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不同精神障碍患者的自我污名对自尊的影响。

The impact of self-stigma on self-esteem among persons with different mental disorders.

机构信息

Gyeongsang National University, Jinju, Republic of Korea.

出版信息

Int J Soc Psychiatry. 2019 Nov;65(7-8):558-565. doi: 10.1177/0020764019867352. Epub 2019 Aug 2.

Abstract

BACKGROUND

This study assumes that just as public stigma differs depending on types of mental disorder, so too does self-stigma.

AIMS

This study aims to compare self-stigma among persons with schizophrenia, alcohol use disorder and gambling disorder, and thereby analyze the effects of self-stigma on their self-esteem.

METHODS

A total of 321 Korean adults involved in community mental services for schizophrenia ( = 116), alcohol use disorder ( = 102) and gambling disorder ( = 103) were surveyed ( = 40.74, standard deviation () = 10.10, 83.8% male, 16.2% female). Participants were questioned on self-stigma and self-esteem. One-way analysis of variance (ANOVA) was used to compare the self-stigma by mental disorder type. Furthermore, in order to analyze the effects of self-stigma on self-esteem with subjects' age and educational background controlled, hierarchical regression analysis was used.

RESULTS

The self-stigma of gambling disorder group was highest not only in overall self-stigma but also some of its subscales - alienation, stereotype endorsement and stigma resistance - followed by alcohol use disorder group and schizophrenia group. In all three groups, self-stigma had a negative effect on self-esteem, while stigma resistance of subscales was the most important predictor. In addition to stigma resistance, alienation was a predictor in the schizophrenia group, alienation and social withdrawal in the alcohol use disorder group and social withdrawal was a significant predictor in the gambling disorder group. Therefore, the predictors of self-esteem differed depending on the type of mental disorder.

CONCLUSION

Based on these results, we suggest cognitive-behavioral intervention to raise subject awareness of the unjust social stigma and boost self-advocacy to resist the stigma.

摘要

背景

本研究假设,正如公众污名因精神障碍类型而异,自我污名也是如此。

目的

本研究旨在比较精神分裂症、酒精使用障碍和赌博障碍患者的自我污名,并分析自我污名对其自尊的影响。

方法

共有 321 名参与社区精神服务的韩国成年人(精神分裂症组 = 116 人,酒精使用障碍组 = 102 人,赌博障碍组 = 103 人)参与了调查( = 40.74,标准差()= 10.10,83.8%为男性,16.2%为女性)。参与者被问及自我污名和自尊。采用单因素方差分析(ANOVA)比较不同精神障碍类型的自我污名。此外,为了在控制被试年龄和教育背景的情况下分析自我污名对自尊的影响,采用了分层回归分析。

结果

赌博障碍组的自我污名不仅在总体自我污名方面最高,而且在一些子量表方面——如疏离感、刻板印象认同和抗污名性——也最高,其次是酒精使用障碍组和精神分裂症组。在这三个组中,自我污名都对自尊产生了负面影响,而子量表的抗污名性是最重要的预测因素。除了抗污名性,疏离感是精神分裂症组的预测因素,疏离感和社交退缩是酒精使用障碍组的预测因素,而社交退缩是赌博障碍组的重要预测因素。因此,自尊的预测因素因精神障碍类型而异。

结论

基于这些结果,我们建议进行认知行为干预,以提高患者对不公正社会污名的认识,并增强自我倡导以抵制污名。

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