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患有严重精神疾病的女性的性别和歧视的治疗经历。

Treatment experiences with gender and discrimination among women with serious mental illness.

机构信息

Department of Clinical Psychology.

出版信息

Psychol Serv. 2021 Feb;18(1):64-72. doi: 10.1037/ser0000346. Epub 2019 Mar 25.

DOI:10.1037/ser0000346
PMID:30907615
Abstract

The unique experiences of women with serious mental illness (SMI) are often overlooked in the literature in mental health and rehabilitation services. This population faces increased risk of violence, sexual abuse, treatment bias, and a number of health problems when compared with their male counterparts. Further research is needed to identify these differences and suggest clinical implications for working with women with SMI. The present qualitative research includes data from a grounded theory study analyzing interviews with 20 women with SMI to explore their treatment experiences with mental health providers. The following themes pertaining to treatment experiences of women with SMI were generated from qualitative analysis: diminishing dismissals (questions as to the legitimacy of the symptoms and concerns of women with SMI in their mental health treatment), symptom misattribution (erroneous ascriptions of their mental health symptoms), male mistrust (wariness toward, and avoidance of, male providers), psychiatric insults (perceptions that mental health providers tend to make stigmatizing diagnoses), doomsday predictions (experience of providers' negative prognoses of their future), and diagnostic reordering (tendency of mental health providers to revise prior diagnoses of women with SMI in ways that reduce stigma and build trust). Clinical implications of these findings will be discussed, including the need for enhanced awareness of providers as to the perceptions and expectations of gender bias in treatment among women with SMI. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

摘要

女性在严重精神疾病(SMI)方面的独特体验在心理健康和康复服务领域的文献中经常被忽视。与男性相比,这一人群面临着更高的暴力、性虐待、治疗偏见和一系列健康问题的风险。需要进一步的研究来确定这些差异,并为与患有 SMI 的女性合作提出临床意义。本定性研究包括一项扎根理论研究的数据,该研究分析了对 20 名患有 SMI 的女性的访谈,以探讨她们在心理健康提供者方面的治疗经历。从定性分析中得出了与患有 SMI 的女性治疗经历相关的以下主题:减少轻视(对女性 SMI 症状和担忧的合法性提出质疑)、症状归因错误(对她们的心理健康症状错误归因)、男性不信任(对男性提供者的警惕和回避)、精神病侮辱(认为心理健康提供者往往会做出污名化的诊断)、末日预言(提供者对她们未来的负面预测)和诊断重新排序(心理健康提供者倾向于以减少污名和建立信任的方式修改对患有 SMI 的女性的先前诊断)。将讨论这些发现的临床意义,包括增强提供者对女性 SMI 患者治疗中性别偏见的看法和期望的认识的必要性。(PsycInfo 数据库记录(c)2021 APA,保留所有权利)。

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