Lucksted Alicia, Drapalski Amy L, Brown Clayton H, Wilson Camille, Charlotte Melanie, Mullane Audrina, Fang Li Juan
Dr. Lucksted, Ms. Charlotte, and Ms. Fang are with the Department of Psychiatry, Division of Psychiatric Services Research, and Dr. Brown is with the Department of Epidemiology and Public Health, all at the University of Maryland School of Medicine, Baltimore (e-mail:
Psychiatr Serv. 2017 Apr 1;68(4):360-367. doi: 10.1176/appi.ps.201600037. Epub 2016 Dec 1.
This community-based randomized controlled trial was carried out to test the Ending Self-Stigma (ESS) psychoeducational intervention, which is designed to help adults with serious mental illnesses reduce internalization of mental illness stigma and its effects.
A total of 268 adults from five different mental health programs in Maryland took part. After baseline interview, consenting participants were randomly assigned to the nine-week ESS intervention or a minimally enhanced treatment-as-usual control condition. Participants were assessed by using symptom, psychosocial functioning, and self-stigma measures at baseline, postintervention, and six-month follow-up. Demographic characteristics were assessed at baseline.
Compared with participants in the control condition, ESS group participants showed significant decreases on the stereotype agreement and self-concurrence subscales of the Self Stigma of Mental Illness Scale, significant improvement on the alienation and stigma resistance subscales of the Internalized Stigma Mental Illness measure, and a significant increase in recovery orientation from baseline to postintervention. None of these differences were sustained at six-month follow-up.
Results indicate that ESS was useful in helping to reduce key aspects of internalized stigma among individuals with mental illnesses and that advances in the delivery, targeting, and content of the intervention in the field may be warranted to increase its potency.
开展这项基于社区的随机对照试验，以测试终结自我污名化（ESS）心理教育干预措施，该措施旨在帮助患有严重精神疾病的成年人减少精神疾病污名化的内化及其影响。
来自马里兰州五个不同心理健康项目的268名成年人参与了研究。在基线访谈后，同意参与的参与者被随机分配到为期九周的ESS干预组或最低限度强化的常规治疗对照组。在基线、干预后和六个月随访时，使用症状、心理社会功能和自我污名化测量方法对参与者进行评估。在基线时评估人口统计学特征。
与对照组的参与者相比，ESS组的参与者在精神疾病自我污名量表的刻板印象认同和自我认同子量表上显著下降，在内化污名精神疾病测量的疏离和污名抵抗子量表上显著改善，并且从基线到干预后恢复导向显著增加。这些差异在六个月随访时均未持续存在。
结果表明，ESS有助于减少精神疾病患者内化污名的关键方面，并且可能需要在该领域干预措施的实施、目标定位和内容方面取得进展，以提高其效力。
