Internalized stigma in adults with early phase versus prolonged psychosis
Internalized stigma in adults with early phase versus prolonged psychosis
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DOI：
10.1111/eip.12553
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发表时间：
2019-08-01
影响因子：
2
通讯作者：
Vohs, Jenifer L.
中科院分区：
文献类型：
--
作者：
Firmin, Ruth L.;Lysaker, Paul H.;Vohs, Jenifer L.
目的 尽管内在耻辱与长期精神病患者的负面结果相关，但令人惊讶的是，很少有人关注在疾病过程中耻辱何时内化以及内化对疾病过程中症状或社会功能的影响。因此，本研究调查了（1）精神病后期患者的内在耻辱是否更大，以及（2）与早期精神病相比，长期精神病患者的内在耻辱是否与社会功能或症状有更强的负相关关系。方法 分别在早期干预诊所和退伍军人管理局医疗中心接受门诊服务的早期精神病患者 (n = 40) 和长期精神病患者 (n = 71) 完成了内化耻辱的自我报告测量以及症状和社会功能的面谈评估测量。结果控制教育、种族和性别差异后，与早期精神病相比，长期精神病患者的内在耻辱显着更大。在两组中，内在耻辱与社会功能呈负相关，与症状呈正相关。此外，早期阶段的认知症状与内在耻辱之间的关系显着更大。刻板印象认可、歧视经历和社交退缩也与两个样本的症状和社会功能存在差异相关。结论 研究结果表明，内化耻辱是纳入早期精神病模型的一个重要变量。此外，内化耻辱可能是早期精神病患者的一个可能的治疗目标。
Aim Although internalized stigma is associated with negative outcomes among those with prolonged psychosis, surprisingly little work has focused on when in the course of one's illness stigma is internalized and the impact of internalization on symptoms or social functioning over the course of the illness. Therefore, this study investigated whether (1) internalized stigma is greater among those later in the course of psychosis and (2) whether internalized stigma has a stronger negative relationship with social functioning or symptoms among those with prolonged compared to early phase psychosis. Methods Individuals with early phase (n = 40) and prolonged psychosis (n = 71) who were receiving outpatient services at an early-intervention clinic and a VA medical center, respectively, completed self-report measures of internalized stigma and interview-rated measures of symptoms and social functioning. Results Controlling for education, race and sex differences, internalized stigma was significantly greater among those with prolonged psychosis compared to early phase. Internalized stigma was negatively related to social functioning and positively related to symptoms in both groups. Furthermore, the magnitude of the relationship between cognitive symptoms and internalized stigma was significantly greater among those with early phase. Stereotype endorsement, discrimination experiences and social withdrawal also differentially related to symptoms and social functioning across the 2 samples. Conclusions Findings suggest that internalized stigma is an important variable to incorporate into models of early psychosis. Furthermore, internalized stigma may be a possible treatment target among those with early phase psychosis.