"A disease like any other"? A decade of change in public reactions to schizophrenia, depression, and alcohol dependence.
"A disease like any other"? A decade of change in public reactions to schizophrenia, depression, and alcohol dependence.
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“像其他任何疾病”？公众对精神分裂症，抑郁和酒精依赖的反应变化了十年。
DOI：
10.1176/appi.ajp.2010.09121743
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发表时间：
2010-11
期刊：
影响因子：
--
通讯作者：
Link BG
中科院分区：
文献类型：
--
作者：
Pescosolido BA;Martin JK;Long JS;Medina TR;Phelan JC;Link BG
临床医生、倡导者和政策制定者将精神疾病作为医学疾病，努力克服服务使用率低、依从率低和耻辱感。作者通过对公众对治疗和偏见的认可进行10年的比较，研究了这种方法的影响。作者分析了1996年和2006年一般社会调查的心理健康模块中描述符合DSM-IV精神分裂症，重度抑郁症和酒精依赖标准的个人的小插曲的反应，以探索是否更多的公众1）接受精神疾病的神经生物学理解; 2）赞同提供者，包括精神病医生的治疗;和3）报告社区接受或拒绝患有这些疾病的人。多变量分析检查是否接受神经生物学原因增加治疗支持和减少耻辱。2006年，67%的公众将抑郁症归因于神经生物学原因，而1996年为54%。高比例的受访者赞同治疗，赞同医生治疗的比例普遍增加，赞同精神科医生治疗酒精依赖（从1996年的61%增加到2006年的79%）和严重抑郁症（从1996年的75%增加到2006年的85%）的比例也有具体增加。与这些疾病相关的社会距离和感知危险并没有显著减少。持有这些疾病的神经生物学概念增加了支持治疗的可能性，但通常与耻辱无关。如果相关，其效果是增加，而不是减少，社区拒绝。越来越多的公众接受了对精神疾病的神经生物学理解。这种观点转化为对服务的支持，但没有转化为减少耻辱。重新制定减少污名化战略可能需要提供者和倡导者转向强调能力和包容。
Clinicians, advocates, and policy makers have presented mental illnesses as medical diseases in efforts to overcome low service use, poor adherence rates, and stigma. The authors examined the impact of this approach with a 10-year comparison of public endorsement of treatment and prejudice. The authors analyzed responses to vignettes in the mental health modules of the 1996 and 2006 General Social Survey describing individuals meeting DSM-IV criteria for schizophrenia, major depression, and alcohol dependence to explore whether more of the public 1) embraces neurobiological understandings of mental illness; 2) endorses treatment from providers, including psychiatrists; and 3) reports community acceptance or rejection of people with these disorders. Multivariate analyses examined whether acceptance of neurobiological causes increased treatment support and lessened stigma. In 2006, 67% of the public attributed major depression to neurobiological causes, compared with 54% in 1996. High proportions of respondents endorsed treatment, with general increases in the proportion endorsing treatment from doctors and specific increases in the proportions endorsing psychiatrists for treatment of alcohol dependence (from 61% in 1996 to 79% in 2006) and major depression (from 75% in 1996 to 85% in 2006). Social distance and perceived danger associated with people with these disorders did not decrease significantly. Holding a neurobiological conception of these disorders increased the likelihood of support for treatment but was generally unrelated to stigma. Where associated, the effect was to increase, not decrease, community rejection. More of the public embraces a neurobiological understanding of mental illness. This view translates into support for services but not into a decrease in stigma. Reconfiguring stigma reduction strategies may require providers and advocates to shift to an emphasis on competence and inclusion.
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DOI：
10.1111/j.1368-5031.2006.00743.x
发表时间：
2006-03-01
影响因子：
2.6
作者：
Bag, B;Yilmaz, S;Kirpinar, I
通讯作者：
Kirpinar, I
影响因子：
6.7
作者：
Grausgruber, A.;Meise, U.;Fleischhacker, W. W.
通讯作者：
Fleischhacker, W. W.
影响因子：
3.8
作者：
Blumner, Kate H.;Marcus, Steven C.
通讯作者：
Marcus, Steven C.
影响因子：
10.5
作者：
Link, BG;Phelan, JC
通讯作者：
Phelan, JC
影响因子：
6.7
作者：
Jorm, A. F.;Griffiths, K. M.
通讯作者：
Griffiths, K. M.