结束自我污名的结果，一种减少内化污名的集体干预，在患有严重精神疾病的个人中,Psychiatric Services

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结束自我污名的结果，一种减少内化污名的集体干预，在患有严重精神疾病的个人中
Psychiatric Services ( IF 3.3 ) Pub Date : 2021-02-01 , DOI: 10.1176/appi.ps.201900296
Amy L Drapalski ₁ , Alicia Lucksted ₁ , Clayton H Brown ₁ , Li Juan Fang ₁

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目标结束自我污名是一项为期九节的小组干预，旨在教患有精神疾病的个人一套工具和策略，以有效处理自我污名及其影响。作者在一组退伍军人中与一个专注于一般健康和健康教育（健康和健康干预）的积极对照组一起检查了结束自我污名的效果。方法患有严重精神疾病的退伍军人 (N=248) 被随机分配到终结自我污名或健康与健康干预组。参与者在基线、治疗后和 6 个月的随访中完成了对症状、内化污名、康复、归属感和心理社会功能其他方面的评估。反复测量，混合效应模型用于检查组×时间交互对结果的影响。结果两组中的个体在治疗后都经历了显着但适度的自我污名减少和心理归属感的增加。结束自我污名和健康与健康干预在治疗后的主要（自我污名）或次要（自我效能、归属感或恢复）结果方面没有显着差异。显着的精神病症状缓和了对自我污名的治疗效果，因此在基线时具有显着精神病症状的个体中，参与结束自我污名的人比健康和健康干预的人的内化污名显着减少。结论直接针对自我污名的干预措施以及可能更间接地解决它的干预措施可能有助于减少内化的污名。经历精神病症状的人可能更有可能从专门针对自我污名的干预措施中受益。

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Outcomes of Ending Self-Stigma, a Group Intervention to Reduce Internalized Stigma, Among Individuals With Serious Mental Illness

OBJECTIVE Ending Self-Stigma is a nine-session group intervention designed to teach individuals experiencing mental illness a set of tools and strategies to effectively deal with self-stigma and its effects. The authors examined the efficacy of Ending Self-Stigma with an active comparison group focused on general health and wellness education (the Health and Wellness intervention) in a cohort of veterans. METHODS Veterans with serious mental illness (N=248) were randomly assigned to either the Ending Self-Stigma or the Health and Wellness intervention. Participants completed assessments of symptoms, internalized stigma, recovery, sense of belonging, and other aspects of psychosocial functioning at baseline, posttreatment, and 6-month follow-up. Repeated-measures, mixed-effects models were used to examine the effects of group × time interactions on outcomes. RESULTS Individuals in both groups experienced significant but modest reductions in self-stigma and increases in psychological sense of belonging after the treatments. The Ending Self-Stigma and Health and Wellness interventions did not significantly differ in primary (self-stigma) or secondary (self-efficacy, sense of belonging, or recovery) outcomes at posttreatment. Significant psychotic symptoms moderated treatment effects on self-stigma, such that among individuals with significant psychotic symptoms at baseline, those who participated in Ending Self-Stigma had a significantly greater reduction in internalized stigma than those in the Health and Wellness intervention. CONCLUSIONS Interventions directly targeting self-stigma and those that may address it more indirectly may be helpful in reducing internalized stigma. Individuals experiencing psychotic symptoms may be more likely to benefit from interventions that specifically target self-stigma.

更新日期：2021-02-01

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