Wood Lisa, Irons Chris
North East London Foundation Trust, Goodmayes Hospital, Ilford, Essex, UK.
Clinical Psychology, University of Derby, UK.
Psychol Psychother. 2017 Sep;90(3):419-431. doi: 10.1111/papt.12127. Epub 2017 Jul 3.
Experienced stigma is detrimental to those who experience psychosis and can cause emotional distress and hinder recovery. This study aimed to explore the relationship between experienced stigma with emotional distress and recovery in people with psychosis. It explored the role of external shame and social rank as mediators in these relationships.
A cross-sectional design was implemented.
Fifty-two service users were administered a battery of questionnaires examining experienced stigma, external shame, social rank, personal recovery, positive symptoms, depression, and anxiety. Correlation and multiple regression analysis were conducted on the data. Where appropriate, mediation analysis was employed to explore social rank and external shame as mediatory variables.
Experienced stigma was significantly related to shame (social rank and external shame), positive symptoms, emotional distress (depression and anxiety), and personal recovery. The impact of experienced stigma on depression was mediated by external shame. Social rank was a mediator between experienced stigma and personal recovery only.
People with psychosis who have experienced stigma are likely to experience emotional distress and be inhibited in their recovery. This was found to be partly mediated by external shame and low social rank. Clinical approaches to stigma need to target these as potential maintenance factors.
Experienced stigma is significantly related to shame (social rank and external shame) emotional distress, and reduced personal recovery. External shame mediated the relationship between experienced stigma and depression in psychosis. Social rank mediated the relationship between experienced stigma and personal recovery. Clinical approaches to stigma should include the assessment of external shame and low social rank.
经历过污名化对患有精神病的人有害，会导致情绪困扰并阻碍康复。本研究旨在探讨精神病患者经历的污名化与情绪困扰及康复之间的关系。研究还探讨了外部羞耻感和社会地位在这些关系中作为中介变量的作用。
采用横断面设计。
对52名服务使用者进行了一系列问卷调查，内容包括经历的污名化、外部羞耻感、社会地位、个人康复、阳性症状、抑郁和焦虑。对数据进行了相关性和多元回归分析。在适当情况下，采用中介分析来探讨社会地位和外部羞耻感作为中介变量的情况。
经历的污名化与羞耻感（社会地位和外部羞耻感）、阳性症状、情绪困扰（抑郁和焦虑）以及个人康复显著相关。经历的污名化对抑郁的影响通过外部羞耻感介导。社会地位仅在经历的污名化与个人康复之间起中介作用。
经历过污名化的精神病患者可能会经历情绪困扰并在康复过程中受到阻碍。研究发现这部分是由外部羞耻感和低社会地位介导的。针对污名化的临床方法需要将这些因素作为潜在的维持因素加以关注。
经历的污名化与羞耻感（社会地位和外部羞耻感）、情绪困扰以及个人康复减少显著相关。外部羞耻感介导了精神病患者经历的污名化与抑郁之间的关系。社会地位介导了经历的污名化与个人康复之间的关系。针对污名化的临床方法应包括对外部羞耻感和低社会地位的评估。
