The Paradox of Self Stigma in Serious Mental Illnes

描述(申请人提供)：许多精神病患者可能会通过自我羞辱来回应污名。自卑(定义为自尊降低和自我效能感减弱，因为相信关于精神疾病的各种刻板印象而导致)已被证明破坏了对经验合理的治疗方案的坚持，并破坏了对康复目标的追求。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刻板印象的反应是自尊和自我效能感降低。然而，其他人则受到刻板印象的鼓舞，并以正义的愤怒回应。第三组人似乎对这种体验完全漠不关心。为了更好地理解自我污名和我们的悖论模型，我们在这项探索性/发展性拨款申请中提出了两项研究。在研究1中，我们开发和评估了严重精神残疾人群的自我污名测量。测试项目反映了自我污名的三个组成部分：意识到刻板印象，将刻板印象应用于自己(刻板印象自我认同)，以及自我认同导致自尊和自我效能降低(自我认同自尊降低)。我们使用Link(1987；et al.，2001)的贬值-歧视测量作为量表来评估刻板印象意识，并增加了相应的条目来评估刻板印象自我认同和自我认同自尊的降低。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更合理的心理测量学测量。在第二阶段，将对70名其他严重精神疾病参与者进行修订后的量表，以及自尊、自我效能、抑郁、社交线索知觉、疾病意识和思维障碍的测量。 在研究2中，将评估知觉合法性和群体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污名的测量。他们还将完成对精神疾病刻板印象的合法性以及对被贴上精神疾病标签的人的群体认同的衡量。正义的愤怒也会被收集起来。这项拟议研究的结果将为设计帮助人们应对自我污名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.