Stigma of Depression Is More Severe in Chinese Americans than Caucasian Americans
Stigma of Depression Is More Severe in Chinese Americans than Caucasian Americans
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DOI：
10.1521/psyc.2008.71.3.210
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发表时间：
2008-09-01
影响因子：
2.4
通讯作者：
Chen, Hongtu
中科院分区：
文献类型：
--
作者：
Hsu, L. K. George;Wan, Yu Mui;Chen, Hongtu
精神疾病的耻辱是诊断和治疗的主要障碍，亚洲人的情况可能比白种人更糟。本研究比较了50名华裔美国人（CA）和50名白种人美国人（WA）的抑郁耻辱感。受试者被要求按照以下顺序阅读5个病例：糖尿病（1313）、重度抑郁症（MDD）、躯体形式抑郁症（SD）、精神病性抑郁症（PD）和不明原因发热（HA）。每个病例的诊断都没有透露。然后，受试者根据李克特量表（Likert scale）从“非常不同意”到“非常同意”对每种情况的反应进行评分，并对包含6种污名因素的25种陈述进行评分：恐惧、羞耻、认知扭曲、社会共识、歧视和制裁。由每个因素的评分构成的综合分数被用来计算病耻感的严重程度。5例患者的病耻感均较WA加重。两组都认为DB和HA是最不光彩的，而PD是最不光彩的。CA认为SD比MDD更容易被污名化，但WA没有。我们得出结论，耻辱感的形成和严重程度是由恐惧、羞耻、认知扭曲、社会沟通、共识和制裁决定的。精神症状，特别是精神病性症状，比身体症状更令人感到耻辱，尤其是对CA而言。认为抑郁症就像一种身体疾病，并没有减少它的耻辱。
Stigma of mental illness is a major obstacle to its diagnosis and treatment and may be worse among Asians than Caucasians. This study compared the stigma of depression in 50 Chinese Americans (CA) and 50 Caucasian Americans (WA). Subjects were asked to read 5 case vignettes in the following order: diabetes mellitus (1313), major depressive disorder (MDD), somatoform depression (SD), psychotic depression (PD), and fever of unknown origin (HA). Diagnosis of each case was not revealed. Subjects then rated their response to each case, on a Likert scale from "strongly disagree" to "strongly agree," to 25 statements that contained 6 stigma factors: fear, shame, cognitive distortion, social consensus, discrimination, and sanction. Composite scores constructed from ratings of each factor were used to calculate the severity of stigma. Stigma of all 5 cases was worse in CA than WA. Both groups ranked DB and HA to be least and PD to be most stigmatizing. CA rated SD to be less stigmatizing than MDD but not WA. We concluded that stigma formation and severity were determined by fear, shame, cognitive distortion, social communication, consensus, and sanction. Mental symptoms, particularly psychotic symptoms, were more stigmatizing than physical symptoms, especially for CA. Belief that depression was like a physical illness did not diminish its stigma.