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修改有未治疗精神障碍的本科生的心理健康求助污名:一项新型认知偏差修正干预的初步随机试验。

Modifying mental health help-seeking stigma among undergraduates with untreated psychiatric disorders: A pilot randomized trial of a novel cognitive bias modification intervention.

机构信息

Florida State University, United States.

Florida State University, United States.

出版信息

Behav Res Ther. 2018 Apr;103:33-42. doi: 10.1016/j.brat.2018.01.008. Epub 2018 Feb 2.

DOI:10.1016/j.brat.2018.01.008
PMID:29428819
Abstract

Help-seeking stigma is a potent barrier to the utilization of mental health services. This study aimed to determine if, compared to a psychoeducation condition, individuals randomized to a novel cognitive bias modification intervention for help-seeking stigma (CBM-HS) demonstrate greater reductions in help-seeking stigma, as well as increases in readiness to change and help-seeking behaviors. Participants included 32 undergraduates with a DSM-5 psychiatric disorder who denied past-year mental health treatment. Post-randomization, three intervention sessions were delivered in one-week intervals (45 min total). Participants were assessed at baseline, mid-intervention, one-week post-intervention, and two-month follow-up. RM-ANOVAs were utilized among the intent-to-treat sample. There were no significant differences across time points between the intervention groups for help-seeking stigma and readiness to change. At two-month follow-up, 25% of participants initiated mental health treatment (29.4% CBM-HS, 20.0% psychoeducation). Strikingly, across groups, there was a statistically significant reduction in help-seeking self-stigma (F[2.214,66.418] = 5.057, p = 0.007, η = 0.144) and perceived public stigma (F[3,90] = 6.614, p < 0.001, η = 0.181) from baseline to two-month follow-up, indicating large effects; 18.8% achieved clinically significant change, among whom two-thirds were in the CBM-HS condition. Two brief, scalable interventions appear to reduce help-seeking stigma among undergraduates with untreated psychiatric disorders. Studies are needed to evaluate these interventions against an inactive control.

摘要

求助污名是利用心理健康服务的一个强大障碍。本研究旨在确定与心理教育条件相比,随机分配到一种新的求助污名认知偏差修正干预(CBM-HS)的个体是否表现出更大程度的求助污名减少,以及改变意愿和求助行为的增加。参与者包括 32 名被诊断患有 DSM-5 精神障碍且否认过去一年接受过心理健康治疗的本科生。随机分组后,在一周的间隔内进行了三次干预(共 45 分钟)。参与者在基线、干预中期、干预后一周和两个月随访时进行评估。意向治疗样本采用 RM-ANOVA。在干预组之间,求助污名和改变意愿在各个时间点上没有显著差异。在两个月的随访中,25%的参与者开始接受心理健康治疗(CBM-HS 组为 29.4%,心理教育组为 20.0%)。引人注目的是,在所有组中,求助自我污名(F[2.214,66.418] = 5.057,p = 0.007,η = 0.144)和感知公众污名(F[3,90] = 6.614,p < 0.001,η = 0.181)从基线到两个月的随访中均有显著降低,表明有较大的影响;18.8%的人达到了临床显著的变化,其中三分之二的人在 CBM-HS 条件下。两项简短的、可扩展的干预措施似乎可以减少未接受治疗的精神障碍本科生的求助污名。需要进行研究以评估这些干预措施与无效对照的效果。

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