歧视与病耻感量表(DISC)中文版在精神障碍患者中的信度和效度研究

目的:评估歧视与病耻感量表(DISC)在中国精神障碍患者中的信度和效度。方法:引进Thornicroft团队研发的DISC,按初译、回译等步骤形成DISC中文版,以242例精神障碍患者作为受访对象,验证量表的信度和效度。结果:DISC的Cronbach'α系数为0.70,分半信度为0.85,总分重测信度为0.83;DISC分量表1总分与精神疾病内在病耻感调查表(ISMI)歧视经历因子分呈正相关(r=0.417,P0.01),分量表2总分与ISMI社会退缩因子分呈正相关(r=0.332,P0.01);分量表2总分与自尊量表(SES)总分呈正相关(r=0.250,P0.01),分量表3总分与SES总分呈负相关(r=-0.187,P0.01);分量表4总分与社会支持评定量表(SSRS)客观支持分以及对支持的利用度分均呈正相关(r=0.177,0.170,P均0.01)。结论:DISC中文版具有较好的信度和效度,可作为评估精神障碍患者歧视与病耻感的临床工具。     

冗思反应量表中文版在抑郁障碍患者中的运用结果分析

目的 评价冗思反应量表中文版(RRS-C)在抑郁障碍患者中的信、效度.方法 212例抑郁障碍患者完成了RRS-C和流调中心抑郁量表(CES- D),分析RRS-C的Cronbach'sα系数、条目间平均相关系数、总分和各因子的相关系数,并采用验证性因子分析考察其三因子结构.结果 RRS-C总量表的Cronbach's α系数为0.88,三因子的Cronbach's α系数在0.67～0.84;总量表的条目间平均相关系数为0.26,量表总分和各因子间的相关系数在0.71～0.94,各因子条目间平均相关系数在0.29～0.32;验证性因子分析指标(CFI=0.913;GFI=0.905;x2/v＜2;RSMEA=0.072)均符合测量学要求.结论 RRS-C在抑郁障碍患者中有良好的信、效度,可应用于我国抑郁障碍患者冗思特征的测评.     

临床医生精神疾病态度量表中文版在社区精神卫生工作者中的信度、效度研究

目的:探讨临床医生精神疾病态度量表(MICA)中文版在社区精神卫生工作者中的信度、效度与可接受性。方法:应用MICA中文版对广州市8个区(市)80名社区精神卫生工作者进行间隔1周的两次调查、报告和意向行为量表(RIBS)调查,并附加关于生活中对精神疾病患者态度及对MICA理解度的调查。结果:MICA中文版内部一致性信度(Cronbach’α)为0.720,分半信度为0.685,重测信度为0.764(P0.05);表面效度良好;与RIBS总分及附加条目评分呈负相关(r=-0.516,r=-0.310;P均0.01)。主成份分析产生6个因子,共解释方差65.1%。该量表3 min内可完成。结论:MICA中文版是社区精神卫生工作者对精神疾病态度的有效评估工具。     

中文版精神疾病愤怒量表的信度和效度 评价

目的 检验中文版精神疾病愤怒量表（PARS）的信度和效度。方法 经原著者同意,汉 化英文版精神疾病愤怒量表,该量表包括41 个条目,利用该量表于2016 年1—12 月在上海市精神卫生 中心对125 例精神疾病患者进行评估,Cronbach''s α 计算内部一致性信度,Guttman Split-Half 计算分半 信度;计算每个条目与总分的Pearson 相关系数,并应用探索性因子分析检测PARS 的结构效度;应用 Pearson 相关分析探讨PARS 与阳性与阴性症状量表（PANSS）的校标关联效度。结果 中文版RARS 的 Cronbach''s α 系数为0.89,Guttman Split-Half 系数为0.88;各条目与总分之间的相关系数在0.19～0.72 （P＜ 0.05）;探索性因子分析共得出9 个因子,解释总方差的67%;PARS 与PANSS 中G14 条目（愤怒控制 缺乏）存在明显相关（r=0.54,P＜ 0.05）。结论 中文版PARS评估精神疾病愤怒症状具有良好的信度和 效度,可用于我国精神疾病患者愤怒的症状研究。     

