Constructing illness: how the public in eight Western nations respond to a clinical description of "schizophrenia".
Constructing illness: how the public in eight Western nations respond to a clinical description of "schizophrenia".
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DOI：
10.1016/j.socscimed.2011.06.029
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发表时间：
2011-09
影响因子：
5.4
通讯作者：
Pescosolido, Bernice A.
中科院分区：
文献类型：
--
作者：
Olafsdottir, Sigrun;Pescosolido, Bernice A.
根据经典和当代的社会理论，社区对个人如何应对健康问题至关重要。对症状的文化反应为基层诊断提供了基础；为标记个人和社会的健康素养提供了一种标准；并反映了现代医学知识的文化根深蒂固。利用2004至2007年间从全球背景下的耻辱-精神健康研究(SGC-MHS)收集的数据，该研究从符合DSM-IV标准的个人描述的小片段中识别精神分裂症，我们检验了LAY诊断的性质和相关性。聚焦于SGC-MHS中的西方社会，我们提出了三个问题，涉及保加利亚(N=255)、塞浦路斯(N=253)、德国(N=382)、匈牙利(N=352)、冰岛(N=291)、西班牙(N=327)、英国(N=289)和美国(N=449)的问题识别。精神分裂症被认为是一种精神疾病的跨国差异是什么？外行诊断是否与个人的社会人口学特征和/或他们对潜在原因的评估有关？外行诊断是否可能塑造疾病职业生涯的性质和方向？我们发现，在这些西方国家中，“精神疾病”的普遍诊断率很高，不同国家之间存在一些差异，尽管差异不大。更具体的“精神分裂症”诊断的差异更大，尽管在国家排序中相当一致。业外诊断最一致的是归因，不一致的是社会人口学，通常与受访者的治疗建议和预期结果相关。根据对公众信仰和知识的假设，这些假设通常是研究、社区努力、临床计划和卫生政策的基础，这些发现表明，有必要对非专业诊断的复杂性有更好的理解。
According to classic and contemporary social theory, the community is crucial to how individuals respond to the onset of health problems. Cultural response to symptoms provides the foundation for lay diagnosis; offers a gauge for marking individual and societal health literacy; and reflects the cultural embeddedness of modern medical knowledge. Using data collected between 2004 and 2007 from the Stigma in Global Context – Mental Health Study (SGC-MHS) on the recognition of schizophrenia from vignettes describing individuals meeting DSM-IV criteria, we examine the nature and correlates of lay diagnosis. Focusing on Western societies in the SGC-MHS, we ask three questions regarding problem recognition in Bulgaria (N=255), Cyprus (N=253), Germany (N=382), Hungary (N=352), Iceland (N=291), Spain (N=327), Great Britain (N=289), and the United States (N=449). What is the cross-national variation in recognition of schizophrenia as a mental illness? Is lay diagnosis associated with individuals’ socio-demographic characteristics and/or their evaluation of underlying causes? Are lay diagnoses likely to shape the nature and direction of the illness career? We find lay diagnosis of “mental illness” to be high across these Western nations with some, though modest, difference across countries. Variation for the more specific diagnosis of “schizophrenia” is greater, though fairly consistent in country ordering. Lay diagnoses are shaped most consistently by attributions, inconsistently by socio-demographics, and generally associated with respondents’ treatment recommendations and expected outcomes. In light of assumptions about public beliefs and knowledge that often underlie research, community efforts, clinical programs, and health policy, these findings suggest that a greater understanding of the complexities of lay diagnosis is warranted.
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影响因子：
5.4
作者：
CALNAN, M
通讯作者：
CALNAN, M
影响因子：
5.4
作者：
Bendelow, GA;Williams, SJ
通讯作者：
Williams, SJ
影响因子：
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作者：
FREIDSON, E
通讯作者：
FREIDSON, E
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5.4
作者：
DEAN, K
通讯作者：
DEAN, K
影响因子：
5.4
作者：
HAUG, MR;WYKLE, ML;NAMAZI, KH
通讯作者：
NAMAZI, KH