Nelson Erik, Werremeyer Amy, Kelly Gina Aalgaard, Skoy Elizabeth
(Corresponding author) PharmD Candidate 2018, North Dakota State University, School of Pharmacy, Fargo, North Dakota,
Faculty Mentor, Associate Professor of Practice, North Dakota State University, School of Pharmacy, Fargo, North Dakota.
Ment Health Clin. 2018 Aug 30;8(5):214-221. doi: 10.9740/mhc.2018.09.214. eCollection 2018 Sep.
Aspects of self-stigma and medication-related stigma among individuals with depressive disorders remain largely unexplored. The primary objective of this study is to highlight and characterize self-stigma and medication-related stigma experiences of antidepressant users.
This is a secondary analysis of data obtained from PhotoVoice studies examining psychotropic medication experiences. Transcripts of reflections from 12 individuals self-reporting a depressive disorder diagnosis and receipt of a prescription for an antidepressant were included. A directed content analysis approach based on expansion of the Self-Stigma of Depression Scale and an iterative process of identification of medication-stigma and stigma-resistance were used. Total mentions of self-stigma, stigma resistance, medication stigma, and underlying themes were tallied and evaluated.
Self-stigma was mentioned a total of 100 times with at least 2 mentions per participant. Self-blame was the most prominent construct of self-stigma and was mentioned nearly twice as often as any other self-stigma construct. Most participants also made mentions of self-stigma resistance. Half of the individual participants mentioned stigma resistance more times than they mentioned self-stigma, which suggests some surmounting of self-stigma. Medication-related stigma was also prominent, denoting negativity about the presence of medications in one's life.
Self-stigma related to self-blame may be problematic for antidepressant users. Identification and measurement of stigma resistance, especially in peer interactions, may represent a promising concept in overcoming self-stigma. Future work should explore emphasizing self-blame aspects when designing interventions to reduce self-stigma among individuals with depressive disorders and explore development of tools to measure stigma resistance.
抑郁症患者的自我污名化和药物相关污名化的诸多方面在很大程度上仍未得到充分研究。本研究的主要目的是突出并描述抗抑郁药使用者的自我污名化和药物相关污名化经历。
这是一项对从考察精神药物使用经历的照片发声研究中获取的数据进行的二次分析。纳入了12名自我报告患有抑郁症诊断并接受抗抑郁药处方的个体的反思记录。采用了基于抑郁症自我污名化量表扩展以及药物污名化和污名抵抗识别迭代过程的定向内容分析方法。对自我污名化、污名抵抗、药物污名化及潜在主题的总提及次数进行了统计和评估。
自我污名化共被提及100次，每位参与者至少提及2次。自责是自我污名化最突出的构成要素，其被提及的频率几乎是任何其他自我污名化构成要素的两倍。大多数参与者也提到了自我污名抵抗。半数个体参与者提及污名抵抗的次数多于提及自我污名的次数，这表明自我污名有一定程度的克服。药物相关污名化也很突出，表明对生活中存在药物持负面态度。
与自责相关的自我污名化可能对抗抑郁药使用者存在问题。识别和测量污名抵抗，尤其是在同伴互动中，可能是克服自我污名化的一个有前景的概念。未来的工作应探索在设计干预措施以减少抑郁症患者的自我污名化时强调自责方面，并探索开发测量污名抵抗的工具。
