Toward understanding the insight paradox: Internalized stigma moderates the association between insight and social functioning, hope, and self-esteem among people with schizophrenia spectrum disorders
Toward understanding the insight paradox: Internalized stigma moderates the association between insight and social functioning, hope, and self-esteem among people with schizophrenia spectrum disorders
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DOI：
10.1093/schbul/sbl016
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发表时间：
2007-01-01
影响因子：
6.6
通讯作者：
Yanos, Philip T.
中科院分区：
文献类型：
--
作者：
Lysaker, Paul H.;Roe, David;Yanos, Philip T.
研究自相矛盾地将疾病意识与更好的功能结果和更少的希望和自尊联系起来。对这些发现的一种可能解释是，接受患有精神分裂症可能会对结果产生不同的影响，这取决于个人对这种接受的理解，特别是他或她是否接受对精神疾病的污名化信念。为了探索这种可能性，我们对75名精神分裂症谱系障碍患者进行了聚类分析，基于使用正面和负面综合症量表的单一洞察力测量，使用精神疾病内化耻辱量表的内化耻辱，并比较了同时评估希望和自尊的组。聚类分析产生三组：低视力/轻度柱头（n = 23），高洞察力/轻微柱头（n = 25），高洞察力/中度柱头（n = 27）。正如预测的那样，方差比较分析显示，高洞察力/中度耻辱组在贝克绝望量表和多维自尊量表上的希望水平显著最低。正如预测的那样，高洞察力/最小耻辱组的社会功能受损程度也明显低于其他组。讨论了协助人们应对疾病和耻辱意识的影响。
Research has paradoxically linked awareness of illness to both better function outcomes and lesser hope and self-esteem. One possible explanation for these findings is that acceptance of having schizophrenia may impact outcomes differently depending on the meanings the person attaches to this acceptance, particularly whether he or she accepts stigmatizing beliefs about mental illness. To explore this possibility we performed a cluster analysis of 75 persons with schizophrenia spectrum disorders based on single measures of insight using the Positive and Negative Syndrome Scale, internalized stigma using the Internalized Stigma of Mental Illness Scale, and compared groups on concurrent assessments of hope and self-esteem. Three groups were produced by the cluster analyses: low in sight/mild stigma (n = 23), high insight/minimal stigma (n = 25), and high insight/moderate stigma (n = 27). As predicted, analysis of variance-comparing groups revealed that the high insight/moderate stigma group had significantly the lowest levels of hope on the Beck Hopelessness Scale and self-esteem using the Multidimensional Self-esteem Inventory. As predicted, the high insight/minimal stigma group also had significantly less impaired social function than the other groups. Implications for assisting persons to come to cope with awareness of illness and stigma are discussed.