An Integrative Cognitive Model of Internalized Stigma in Psychosis
An Integrative Cognitive Model of Internalized Stigma in Psychosis
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DOI：
10.1017/s1352465817000224
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发表时间：
2017-11-01
影响因子：
1.8
通讯作者：
Morrison, Anthony P.
中科院分区：
文献类型：
--
作者：
Wood, Lisa;Byrne, Rory;Morrison, Anthony P.
背景：内化耻辱对于那些经历过精神病的人来说是一个重大困难，但它从未用认知理论来概念化。目的：本文的目的是概述一个认知模型，该模型概念化了同样经历过精神病的人所经历的内化耻辱。方法：回顾、批判和综合以前的文献来开发模型。它借鉴了先前的内化耻辱的社会认知模型，并整合了认知行为理论和社会心态理论。结果：本文确定了有助于内化耻辱的发展和维持的关键认知、行为和情感过程，同时也认识到文化背景在创造精神病的负面刻板印象中的核心重要性。此外，还确定了减轻内在耻辱的治疗策略。探讨了一个案例，并制定了一个制定和简短的干预计划，以在实践中说明该模型。结论：提出了一种综合认知模型，可用于开发个体化案例表述，从而指导针对精神病患者的内在耻辱的认知行为干预。需要更多的研究来检验此类干预措施的有效性。此外，必须继续研究在社会层面改变耻辱感的干预措施。
Background: Internalized stigma is a significant difficulty for those who experience psychosis, but it has never been conceptualized using cognitive theory. Aims: The aim of this paper is to outline a cognitive model conceptualizing internalized stigma experienced by people who also experience psychosis. Method: Previous literature is reviewed, critiqued and synthesized to develop the model. It draws upon previous social cognitive models of internalized stigma and integrates cognitive behavioural theory and social mentality theory. Results: This paper identifies key cognitive, behavioural and emotional processes that contribute to the development and maintenance of internalized stigma, whilst also recognizing the central importance of cultural context in creating negative stereotypes of psychosis. Moreover, therapeutic strategies to alleviate internalized stigma are identified. A case example is explored and a formulation and brief intervention plan was developed in order to illustrate the model in practice. Conclusion: An integrative cognitive model is presented, which can be used to develop individualized case formulations, which can guide cognitive behavioural interventions targeting internalized stigma in those who experience psychosis. More research is required to examine the efficacy of such interventions. In addition, it is imperative to continue to research interventions that create change in stigma at a societal level.