Mental Health Service, San Francisco VA Health Care System, San Francisco, CA, USA; Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA.
Mental Health Service, San Francisco VA Health Care System, San Francisco, CA, USA; Department of Clinical Psychology, California School of Professional Psychology, Alliant International University, San Francisco, CA, USA.
Psychiatry Res. 2016 Jun 30;240:253-259. doi: 10.1016/j.psychres.2016.04.035. Epub 2016 Apr 29.
We investigated the relationship between internalized stigma of mental illness at baseline and depressive and psychotic symptoms 3 and 6 months later, controlling for baseline symptoms. Data on homeless veterans with severe mental illness (SMI) were provided by the Northeast Program Evaluation Center (NEPEC) Special Needs-Chronic Mental Illness (SN-CMI) study (Kasprow and Rosenheck, 2008). The study used the Internalized Stigma of Mental Illness (ISMI) scale to measure internalized stigma at baseline and the Symptom Checklist-90-R (SCL-90-R) to measure depressive and psychotic symptoms at baseline and 3 and 6 month follow-ups. Higher levels of internalized stigma were associated with greater levels of depressive and psychotic symptoms 3 and 6 months later, even controlling for symptoms at baseline. Alienation and Discrimination Experience were the subscales most strongly associated with symptoms. Exploratory analyses of individual items yielded further insight into characteristics of potentially successful interventions that could be studied. Overall, our findings show that homeless veterans with SMI experiencing higher levels of internalized stigma are likely to experience more depression and psychosis over time. This quasi-experimental study replicates and extends findings of other studies and has implications for future controlled research into the potential long-term effects of anti-stigma interventions on mental health recovery.
我们调查了基线时内化的精神疾病耻辱感与 3 个月和 6 个月后抑郁和精神病症状之间的关系,同时控制了基线症状。无家可归的严重精神疾病(SMI)退伍军人的数据来自东北方案评估中心(NEPEC)特殊需要-慢性精神疾病(SN-CMI)研究(Kasprow 和 Rosenheck,2008)。该研究使用内化精神疾病耻辱感量表(ISMI)来衡量基线时的内化耻辱感,使用症状清单-90-R(SCL-90-R)来衡量基线时以及 3 个月和 6 个月随访时的抑郁和精神病症状。即使控制了基线症状,更高水平的内化耻辱感与 3 个月和 6 个月后的抑郁和精神病症状更严重相关。疏离和歧视体验是与症状最密切相关的分量表。对个别项目的探索性分析提供了对可能成功的干预措施特征的进一步了解,这些干预措施可以进行研究。总的来说,我们的发现表明,经历更高水平内化耻辱感的无家可归的 SMI 退伍军人随着时间的推移更有可能经历更多的抑郁和精神病。这项准实验研究复制和扩展了其他研究的发现,并对未来针对抗耻辱干预对精神健康恢复的潜在长期影响的对照研究具有启示意义。
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