Stigma Associated with a High-Risk State for Psychosis

项目总结 我们建议进行第一项研究，系统地研究与新的 “精神病高危”(“HRP”)的称谓，这是最早发现精神错乱的突破性进展。 使预防精神病的努力成为可能的精神症状。对新的HRP地位的耻辱的关注 因为这一称谓有可能激活同样严重的社会 已知的与“精神错乱”相关的后果。耻辱可能是一个不必要的风险 特别是因为大多数被确认为HRP的人即使在没有干预的情况下也不会继续 发展成精神病。此外，HRP的名称正在6个以上的国家(包括美国)使用和 目前正在讨论是否在2013年将其正式纳入DSM 5。因为没有证据表明 HRP的耻辱，我们汇集了来自两个有经验的成熟研究团队的专业知识 与公认的研究人员一起治疗和跟踪HRP个人及其家庭成员 耻辱和精神病的早期病程。我们提出了一种评估污名的综合方法。 HRP小组(n=196)的经历和家庭成员(n=155)相关的“家庭态度” 最初的HRP鉴定，然后在6个月的随访。我们比较了HRP的耻辱经历 以首发非情感性精神病(FEP；n=100)为基准的组 严重的耻辱。我们在基线上检查HRP指定的耻辱，任何耻辱可能会增加或 随着时间的推移而减少，以及这种耻辱与FEP组相比如何。我们进一步评估纵向 HRP污名和家庭态度对心理、社会和发育变化的影响 HRP组的结果。这项研究承诺将极大地为干预措施提供信息，以对抗其 人力资源规划人员实现发展目标的最早阶段和最大机会 成人期。此外，消除或改善这种对污名的担忧是至关重要的，因为hrp鉴定是一种 预防和治疗精神分裂症的潜在变革性手段，从而减轻 全世界的精神病患者。

PROJECT SUMMARY We propose the first study to systematically examine any potential effects of stigma associated with the new 'high risk for psychosis' ('HRP') designation, a groundbreaking development in the earliest identification of psychotic signs that enables efforts to prevent psychosis. Concerns of stigma towards the new HRP status have been expressed because this designation has the potential to activate the same severe social ramifications known to be associated with an identification of 'psychosis'. Stigma may be an unnecessary risk especially because the majority of those identified as HRP even in the absence of intervention do not go on to develop psychosis. Further, the HRP designation is being used in over 6 countries (including the U.S.) and there is current debate to include it officially within the DSM 5 in 2013. Because no evidence exists regarding stigma of the HRP, we bring together expertise from two well-established research teams that have experience in treating and following HRP individuals and their family members with that of recognized researchers in stigma and the early course of psychosis. We propose a comprehensive approach to assessing stigma experiences among a HRP group (n= 196) and associated 'family attitudes' among family members (n= 155) at initial HRP identification and then at 6 months follow-up. We compare the stigma experiences of the HRP group with that of a first episode non-affective psychosis group (FEP; n= 100) who act as a benchmark for severe stigma. We examine stigma of the HRP designation at baseline, how any stigma may increase or decrease over time, and how this stigma compares with that of an FEP group. We further assess longitudinal impacts of HRP stigma and 'family attitudes' upon changes in psychological, social, and developmental outcomes in the HRP group. This research promises to greatly inform interventions to counter stigma at its earliest stages and maximize opportunities for people at HRP to attain developmental goals leading to adulthood. Further, removing or ameliorating this concern of stigma is crucial, as HRP identification is a potentially transformative means of preventing and treating schizophrenia, thus reducing burden for psychosis worldwide.