Department of Psychology, Oklahoma State University, Stillwater, OK.
University of Oklahoma Health Sciences Center Children's Hospital, Oklahoma City, OK.
Inflamm Bowel Dis. 2018 Apr 23;24(5):960-965. doi: 10.1093/ibd/izy011.
Studies have begun to identify psychosocial factors associated with depressive symptoms in youth with IBD. However, despite considerable speculation in the literature regarding the role of perceived stigma in both social and emotional adjustment outcomes, youth appraisals of stigma have yet to receive empirical attention. The primary purpose of this study was to examine the indirect effect of perceived illness stigma on depressive symptoms through its impact on social belongingness.
Eighty youth (Mage = 14.96) with IBD completed measures of illness stigma, thwarted belongingness, and depressive symptoms during a scheduled clinic visit. Pediatric gastroenterologists provided estimates of disease activity. Analyses examined the direct and indirect effects of illness stigma on perceived thwarted belongingness and depressive symptoms.
Bootstrapped regression results revealed significant illness stigma → depressive symptoms (β = 0.33, 95% CI, 0.108 to 0.526), illness stigma → thwarted belongingness (β =0.41, 95% CI, 0.061 to 0.739), and thwarted belongingness → depressive symptoms (β =0.32, 95% CI, 0.143 to 0.474) direct paths. Mediation analyses revealed a significant illness stigma → thwarted belongingness → depressive symptoms indirect path (β = 0.14, 95% CI, 0.034 to 0.310), suggesting increased appraisals of illness stigma impede youths' perceptions of social belongingness, which in turn, contribute to elevated depressive symptoms.
Youth perceptions of illness stigma negatively impact social belongingness and depressive symptoms in youth with IBD. Further, decreased perceptions of social belongingness may be one potential route through which stigma influences emotional adjustment outcomes. Results support clinical observations regarding the relevance of illness stigma and social functioning as targets of intervention for improving emotional adjustment in youth with IBD. 10.1093/ibd/izy011_video1izy011.video15775252424001.
已有研究开始确定与 IBD 青少年抑郁症状相关的心理社会因素。然而，尽管文献中有大量关于感知耻辱感在社会和情感适应结果中的作用的推测，但青少年对耻辱感的评价尚未得到实证关注。本研究的主要目的是通过考察感知疾病耻辱感对社会归属感的影响，来检验其对抑郁症状的间接影响。
在一次预约就诊中，80 名患有 IBD 的青少年（平均年龄 = 14.96 岁）完成了疾病耻辱感、受挫归属感和抑郁症状的测量。儿科胃肠病学家提供了疾病活动的估计。分析检验了疾病耻辱感对感知受挫归属感和抑郁症状的直接和间接影响。
自举回归结果显示，疾病耻辱感与抑郁症状呈显著相关（β=0.33，95%置信区间，0.108 至 0.526），疾病耻辱感与受挫归属感呈显著相关（β=0.41，95%置信区间，0.061 至 0.739），受挫归属感与抑郁症状呈显著相关（β=0.32，95%置信区间，0.143 至 0.474）。中介分析显示，疾病耻辱感→受挫归属感→抑郁症状的间接路径具有统计学意义（β=0.14，95%置信区间，0.034 至 0.310），这表明，对疾病耻辱感的评估增加会阻碍青少年对社会归属感的感知，进而导致抑郁症状的升高。
青少年对疾病耻辱感的看法对 IBD 青少年的社会归属感和抑郁症状有负面影响。此外，社会归属感的降低可能是耻辱感影响情绪适应结果的潜在途径之一。研究结果支持了临床观察，即疾病耻辱感和社会功能作为干预目标，对改善 IBD 青少年的情绪适应具有重要意义。
