Fertout Mohammed, Jones N, Keeling M, Greenberg N
Academic Department of Military Mental Health, Academic Department of Psychological Medicine, Institute of Psychiatry, Weston Education Centre, London, UK.
Center for Innovation and Research on Veterans and Military Families (CIR), School of Social Work, University of Southern California, Los Angeles, California, USA.
J R Army Med Corps. 2015 Dec;161 Suppl 1:i69-i76. doi: 10.1136/jramc-2015-000587.
UK military research suggests that there is a significant link between current psychological symptoms, mental health stigmatisation and perceived barriers to care (stigma/BTC). Few studies have explored the construct of stigma/BTC in depth amongst deployed UK military personnel.
Three survey datasets containing a stigma/BTC scale obtained during UK deployments to Iraq and Afghanistan were combined (n=3405 personnel). Principal component analysis was used to identify the key components of stigma/BTC. The relationship between psychological symptoms, the stigma/BTC components and help seeking were examined.
Two components were identified: 'potential loss of personal military credibility and trust' (stigma Component 1, five items, 49.4% total model variance) and 'negative perceptions of mental health services and barriers to help seeking' (Component 2, six items, 11.2% total model variance). Component 1 was endorsed by 37.8% and Component 2 by 9.4% of personnel. Component 1 was associated with both assessed and subjective mental health, medical appointments and admission to hospital. Stigma Component 2 was associated with subjective and assessed mental health but not with medical appointments. Neither component was associated with help-seeking for subjective psycho-social problems.
Potential loss of credibility and trust appeared to be associated with help-seeking for medical reasons but not for help-seeking for subjective psychosocial problems. Those experiencing psychological symptoms appeared to minimise the effects of stigma by seeking out a socially acceptable route into care, such as the medical consultation, whereas those who experienced a subjective mental health problem appeared willing to seek help from any source.
英国军事研究表明，当前的心理症状、心理健康污名化与感知到的就医障碍（污名化/就医障碍）之间存在显著联系。很少有研究深入探讨英国现役军事人员中的污名化/就医障碍这一概念。
合并了三个在英国军队部署到伊拉克和阿富汗期间获得的包含污名化/就医障碍量表的调查数据集（n = 3405名人员）。采用主成分分析来确定污名化/就医障碍的关键成分。研究了心理症状、污名化/就医障碍成分与寻求帮助之间的关系。
确定了两个成分：“个人军事信誉和信任的潜在丧失”（污名化成分1，五个项目，占总模型方差的49.4%）和“对心理健康服务的负面看法及寻求帮助的障碍”（成分2，六个项目，占总模型方差的11.2%）。37.8%的人员认可成分1，9.4%的人员认可成分2。成分1与评估的和主观的心理健康、医疗预约及住院有关。污名化成分2与主观和评估的心理健康有关，但与医疗预约无关。两个成分均与因主观心理社会问题寻求帮助无关。
信誉和信任的潜在丧失似乎与因医疗原因寻求帮助有关，但与因主观心理社会问题寻求帮助无关。出现心理症状的人似乎通过寻求社会认可的就医途径（如医疗咨询）来尽量减少污名化的影响，而那些有主观心理健康问题的人似乎愿意从任何来源寻求帮助。