中文版统一肝豆状核变性评分量表的信度和效度的研究

目的 研究中文版统一肝豆状核变性评分量表(UWDRS)的信度和效度.方法 采用翻译和回译将UWDRS翻译为中文版本.应用中文版UWDRS评价110例肝豆状核变性(HLD)患者,评价其信度和效度.结果 中文版UWDRS量表总分为31.27(20.656,0～89),神经功能得分为17.53(15.867,0～64),肝脏功能得分为6.46(6.150,0～ 36),精神症状得分为7.27 (6.045,0～ 26).量表整体Cronbach α系数为0.967,神经功能为0.975、肝脏功能为0.493、精神症状为0.798.总量表Spearman-Brown系数为0.811,神经功能为0.941,肝脏功能为0.392,精神症状为0.775.总量表2次测定的重测相关系数为0.968,神经功能为0.970、肝脏功能为0.628、精神症状得分为0.823(均P＜0.001);总量表的两位评定者间相关系数为0.920,神经功能为0.927,肝脏功能为0.584,精神症状得分为0.676(均P＜0.001).结构效度没有只出现3个明确的因子,但有6个因子解释了总变异的50.685％.总量表的平均量表水平内容效度指数(S-CVI/Ave)值为0.99.结论 中文版UWDRS具有良好的信度和效度,但部分内容尚需进一步修订.     

阿尔茨海默病患者照护需求评估量表的编制及信效度检验

目的 编制阿尔茨海默病（AD）患者照护需求评估量表并对其进行信效度检验。方法 基 于文献回顾、临床实践、深度访谈并通过 2 轮专家函询，构建初始量表。采用便利抽样法，选取 2020 年 10 月至 2021 年 3 月在重庆市精神卫生中心记忆门诊确诊的 150 例 AD 患者进行预调查，通过项目分析和 探索性因子分析进行条目筛选，形成正式量表。采用便利抽样法，选取 2021 年 5— 7 月在重庆市精神卫 生中心记忆门诊确诊的 105 例 AD 患者进行正式调查，采用 SPSS 25.0 统计学软件和 AMOS 软件对正式量 表进行信度检验及验证性因子分析。结果 AD 患者照护需求评估量表包括日常生活照料要求、医疗照 护需求、康复训练需求、社会心理需求 4 个维度，共 16 个条目，解释的总方差变异为 76.074%；验证性因 子分析显示，χ2 /df=2.043，RMSEA=0.100，TLI=0.907，CFI=0.924。总量表的 Cronbach''s α 系数为 0.902， 分半信度为 0.633，各维度的 Cronbach''s α 系数为 0.736～0.952，分半信度为 0.739～0.931。结论 AD 患 者照护需求评估量表的信效度良好，可作为评估 AD 患者照护需求的测量工具。     

赌博相关认知量表中文版在大学生中的信效度检验

目的观察赌博相关认知量表中文版（GRCS—C）在大学生人群中的适用性。方法采取整群抽样的方法共抽取1787名大学生进行调查,并以赌博冲动量表（GUS—C）、抑郁-焦虑-压力量表（DASS-21）为效标,检验效标效度,其中96名学生4周后用GRcs—C重测。结果GRCS—C总量表的Cronbach’sa系数为0．934,各分量表的“系数在0．673～0．839;量表分半信度在0．706～0．880,4周后的重测信度在0．728～0．900,23个条目间的平均相关系数为0．398,5个分量表的条目间平均相关系数在0．371～0．553。验证性因素分析显示GRCS—C二阶五因素结构模型拟合最好（x^2/df=12．305,GFI-0．867,NFI-0．867,IFI=0．877,RMSEA=0．080）。赌博相关认知量表（GRCS—C）总分及其分量表和GUS—C总分的相关系数在0．256～0．357,与DASS-21总分及其分量表的相关系数在0．124-0．207（P〈0．01）。在赌博相关认知总分及4个分量表（赌博期待、无力戒毒、控制错觉和解释偏差）得分上男性高于女性,差异有统计学意义（P〈0．01）。结论GRCS--C具有较好的信度和效度,可以在国内大学生群体研究中采用。     

