成见会留下印记吗？认知成见的负面影响与自尊对精神分裂症患者长期社会功能的正面影响之间的相互作用

IF 3.6 2区医学 Q1 PSYCHIATRY

Schizophrenia Research Pub Date : 2024-10-31 DOI:10.1016/j.schres.2024.10.011

Mariam P. Ali , Natalia Tiles-Sar , Claudia J.P. Simons , Dominika A. Osicka , GROUP Investigators , Tesfa Dejenie Habtewold , Lisette Van der Meer , Richard Bruggeman , Behrooz Z. Alizadeh

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引用次数: 0

摘要

背景精神分裂症患者通常社会功能低下（SF），这是受污名化的影响，并与自卑有关。在这种情况下，自尊的复杂作用仍未得到充分探讨。本研究深入探讨了感知到的耻辱感对社会功能的短期和长期影响，调查了自尊和自尊的瞬间波动的中介或调节作用。在 T1 阶段，通过自我报告问卷对感知到的耻辱感和自尊进行了测量。T2 阶段的自尊采用经验抽样法进行测量。SF 在两个时间点都进行了测量。结果在短期（β = -4.66，SE = 1.24，p < 0.001）和长期（β = -3.77，SE = 0.51，p < 0.001），感知到的成见与 SF 显著相关。当我们分析具有自尊的样本（N = 157）时，成见仍与 SF 相关（β = -2.78，SE = 1.36，p = 0.043），但当自尊受到控制时，成见与 SF 的相关性就不存在了（β = -2.13，SE = 1.34，p <0.100）。在 T1 中，自尊对成见与 SF 的关系有明显的中介作用，而在 T2 中，自尊仅对 SF 有明显的预测作用（β = 2.17，SE = 0.70，p = 0.002）。自尊的波动没有显示出中介/调节作用。此外，自尊可作为一种缓冲，减轻感知到的成见的负面影响。旨在通过反污名化措施减少污名化和增强自尊的早期干预对于改善自理能力至关重要。

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Does stigma leave its mark? The interplay between negative effects of perceived stigma with positive effect of self-esteem on long-term social functioning in schizophrenia

Background

Individuals with schizophrenia commonly experience poor social functioning (SF), influenced by stigmatization and linked to low self-esteem. The intricate role of self-esteem in this context remains insufficiently explored. This study delves into the short and long-term impact of perceived stigma on SF, investigating the mediating or moderating effects of self-esteem and momentary fluctuations in self-esteem.

Methods

Data were derived from a longitudinal cohort of individuals with schizophrenia and related disorders from the 2nd (T₁) and 3rd (T₂) waves. Perceived stigma and self-esteem were measured at T₁ with self-report questionnaires. Self-esteem at T₂ was measured with the experience sampling method. SF was measured at both time points. Multiple regression was applied to analyse the effect of perceived stigma and the role of (fluctuations in) self-esteem on SF.

Results

Perceived stigma significantly correlated with SF in the short-term (β = −4.66, SE = 1.24, p < 0.001) and long-term (β = −3.77, SE = 0.51, p < 0.001). Once we analysed samples with self-esteem (N = 157), stigma was still associated with SF (β = −2.78, SE = 1.36, p = 0.043), but not when self-esteem was controlled for (β = −2.13, SE = 1.34, p < 0.100). Self-esteem significantly mediated stigma-SF relationship in T₁ whereas in T₂ it only significantly predicted SF (β = 2.17, SE = 0.70, p = 0.002). Fluctuations in self-esteem did not show mediating/moderating effects.

Conclusion

Perceived stigma significantly predicts poor SF both concurrently and, to some extent, over the long term. Moreover, self-esteem may serve as a buffer that mitigates the negative impact of perceived stigma. Early interventions aimed at reducing stigma and enhancing self-esteem through anti-stigma initiatives are essential for improving SF.

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来源期刊

Schizophrenia Research 医学-精神病学

CiteScore

7.50

自引率

8.90%

发文量

429

审稿时长

10.2 weeks

期刊介绍： As official journal of the Schizophrenia International Research Society (SIRS) Schizophrenia Research is THE journal of choice for international researchers and clinicians to share their work with the global schizophrenia research community. More than 6000 institutes have online or print (or both) access to this journal - the largest specialist journal in the field, with the largest readership! Schizophrenia Research''s time to first decision is as fast as 6 weeks and its publishing speed is as fast as 4 weeks until online publication (corrected proof/Article in Press) after acceptance and 14 weeks from acceptance until publication in a printed issue. The journal publishes novel papers that really contribute to understanding the biology and treatment of schizophrenic disorders; Schizophrenia Research brings together biological, clinical and psychological research in order to stimulate the synthesis of findings from all disciplines involved in improving patient outcomes in schizophrenia.