a Departamento de Psicología Social y de las Organizaciones , Universidad Nacional de Educación a Distancia (UNED) , Madrid , Spain.
Psychol Health Med. 2019 Sep;24(8):992-1004. doi: 10.1080/13548506.2019.1612076. Epub 2019 May 3.
The internalization of schizophrenia-related stigma highly affects people living with this disease, hindering their recovery process. The aim of this work is to study the effect of alienation and stereotype endorsement on the specific dimensions of schizophrenia-specific quality of life (SQoL), through the damage on self-esteem and self-efficacy. The model was tested in 167 patients with schizophrenia by path analysis using maximum likelihood procedure. The data fit the proposed model, but not all hypothesized predictions were met. A negative effect of alienation on self-esteem and self-efficacy was shown, while the negative effect of stereotype endorsement on these self-concept-related variables was non-significant. Self-esteem significantly contributed to the variance of the three dimensions of SQoL, while self-efficacy seems not to be involved in the model. Our results suggest that both alienation and stereotype endorsement have a direct effect on psychosocial SQoL and physical SQoL, while motivation and energy-related SQoL is affected only indirectly by alienation (through the decrease of self-esteem). Finally, we found that self-esteem significantly mediates the negative effect of alienation on the three dimensions of SQoL. We propose that the strengthening of self-esteem would mitigate the damage on SQoL, protecting specially the motivation and energy dimension, which may favor recovery.
精神分裂症相关污名内化会严重影响患者的生活，阻碍其康复过程。本研究旨在通过自尊和自我效能感的损害，探讨异化和刻板印象认同对精神分裂症特异性生活质量（SQoL）特定维度的影响。采用最大似然程序的路径分析对 167 名精神分裂症患者进行了模型检验。数据拟合了所提出的模型，但并非所有假设预测都得到了满足。异化对自尊和自我效能感有负面影响，而刻板印象认同对这些自我概念相关变量的负面影响不显著。自尊对 SQoL 的三个维度的差异有显著贡献，而自我效能感似乎未参与该模型。我们的结果表明，异化和刻板印象认同都对心理社会 SQoL 和身体 SQoL 有直接影响，而与动机和能量相关的 SQoL 仅受到异化的间接影响（通过自尊的降低）。最后，我们发现自尊显著中介了异化对 SQoL 三个维度的负性影响。我们提出，增强自尊可以减轻对 SQoL 的损害，特别保护动机和能量维度，这可能有利于康复。
