Reducing the Adverse Impact of Mental Illness Stigma Among Family Caregivers

减少家庭护理人员精神疾病耻辱的不利影响

• 批准号: 7667402
• 负责人: Deborah A. Perlick
• 金额: $ 30.35万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-20 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7667402
• 关键词: Adherence; Adverse effects; Advocate; Affect; American; Caregiver Burden; Caregivers; Caring; Chronic; Clinical; Companions; Competence; Connecticut; Depressed mood; Discrimination; Doctor of Philosophy; Education; Family; Family Caregiver; Family member; Feeling; Focus Groups; Friends; General Population; Health; Healthcare; Hospitals; Institutes; Intervention; Life; Link; Measures; Medical; Mental Health; Mental Health Services; Mental disorders; Modeling; Personal Satisfaction; Persons; Pilot Projects; Randomized; Recovery; Relative (related person); Research; Research Methodology; Research Personnel; Resources; Schizophrenia; Seasons; Services; Sleep Disorders; Social support; Staging; Stigmata; Stigmatization; Structure; Symptoms; Testing; Time; Training; Training Programs; Videotape; Violence; Voice; Withdrawal; Work; base; caregiving; coping; depression; experience; family influence; follow-up; improved; member; novel strategies; peer; post intervention; programs; psychologic; severe mental illness; social; social stigma; sound; therapy development

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.

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遭受精神疾病的污名和歧视，导致自责、无能、退出社会支持以及增加照顾者负担和/或抑郁的感觉。拟议的研究旨在通过评估 NAMI-Connecticut（Trade Zavatsky，项目总监，P.I.）和西奈山研究人员（Deborah Perlick，Ph.D.，P.I.）开发的项目（称为“我们自己的声音家庭伴侣”（IOOV-FC））的可行性、可接受性和初步效果，减少对精神分裂症患者家庭照顾者的耻辱的不利影响。 IOOV-FC 是以国家精神疾病联盟 (NAMI) 开发的 In Our Own Voice (IOOV) 为蓝本，旨在减少针对消费者的耻辱。在第 1,10 年，每个家庭成员、消费者和临床医生将评估 IOOV-FC 预试点版本的可接受性和构建有效性，每个利益相关者的 2 个焦点小组将召开会议，以确定家庭成员与耻辱相关的需求，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，在同行主导的关于从症状出现到康复过程中遇到的精神疾病耻辱的讨论中，改善耻辱应对。 12 名家庭成员将接受 IOOV-FC 实施培训。患有精神分裂症的消费者家庭将被随机分配接受 IOOV-FC (N = 70) 或由专家提供的家庭教育课程 (N = 70)，并将在干预前、干预后立即以及干预后 3 个月和 6 个月评估自我耻辱和社交退缩的措施。主要分析将是混合效应模型，其中时间、治疗组及其相互作用（时间x治疗组）是固定效应，受试者是随机效应；似然比检验将评估每个后续点的组间差异。由于精神疾病耻辱是使用精神卫生服务的障碍，而家庭会影响消费者对服务的使用，因此让家庭更好地应对精神疾病耻辱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基于合理的社会心理学原理并以广泛传播的消费者反耻辱计划为蓝本来改善耻辱应对的新方法。