卒中危险因素初筛表的信度及效度研究

目的 检验卒中危险因素初筛表的信度、效度。 方法 对130例测试对象进行卒中危险因素初筛表、改良弗明汉卒中风险评估量表（Framingham Stroke Profile,FSP）进行调查,检验卒中危险因素初筛表的信度及效度。 结果 卒中危险因素初筛表的Cronbach α系数为0.701,分半信度为0.826,重测信度为0.94。因子分 析法提取5个共性因子,公因子的累计方差贡献率为62.199%,量表的结构效度、内容效度、效标效度 达到测量学要求。 结论 卒中危险因素初筛表具有较好的信度与效度,符合量表测量学的要求,可作为我国卒中风险 评估的工具。     

濮阳市精神卫生服务现状与对策研究

目的 对濮阳市2007年精神卫生服务现状做一全面调查,为政府相关部门制定精神卫生工作规划提供依据.方法 采用问卷调查法与小组访谈法.结果 全市有精神卫生专科医院4家,精神科床位292张,精神科医师45人,精神科护士91人,平均分别为0.81张/万人,1.24人/10万人,2.51人/10万人;病床使用率为75.04%;医疗设备简陋,缺乏先进诊疗设备和高层次的人才;4家医院总收入为626万元,平均2.48万元/人;2家医院有少量差额拨款,政府投入严重不足;全市仅有4家综合医院开设精神科.精神卫生专业人员风险大、待遇低;公众精神卫生知识匮乏,一些重要的精神卫生问题未被公众识别,精神疾病患者的就诊率低.结论 建立全市精神卫生工作统一管理协调机构;加大政府财政投入;加强专业人员培养;完善全市精神卫生服务体系和网络建设;加大精神卫生知识宣传力度,消除社会对精神痛患者的偏见与歧视;从政策入手妥善解决重性精神痰病患者的基本医疗问题.     

精神疾病内在病耻感调查表在精神分裂症患者中的信度和效度

目的:评价精神疾病内在病耻感调查表(internalized stigma of mental illness inventory,ISMI)在精神分裂症患者中的信度和效度。方法:选择慢性稳定期精神分裂症患者191例,自行完成ISMI量表及病耻感总体评价,随机抽取42例患者于2周后复测ISMI。使用SPSS软件对量表的信度、效度进行分析。结果:被试者ISMI总分平均为(65.12±12.86)分;复测信度相关性系数为0.87;分半信度系数为0.85;所有29条目Cronbach α系数为0.94。平行效度相关系数为0.66;结构效度采用因子分析法,经方差最大旋转后结果揭示主成分累计贡献率57.80%。结论:ISMI量表对评定精神分裂症患者的病耻感有较好的信度和效度。     

Public Stigma of Mental Illness in the United States: A Systematic Literature Review

Public stigma is a pervasive barrier that prevents many individuals in the U.S. from engaging in mental health care. This systematic literature review aims to: (1) evaluate methods used to study the public’s stigma toward mental disorders, (2) summarize stigma findings focused on the public’s stigmatizing beliefs and actions and attitudes toward mental health treatment for children and adults with mental illness, and (3) draw recommendations for reducing stigma towards individuals with mental disorders and advance research in this area. Public stigma of mental illness in the U.S. was widespread. Findings can inform interventions to reduce the public’s stigma of mental illness.     

Review of mental‐health‐related stigma in Japan

The aim of this study is to understand the nature and characteristics of mental‐health‐related stigma among Japanese people. We searched relevant studies in English or Japanese published since 2001 using MEDLINE and PsycINFO, and found 19 studies that examined mental‐health‐related stigma in Japan. Regarding knowledge about mental illness, reviewed studies showed that in the Japanese general population, few people think that people can recover from mental disorders. Psychosocial factors, including weakness of personality, are often considered the cause of mental illness, rather than biological factors. In addition, the majority of the general public in Japan keep a greater social distance from individuals with mental illness, especially in close personal relationships. Schizophrenia is more stigmatized than depression, and its severity increases the stigmatizing attitude toward mental illness. The literature also showed an association between more direct social contact between health professionals and individuals with mental illness and less stigmatization by these professionals. Less stigmatization by mental health professionals may be associated with accumulation of clinical experience and daily contact with people who have mental illness. Stigmatizing attitudes in Japan are stronger than in Taiwan or Australia, possibly due to institutionalism, lack of national campaigns to tackle stigma, and/or society's valuing of conformity in Japan. Although educational programs appear to be effective in reducing mental‐health‐related stigma, future programs in Japan need to address problems regarding institutionalism and offer direct social contact with people with mental illness.     

