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解析精神障碍患者人际能力、社交网络、社会支持与被污名化体验之间的关系:路径建模方法。

Disentangling the relationships between interpersonal competence, social network, social support and the experience of being stigmatized among people with psychotic disorders: A path modeling approach.

机构信息

First Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland.

Institute of Education, Jagiellonian University, Cracow, Poland.

出版信息

Schizophr Res. 2021 Feb;228:305-310. doi: 10.1016/j.schres.2020.12.033. Epub 2021 Jan 23.

Abstract

BACKGROUND

Deficits in social skills are common among people with psychosis and may contribute to the severity of the stigmatization they experience. The aim of the present research was to shed light on the mechanisms through which lack of interpersonal competence may lead to an increased exposure to stigma by investigating the mediating effects of social network and social support.

METHODS

A sample of 207 patients diagnosed with psychotic disorders was recruited for the study. The pattern of relationships between interpersonal competence, social network, social support and experienced stigma was analyzed using path modeling.

RESULTS

The level of interpersonal competence was found to be directly negatively related to the intensity of experienced stigma (β = -0.20, SE = 0.08; P < 0.05) and directly positively related to the scope of social network (β = 0.36, SE = 0.08, P < 0.01) and social support (β = 0.36, SE = 0.08, P < 0.01). The analysis of mediation pathways between interpersonal competence and stigma experiences revealed significant indirect effect through social support (β = -0.08, 95% CI: -0.16 to -0.02) and sequential effect through social network and social support (β = -0.03, 95% CI: -0.06 to -0.01). The indirect pathway from interpersonal competence to stigma via social network alone turned out to be non-significant.

CONCLUSIONS

The findings indicate that poor interpersonal competence may increase the extent of the stigma experienced by people with psychotic illness both directly and indirectly, with social support being the key mediator. Since interpersonal competence, social network and social support are potentially modifiable factors, they should be considered as possible targets of anti-stigma interventions.

摘要

背景

社交技能缺陷在精神病患者中很常见,可能导致他们所经历的污名化的严重程度增加。本研究旨在通过调查社交网络和社会支持的中介作用,阐明人际交往能力不足如何导致更多的污名化,从而揭示其中的机制。

方法

本研究招募了 207 名被诊断为精神障碍的患者。采用路径模型分析人际交往能力、社交网络、社会支持与体验到的污名之间的关系模式。

结果

人际交往能力的水平与体验到的污名强度呈直接负相关(β=-0.20,SE=0.08;P<0.05),与社交网络的范围呈直接正相关(β=0.36,SE=0.08,P<0.01)和社会支持(β=0.36,SE=0.08,P<0.01)。人际交往能力与污名体验之间的中介途径分析显示,社会支持具有显著的间接效应(β=-0.08,95%置信区间:-0.16 至-0.02),而社交网络和社会支持具有顺序效应(β=-0.03,95%置信区间:-0.06 至-0.01)。仅通过社交网络从人际交往能力到污名的间接途径结果不显著。

结论

研究结果表明,人际交往能力差可能会直接和间接增加精神病患者体验到的污名程度,社会支持是关键的中介因素。由于人际交往能力、社交网络和社会支持是潜在的可改变因素,因此应将其视为可能的反污名干预目标。

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