions of treatment effectiveness.

摘要

尽管在治疗方面取得了重大进展,但在过去几十年里,对患有精神疾病和药物成瘾者的污名化和歧视一直存在。先前的研究表明,将其他受污名化的健康状况(如艾滋病毒/艾滋病)描述为可治疗的,能够改善公众对患者的态度。我们的研究比较了描述未治疗且有症状的与成功治疗且无症状的精神疾病和药物成瘾者的短文,对公众对这些状况的几个态度维度的影响。我们使用来自一个在线面板的全国样本(N = 3940)进行了一项嵌入调查的随机实验。受访者被随机分配阅读十个短文中的一篇。短文一是对照短文,短文2 - 5描述了患有未治疗的精神分裂症、抑郁症、处方止痛药成瘾和海洛因成瘾的个体,短文6 - 10描述了患有相同状况但已成功治疗的个体。在阅读随机分配的短文后,受访者回答了关于他们对精神疾病或药物成瘾相关态度的问题。对未治疗且有症状的精神分裂症、抑郁症和海洛因成瘾的描述加剧了公众对患有精神疾病和药物成瘾者的负面态度。相比之下,对成功治疗的精神分裂症、处方止痛药成瘾和海洛因成瘾的描述导致对社交距离的渴望降低、对治疗效果的信念增强,以及对患有这些状况者的歧视意愿降低。描述成功治疗的精神疾病和药物成瘾者是一种有前景的策略,可减少对这些患者的污名化和歧视,并改善公众对治疗效果的认知。

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