Miller Carol T, Solomon Sondra E, Varni Susan E, Hodge James J, Knapp F Andrew, Bunn Janice Y
Department of Psychological Science, University of Vermont, Burlington, VT, 05405, USA.
Vermont Child Health Improvement Program, University of Vermont, Burlington, VT, 05405, USA.
Soc Sci Med. 2016 Aug;162:97-105. doi: 10.1016/j.socscimed.2016.06.025. Epub 2016 Jun 16.
Cross-sectional studies demonstrate that perceived discrimination is related to the psychological and physical well-being of stigmatized people. The theoretical and empirical foci of most of this research in on how racial discrimination undermines well-being. The present study takes a transactional approach to examine people with HIV, a potentially concealable stigma.
The transactional approach posits that even as discrimination adversely affects the psychological well-being of people with HIV, psychological distress also makes them more sensitive to perceiving that they may be or have been stigmatized, and may increase the chances that other people actually do stigmatize them.
This hypothesis was tested in a longitudinal study in which 216 New England residents with HIV were recruited to complete measures of perceived HIV stigma and well-being across three time points, approximately 90 days apart. This study also expanded on past research by assessing anticipated and internalized stigma as well as perceived discrimination.
Results indicated that all of these aspects of HIV stigma prospectively predicted psychological distress, thriving, and physical well-being. Equally important, psychological distress and thriving also prospectively predicted all three aspects of HIV stigma, but physical well-being did not.
These findings suggest that people with HIV are ensnared in a cycle in which experiences of stigma and reduced psychological well-being mutually reinforce each other.
横断面研究表明，感知到的歧视与受污名化人群的心理和身体健康状况有关。这项研究大多的理论和实证焦点在于种族歧视如何损害幸福感。本研究采用一种相互作用的方法来研究感染艾滋病毒的人群，这是一种潜在的可隐藏的污名。
相互作用的方法假定，即使歧视对艾滋病毒感染者的心理健康产生不利影响，但心理困扰也会使他们更容易察觉到自己可能正在或已经受到污名化，并且可能增加其他人实际对他们进行污名化的可能性。
在一项纵向研究中对这一假设进行了检验，研究招募了216名新英格兰地区的艾滋病毒感染者，让他们在三个时间点（相隔约90天）完成感知到的艾滋病毒污名及幸福感的测量。本研究还通过评估预期污名、内化污名以及感知到的歧视，对以往研究进行了扩展。
结果表明，艾滋病毒污名的所有这些方面都能前瞻性地预测心理困扰、茁壮成长感和身体健康状况。同样重要的是，心理困扰和茁壮成长感也能前瞻性地预测艾滋病毒污名的所有三个方面，但身体健康状况则不能。
这些发现表明，艾滋病毒感染者陷入了一个循环，在这个循环中，污名经历和心理健康状况下降会相互强化。
