Reducing the Adverse Impact of Mental Illness Stigma Among Family Caregivers

描述（由申请人提供）：研究表明，照顾患有严重精神疾病的亲属的家庭成员以及消费者都会经历精神疾病的污名化和歧视，导致自责，无能，退出社会支持以及增加照顾者负担和/或抑郁症。拟议的研究旨在通过评估NAMI康涅狄格州开发的一项计划的可行性，可接受性和初步疗效，减少对精神分裂症患者家庭照顾者的耻辱的不良影响（贸易Zavatsky，项目主任，PI）。和西奈山的研究人员（Deborah Perlick，博士，P.I.），在我们自己的声音家庭伴侣（IOOV-FC）。IOOV-FC是模仿我们自己的声音（IOOV），由全国精神疾病联盟（NAMI）开发，以减少针对消费者的耻辱。在第一年，10名家庭成员，消费者和临床医生将评估IOOV-FC预试验版本的可接受性和结构效度，每个利益相关者的2个焦点小组将召开会议，以确定家庭成员的污名相关需求，以开发新版本的IOOV-FC。IOOV-FC旨在通过与其他家庭的接触和社会比较，在同龄人主导的讨论中，从症状出现到康复期间遇到的精神疾病耻辱，改善耻辱应对。12名家庭成员将接受培训，以提供IOOV-FC。患有精神分裂症的消费者的家庭将被随机化以接受IOOV-FC（N = 70）或由专家提供的家庭教育课程（N = 70），并且将在干预前、干预后立即以及干预后3个月和6个月对自我耻辱和社交退缩的测量进行评估。主要分析将采用混合效应模型，其中时间、治疗组及其相互作用（时间×治疗组）为固定效应，受试者为随机效应;似然比检验将评价每个随访时间点的组间差异。由于精神疾病污名化是使用精神卫生服务的障碍，家庭影响消费者对服务的使用，使家庭能够更好地科普精神疾病污名化将有助于消费者及其家庭成员获得精神卫生保健。拟议的研究代表了一种新的方法，以改善耻辱应对的基础上健全的社会心理学原则和广泛传播的反耻辱计划的消费者为蓝本。

DESCRIPTION (provided by applicant): Studies have shown that family members who care for relatives with severe mental illness experience mental illness stigmatization and discrimination, as well as consumers, leading to feelings of self-blame, incompetence, withdrawal from social supports and increased caregiver burden and/or depression. The proposed research aims to reduce the adverse effects of stigma directed towards family caregivers of people with schizophrenia by assessing the feasibility, acceptability and initial efficacy of a program developed by NAMI-Connecticut (Trade Zavatsky, Program Director, P.I.) and researchers at Mount Sinai (Deborah Perlick, Ph.D., P.I.), termed In Our Own Voice-Family Companion (IOOV-FC). IOOV-FC is modeled after In Our Own Voice (IOOV), developed by the National Alliance on Mental Illness (NAMI) to reduce stigma directed towards consumers. During Year 1, 10 each of family members, consumers and clinicians will evaluate the acceptability and construct validity of the prepilot version of IOOV-FC and 2 focus groups of each stakeholder will convene to identify the stigma-related needs of family members to develop a new version of IOOV-FC. IOOV-FC aims to improve stigma coping through contact and social comparison with other families in a peer-led discussion of mental illness stigma encountered from the onset of symptoms to recovery. Twelve family members will be trained to deliver IOOV-FC. Families of consumers with schizophrenia will be randomized to receive either IOOV-FC (N = 70) or a family education course delivered by an expert (N = 70) and will be evaluated pre- intervention, immediately and 3 and 6 months post-intervention on measures of self-stigma and social withdrawal. The major analysis will be a mixed effects model in which time, treatment group, and their interactions (time x treatment group) are fixed effects, and subjects are random effects; likelihood ratio tests will evaluate group differences at each follow-up point. Because mental illness stigma is a barrier to mental health service use, and families influence consumers' use of services, equipping families to better cope with mental illness stigma will facilitate access to mental health care for both consumers and their family members. The proposed research represents a novel approach to improving stigma coping based on sound social psychological principles and modeled after a widely-disseminated anti-stigma program for consumers.