Department of Psychology, University of Toronto Scarborough, Toronto, ON, Canada.
Department of Psychology, Queen's University, Kingston, ON, Canada.
Schizophr Res. 2022 Jun;244:91-100. doi: 10.1016/j.schres.2022.05.016. Epub 2022 May 28.
Psychotic disorders are among the most highly stigmatized mental disorders, and individuals with psychosis experience significant exclusion from the community. Stigma reduction programs have done little to reduce social exclusion of individuals with psychosis, and there are significant limitations to the traditional stigma model as it applies to social exclusion. Herein, we present the Interactional Processing Model (IPM) of social exclusion towards individuals with psychosis. The IPM considers social exclusion to be the result of two interacting pathways with additional consideration for a feedback loop through which social exclusion sets in motion natural behavioural responses of individuals with psychosis that inadvertently perpetuates exclusion. The IPM considers initial social exclusion to be the result of an interaction between these two pathways. The first path aligns with the traditional stigma model and consists of the community becoming aware that an individual is diagnosed with a psychotic disorder and then excluding the individual based on pre-existing, generalized knowledge about the disorder. The second path to exclusion involves the observation of atypical behaviours from the individual, and generation of an individualized exclusion response. We provide initial empirical support for the IPM of social exclusion, outline testable hypotheses stemming from the model, and discuss implications for novel ways to consider both societal stigma reduction and personalized intervention.
精神病障碍是最受污名化的精神障碍之一，精神病患者经历了严重的社会排斥。减少污名化的项目几乎没有减少精神病患者的社会排斥，传统的污名模型在适用于社会排斥方面存在重大局限性。在此，我们提出了针对精神病患者的社会排斥的互动处理模型（IPM）。IPM 认为社会排斥是两个相互作用的途径的结果，并额外考虑了一个反馈循环，通过该循环，社会排斥引发了精神病患者的自然行为反应，这些反应无意中使排斥持续下去。IPM 认为最初的社会排斥是这两个途径相互作用的结果。第一条途径与传统的污名模型一致，包括社区意识到个体被诊断出患有精神病障碍，然后根据对该障碍的预先存在的、普遍的了解来排斥该个体。第二条排斥途径涉及观察个体的异常行为，并产生个体化的排斥反应。我们为社会排斥的 IPM 提供了初步的实证支持，概述了源自该模型的可检验假设，并讨论了考虑减少社会污名和个性化干预的新方法的意义。