An admixture analysis of the age at index episodes in bipolar disorder

Similar to members of the public, people with mental illness may exhibit general negative automatic prejudice against their own group. However, it is unclear whether more specific negative stereotypes are automatically activated among diagnosed individuals and how such automatic stereotyping may be related to self-reported attitudes and emotional reactions. We therefore studied automatically activated reactions toward mental illness among 85 people with schizophrenia, schizoaffective or affective disorders as well as among 50 members of the general public, using a Lexical Decision Task to measure automatic stereotyping. Deliberately endorsed attitudes and emotional reactions were assessed by self-report. Independent of diagnosis, people with mental illness showed less negative automatic stereotyping than did members of the public. Among members of the public, stronger automatic stereotyping was associated with more self-reported shame about a potential mental illness and more anger toward stigmatized individuals. Reduced automatic stereotyping in the diagnosed group suggests that people with mental illness might not entirely internalize societal stigma. Among members of the public, automatic stereotyping predicted negative emotional reactions to people with mental illness. Initiatives to reduce the impact of public stigma and internalized stigma should take automatic stereotyping and related emotional aspects of stigma into account.     

Development and responsiveness of a scale to measure clinicians’ attitudes to people with mental illness (medical student version)

Kassam A, Glozier N, Leese M, Henderson C, Thornicroft G. Development and responsiveness of a scale to measure clinicians’ attitudes to people with mental illness (medical student version). Objective: We report the rationale, reliability, validity and responsiveness studies of the Mental Illness: Clinicians’ Attitudes (MICA) Scale, a 16‐item scale designed to measure attitudes of health care professionals towards people with mental illness. Method: Items were generated through focus groups with service users, carers, medical students and trainee psychiatrists. Psychometric testing was completed in a number of student samples. The responsiveness of the scale was tested after a 1.5 h mental illness stigma related intervention with medical students. Results: The MICA scale showed good internal consistency, α = 0.79. The test–retest reliability (concordance) was 0.80 (95% CI: 0.68–0.91). The standardised response mean for the scale was 0.4 (95% CI 0.02–0.8) after a mental illness related stigma intervention. Conclusion: The MICA scale is a responsive, reliable and valid tool, which can be used in medical education and mental health promotion settings and studies.     

Mental illness stigma: Concepts, consequences, and initiatives to reduce stigma

Persons with mental illness frequently encounter public stigma and may suffer from self-stigma. This review aims to clarify the concept of mental illness stigma and discuss consequences for individuals with mental illness. After a conceptual overview of stigma we discuss two leading concepts of mental illness stigma and consequences of stigma, focussing on self-stigma/empowerment and fear of stigma as a barrier to using health services. Finally, we discuss three main strategies to reduce stigma -- protest, education, and contact -- and give examples of current anti-stigma campaigns. Well-designed anti-stigma initiatives will help to diminish negative consequences of mental illness stigma.     

Implicit and explicit stigma of mental illness: links to clinical care

This study examined implicit and explicit measures of bias toward mental illness among people with different levels of mental health training, and investigated the influence of stigma on clinically-relevant decision-making. Participants (N = 1539) comprised of (1) mental health professionals and clinical graduate students, (2) other health care/social services specialists, (3) undergraduate students, and (4) the general public self-reported their attitudes toward people with mental illness, and completed implicit measures to assess mental illness evaluations that exist outside of awareness or control. In addition, participants predicted patient prognoses and assigned diagnoses after clinical vignettes. Compared with people without mental health training, individuals with mental health training demonstrated more positive implicit and explicit evaluations of people with mental illness. Further, explicit (but not implicit) biases predicted more negative patient prognoses, but implicit (and not explicit) biases predicted over-diagnosis, underscoring the value of using both implicit and explicit measures.     

