Department of Psychology, Northwestern University, Evanston, IL, USA.
Department of Psychology, University of Georgia, Athens, GA, USA.
Schizophr Res. 2024 Jul;269:79-85. doi: 10.1016/j.schres.2024.04.023. Epub 2024 May 15.
It is unclear what types of stigma youth at clinical high risk for psychosis (CHR) experience, and the relationship between them and symptomatology. 94 CHR youth, and a control group of 45 youth with no psychosis spectrum symptoms (NP) were rated for perceived devaluation (i.e. negative views from others) and internalized mental health stigma (i.e. the extent to which they would agree with said views) as well as positive and mood symptomatology. CHR youth reported stigma more frequently than the NP group (χ(1) = 53.55, p < .001) and at higher levels (perceived devaluation: t (137) = 8.54, p < .001; internalized stigma: t (137) = 7.48, p < .001). Surprisingly, in the CHR group, positive symptoms held no significant relationship to stigma measures. However, ratings of perceived devaluation stigma were associated with depressive symptomatology (β = 0.27, t = 2.68, p = .0087) and depression scores were conversely associated with perceived devaluation stigma (β = 0.30, t = 2.05, p = .043). These findings speak to the relationship between depressive symptomatology and perceived devaluation stigma in CHR youth. Perceived devaluation stigma showed greater clinical significance and could have different mechanisms than internalized stigma in CHR youth. It is also noteworthy that while positive symptoms play a central role in defining the CHR syndrome, they seem less relevant to the experience of stigma than mood symptoms. These findings highlight the importance of interventions aimed at ameliorating youth's exposure to negative views about mental health as those managing depressive symptomatology.
目前尚不清楚处于精神病高危状态的年轻人(CHR)经历了哪些类型的污名化,以及这些污名化与症状之间的关系。94 名 CHR 青年和 45 名没有精神病症状(NP)的对照组青年被评估了感知歧视(即他人的负面看法)和内化的心理健康污名(即他们对上述看法的认同程度),以及阳性和情绪症状。CHR 青年报告的污名比 NP 组更频繁(χ(1) = 53.55,p <.001),程度也更高(感知歧视:t (137) = 8.54,p <.001;内化的污名:t (137) = 7.48,p <.001)。令人惊讶的是,在 CHR 组中,阳性症状与污名测量无显著关系。然而,感知歧视污名的评定与抑郁症状相关(β = 0.27,t = 2.68,p =.0087),抑郁评分与感知歧视污名呈相反关系(β = 0.30,t = 2.05,p =.043)。这些发现表明抑郁症状与 CHR 青年中感知歧视污名之间的关系。感知歧视污名具有更大的临床意义,并且与 CHR 青年的内化污名可能具有不同的机制。同样值得注意的是,虽然阳性症状在定义 CHR 综合征方面起着核心作用,但它们与情绪症状相比,与污名的相关性较小。这些发现强调了针对减轻年轻人接触到关于心理健康的负面看法的干预措施的重要性,因为这些措施可以改善抑郁症状。