The authors are with the Department of Psychology, John Jay College of Criminal Justice, and the Graduate Center, City University of New York, New York.
Psychiatr Serv. 2017 Oct 1;68(10):1053-1060. doi: 10.1176/appi.ps.201600553. Epub 2017 Jun 15.
Mental health professionals who work with people with serious mental illnesses are believed to experience associative stigma. Evidence suggests that associative stigma could play an important role in the erosion of empathy among professionals; however, no validated measure of the construct currently exists. This study examined the convergent and discriminant validity and factor structure of a new scale assessing the associative stigma experiences of clinicians working with people with serious mental illnesses.
A total of 473 clinicians were recruited from professional associations in the United States and participated in an online study. Participants completed the Clinician Associative Stigma Scale (CASS) and measures of burnout, quality of care, expectations about recovery, and self-efficacy.
Associative stigma experiences were commonly endorsed; eight items on the 18-item scale were endorsed as being experienced "sometimes" or "often" by over 50% of the sample. The new measure demonstrated a logical four-factor structure: "negative stereotypes about professional effectiveness," "discomfort with disclosure," "negative stereotypes about people with mental illness," and "stereotypes about professionals' mental health." The measure had good internal consistency. It was significantly related to measures of burnout and quality of care, but it was not related to measures of self-efficacy or expectations about recovery.
Findings suggest that the CASS is internally consistent and shows evidence of convergent validity and that associative stigma is commonly experienced by mental health professionals who work with people with serious mental illnesses.
从事严重精神疾病患者工作的心理健康专业人员被认为会经历关联污名。有证据表明，关联污名可能在专业人员同理心的侵蚀中发挥重要作用；然而，目前尚无该构念的经过验证的衡量标准。本研究检验了一种新的评估与严重精神疾病患者一起工作的临床医生关联污名体验的量表的聚合效度、区分效度和因子结构。
共从美国的专业协会招募了 473 名临床医生，并参与了一项在线研究。参与者完成了临床医生关联污名量表（CASS）和倦怠、护理质量、康复期望和自我效能感的衡量标准。
关联污名体验得到了广泛的认可；该 18 项量表中的 8 项被超过 50%的样本认为是“有时”或“经常”经历的。新的衡量标准表现出逻辑上的四因素结构：“对专业效能的负面刻板印象”、“对披露的不适”、“对精神疾病患者的负面刻板印象”和“对专业人员心理健康的刻板印象”。该衡量标准具有良好的内部一致性。它与倦怠和护理质量的衡量标准显著相关，但与自我效能感或康复期望的衡量标准无关。
研究结果表明，CASS 具有内部一致性，并表现出聚合效度的证据，并且与严重精神疾病患者一起工作的心理健康专业人员普遍经历关联污名。
