The Paradox of Self Stigma in Serious Mental Illnes

描述（由申请人提供）：许多精神疾病患者可能会通过自我羞辱来回应耻辱。自我污名（定义为由于相信关于精神疾病的各种刻板印象而导致的自尊心降低和自我效能降低）已被证明会破坏对治疗方案的坚持，并破坏对康复目标的追求。然而，个人对污名的反应是一种相当复杂的经历，最好理解为一种悖论。一些精神病患者对精神病的刻板印象的反应是自尊和自我效能的降低。然而，另一些人则被刻板印象所激励，并以正义的愤怒回应。第三类人似乎对这种经历完全漠不关心。我们提出了两项研究，在这个探索性/发展补助金申请，以更好地了解自我污名和我们的悖论模型。在研究1中，我们开发并评估了严重精神残疾患者的自我污名。测试项目反映了自我污名的三个组成部分：刻板印象的意识，刻板印象的应用到一个人的自我（刻板印象自我和谐），并有自我和谐导致自尊和自我效能感下降（自我和谐自尊递减）。我们使用Link's（1987; et al.，2001）的评价-歧视量表作为评价刻板印象意识的量表，并增加了相应的评价刻板印象自我认同和自我认同自尊降低的项目。在开发的初步阶段，50名患有严重精神疾病的研究参与者将完成两次测试;随后的项目分析将产生一个更心理测量的声音测量。在第二阶段，70名其他严重精神疾病的参与者将被管理的修订版的规模沿着措施的自尊，自我效能，抑郁，社会线索感知，疾病意识和思维障碍。 研究二考察了合法性知觉和群体内认同对自我污名的影响。 70名患有严重精神疾病的成年人将接受精神疾病自我羞辱测量。他们还将完成对精神疾病刻板印象的合法性和对被贴上精神病标签的人的群体认同的测量。也会有一种正义的愤怒。拟议研究的结果将为设计帮助人们科普自我羞辱的策略提供必要的第一步。

DESCRIPTION (provided by applicant): Many people with mental illness may personally respond to stigma by self-stigmatizing. Self-stigma (defined as lowered self-esteem and diminished self-efficacy that result from believing the various stereotypes that exist about mental illness) has been shown to undermine adherence to empirically-sound treatment programs as well as derail the pursuit of rehabilitation goals. The personal reaction to stigma is a fairly complex experience however, best understood as a paradox. Some people with mental illness respond to psychiatric stereotypes with diminished self-esteem and self-efficacy. Others, however, are energized by stereotypes and respond with righteous anger. A third group seems to be relatively indifferent to the experience altogether. We propose two studies in this exploratory/developmental grant application to better understand self-stigma and our model of paradox. In STUDY 1, we develop and evaluate a measure of self-stigma in people with serious psychiatric disability. Test items reflect the three components of self-stigma: awareness of the stereotype, application of the stereotype to one's self (stereotype self-concurrence), and having self-concurrence lead to diminished self-esteem and self-efficacy (self-concurrence esteem decrement). We use Link's (1987; et al., 2001) Devaluation-Discrimination Measure as the scale to assess stereotype awareness and add corresponding items that evaluate stereotype self-concurrence and self-concurrence esteem decrement. In a preliminary stage of development, fifty research participants with serious mental illness will complete the test twice; subsequent item analysis will yield a more psychometrically sound measure. In the second stage, a sample of 70 other participants with serious mental illness will be administered the revised version of the scale along with measures of self-esteem, self-efficacy, depression, social cue perception, disease awareness, and thought disorder. In STUDY 2, effects of perceived legitimacy and in-group identification on self-stigma will be assessed. Seventy adults with serious mental illness will be administered the Measure of Self-Stigma in Mental Illness. They will also complete measures of the perceived legitimacy of mental illness stereotypes and in-group identification with people labeled mentally ill. A measure of righteous anger will also be collected. Findings from the proposed research will provide a necessary first step in designing strategies for helping people cope with self-stigma.