Stigma Associated with a High-Risk State for Psychosis

项目摘要 我们提出了第一项研究，系统地检查与新的歧视相关的任何潜在影响。 “精神病高危”（“HRP”）的认定，这是最早识别精神病的一个突破性发展。 使人们能够努力预防精神病的精神病症状。对新HRP地位的耻辱感的担忧 已经表达，因为这种指定有可能激活同样严重的社会问题， 已知与“精神病”的鉴定有关的后果。污名化可能是不必要的风险 特别是因为大多数被确定为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名称已在超过6个国家（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，我们汇集了两个成熟的研究团队的专业知识， 在治疗和以下HRP个人和他们的家庭成员与公认的研究人员， 耻辱感和精神病的早期病程。我们提出了一个全面的方法来评估耻辱 HRP组（n= 196）的经验和家庭成员（n= 155）的相关“家庭态度”， 初始HRP鉴定，然后在6个月随访时。我们比较了HRP的污名体验 组与首次发作非情感性精神病组（FEP; n= 100），作为基准， 严重的耻辱。我们检查了HRP指定在基线的耻辱，如何任何耻辱可能会增加， 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、社会和发展变化的影响 HRP组的结果。这项研究有望为干预措施提供大量信息， 最早的阶段，最大限度地提高HRP人员实现发展目标的机会， 成年此外，消除或改善这种耻辱感是至关重要的，因为HRP鉴定是一种有效的方法。 预防和治疗精神分裂症的潜在变革性手段，从而减轻 精神病世界

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.