Association between perceived social stigma against mental disorders and use of health services for psychological distress symptoms in the older adult population: validity of the STIG scale

Objectives: To document the reliability, construct and nomological validity of the perceived Social Stigmatisation (STIG) scale in the older adult population.

Design: Cross-sectional survey.

Setting: Primary medical health services clinics.

Participants: Probabilistic sample of older adults aged 65 years and over waiting for medical services in the general medical sector (n = 1765).

Measurements: Perceived social stigma against people with a mental health problem was measured using the STIG scale composed of seven indicators.

Results: A second-order measurement model of perceived social stigma fitted adequately the observed data. The reliability of the STIG scale was 0.83. According to our results, 39.6% of older adults had a significant level of perceived social stigma against people with a mental health problem. Results showed that the perception of social stigma against mental health problems was not significantly associated with a respondent gender and age. Results also showed that the perception of social stigma against the mental health problems was directly associated with the respondents’ need for improved mental health (b = ?0.10) and indirectly associated with their use of primary medical health services for psychological distress symptoms (b = ?0.07).

Conclusion: Results lead us to conclude that social stigma against mental disorders perceived by older adults may limit help-seeking behaviours and warrants greater public health and public policy attention. Also, results lead us to conclude that physicians should pay greater attention to their patients’ attitudes against mental disorders in order to identify possible hidden mental health problems.     

Experiences of stigma among people with severe mental illness. Reliability, acceptability and construct validity of the Swedish versions of two stigma scales measuring devaluation/discrimination and rejection experiences

Stigma has been identified as one of the most important obstacles for a successful integration of people with mental illness into the society. Research about stigma has shown negative attitudes among the public towards people with mental illness. Studies so far have, however, put little emphasis on how these negative attitudes are perceived by the mentally ill persons. The aim of the present study was to investigate acceptability and internal consistency of the Swedish versions of two stigma scales, the Devaluation and Discrimination scale and the Rejection experiences scale. Forty individuals were subject to an interview, which also comprised assessments of needs for care, quality of life, therapeutic relationship and empowerment. The results showed that both the Devaluation and Discrimination scale and the Rejection experiences scale had a good internal consistency and acceptability. Stigma in terms of perceived devaluation and discrimination was found to be most markedly associated with empowerment and rejection experiences was found to be most associated with the number of previous psychiatric admissions. It is concluded that the Swedish versions of the Devaluation and Discrimination scale and the Rejection experiences scale may well be used in further studies of stigma among people with mental illness.     

Changes in the perception of mental illness stigma in Germany over the last two decades

PurposeTo examine the evolution of the perception of the stigma attached to mental illness in Germany since 1990 up to the present.Subjects and methodsPopulation surveys were conducted in the old German States (former Federal Republic of Germany) in 1990, 2001, and 2011. The perception of stigma attached to people with mental illness was assessed with the help of Link's perceived discrimination and devaluation scale.ResultsIn the 2011 survey, less mental illness stigma was perceived by respondents than in the previous surveys. In the eyes of the German public, the devaluation and rejection of people with mental illness has substantially decreased since 1990.DiscussionThe perception of a decline of the stigmatization is in contrast to the development of the German public's attitudes towards persons with mental disorders, which remained unchanged or even worsened.ConclusionPerceived and personal attitudes towards persons with mental illness have developed differently, and it remains to be seen whether perceptions of less public stigma will ultimately be followed by improved personal attitudes.     

Suicide and stigma: a review of the literature and personal reflections.

OBJECTIVE: The authors aim to educate mental health practitioners and trainees regarding the issues of stigma and suicide and how stigma impacts this diverse population of suicide attempters, completers, their families, friends, therapists, and others both personally and therapeutically. METHODS: The authors draw upon their own experiences as survivors and review pertinent literature illustrating the history and general impacts of this stigmatization. The authors present suggestions to diminish stigma both for survivors and the general public. RESULTS: Although there appears to have been some diminution in the stigmatization of the mentally ill over the past few decades, there appears to be less diminution in the stigma associated with suicide and suicide-survivorship. CONCLUSION: Mental illness, in general, has become less stigmatized in recent years, but suicide remains nearly as stigmatized as ever.