Department of Psychology, The Pennsylvania State University, University Park, PA, 16802, USA.
Department of Psychology, The Pennsylvania State University, University Park, PA, 16802, USA.
Soc Sci Med. 2018 Jul;208:158-164. doi: 10.1016/j.socscimed.2018.01.015. Epub 2018 Mar 6.
People living with MS often report feeling stigmatized, but little research has examined the psychological impact of this, which is important considering the high prevalence of depression in this population.
The aim of this study was to assess, concurrently and prospectively, the association between stigma and depression in people living with MS.
Data were available from 5369 participants enrolled in the semi-annual survey conducted by the North American Research Committee on Multiple Sclerosis (NARCOMS). Participants reported their MS stigma and depression in the spring 2013 update survey (T1) and their depression again one year later (T2). Demographic and health-related covariates were also assessed.
People experiencing higher levels of stigma reported more depression symptoms and were more likely to meet the threshold for clinical depression at both times, even controlling for covariates. Higher levels of stigma also predicted T2 depression, controlling for T1 depression (and covariates), suggesting a possible causal association. Greater psychosocial reserve, a composite of measures assessing participants' feelings of belonging, social support, and sense of control, attenuated the association between stigma and depression.
Stigma is an important but understudied predictor of depression in people living with MS, but greater psychosocial reserve provides a buffer.
多发性硬化症（MS）患者常自述感到受歧视，但鲜有研究探讨这种歧视对他们的心理影响，鉴于该人群中抑郁症的高发率，这一点很重要。
本研究旨在同时前瞻性评估多发性硬化症患者的耻辱感与抑郁之间的关联。
数据来自北美多发性硬化症研究委员会（NARCOMS）开展的半年期调查的 5369 名参与者。参与者在 2013 年春季更新调查（T1）中报告了他们的多发性硬化症耻辱感和抑郁状况，并在一年后（T2）再次报告了抑郁状况。同时评估了人口统计学和与健康相关的协变量。
经历更高水平耻辱感的人报告了更多的抑郁症状，并且在两次评估中都更有可能达到临床抑郁的阈值，即使控制了协变量也是如此。更高水平的耻辱感也预示着 T2 抑郁，控制了 T1 抑郁（和协变量），表明可能存在因果关系。更大的心理社会储备（一个综合评估参与者归属感、社会支持和控制感的指标）减弱了耻辱感和抑郁之间的关联。
耻辱感是多发性硬化症患者抑郁的一个重要但研究不足的预测因素，但更大的心理社会储备提供了缓冲。
