Wood Lisa, Byrne Rory, Morrison Anthony P
North East London Foundation Trust,Goodmayes Hospital,Barley Lane,Ilford IG3 8XJ and Division of Psychology and Mental Health,University of Manchester,School of Health Sciences,Zochonis Building,ManchesterM13 9PL.
Psychosis Research Unit,Greater Manchester West NHS Foundation Trust,Rico House,Prestwich,ManchesterM25 9WL.
Behav Cogn Psychother. 2017 Nov;45(6):545-560. doi: 10.1017/S1352465817000224. Epub 2017 May 10.
Internalized stigma is a significant difficulty for those who experience psychosis, but it has never been conceptualized using cognitive theory.
The aim of this paper is to outline a cognitive model conceptualizing internalized stigma experienced by people who also experience psychosis.
Previous literature is reviewed, critiqued and synthesized to develop the model. It draws upon previous social cognitive models of internalized stigma and integrates cognitive behavioural theory and social mentality theory.
This paper identifies key cognitive, behavioural and emotional processes that contribute to the development and maintenance of internalized stigma, whilst also recognizing the central importance of cultural context in creating negative stereotypes of psychosis. Moreover, therapeutic strategies to alleviate internalized stigma are identified. A case example is explored and a formulation and brief intervention plan was developed in order to illustrate the model in practice.
An integrative cognitive model is presented, which can be used to develop individualized case formulations, which can guide cognitive behavioural interventions targeting internalized stigma in those who experience psychosis. More research is required to examine the efficacy of such interventions. In addition, it is imperative to continue to research interventions that create change in stigma at a societal level.
内化耻辱感是精神病患者面临的一个重大难题，但从未从认知理论的角度进行概念化阐释。
本文旨在概述一个认知模型，该模型将经历精神病的人所体验到的内化耻辱感进行概念化。
回顾、批判并综合以往文献以构建该模型。它借鉴了以往关于内化耻辱感的社会认知模型，并整合了认知行为理论和社会心理理论。
本文确定了导致内化耻辱感产生和维持的关键认知、行为和情感过程，同时认识到文化背景在塑造对精神病的负面刻板印象方面的核心重要性。此外，还确定了减轻内化耻辱感的治疗策略。探讨了一个案例，并制定了一个病例分析和简短干预计划，以在实践中说明该模型。
提出了一个综合认知模型，该模型可用于制定个性化的病例分析，从而指导针对经历精神病的人的内化耻辱感的认知行为干预。需要更多研究来检验此类干预的效果。此外，必须继续研究在社会层面上改变耻辱感的干预措施。
