Swipe om te navigeren naar een ander artikel
For people with schizophrenia living in the community and receiving outpatient care, the issues of stigma and discrimination and dearth of recovery-oriented services remain barriers to recovery and community integration. The experience of self-stigma and unmet recovery needs can occur regardless of symptom status or disease process, reducing life satisfaction and disrupting overall well-being. The present study examined the mediating role of self-stigma and unmet needs in the relationship between psychiatric symptom severity and subjective quality of life.
Structural equation modeling and mediation analyses were conducted based on a community sample of 400 mental health consumers with schizophrenia spectrum disorders in Hong Kong.
The model of self-stigma and unmet needs as mediators between symptom severity and subjective quality of life had good fit to the data (GFI = .93, CFI = .93, NNFI = .92, RMSEA = .06, χ2/df ratio = 2.62). A higher level of symptom severity was significantly associated with increased self-stigma (R 2 = .24) and a greater number of unmet needs (R 2 = .53). Self-stigma and unmet needs were in turn negatively related to subjective quality of life (R 2 = .45).
It is essential that service providers and administrators make greater efforts to eliminate or reduce self-stigma and unmet recovery needs, which are associated with the betterment of the overall quality of life and long-term recovery. Both incorporating empowerment and advocacy-based interventions into recovery-oriented services and providing community-based, person-centered services to people based on personally defined needs are important directions for future recovery-oriented efforts.
Log in om toegang te krijgen
Met onderstaand(e) abonnement(en) heeft u direct toegang:
Substance Abuse and Mental Health Services Administration. (2005). National consensus conference on mental health recovery and systems transformation. Rockville, MD: Department of Health and Human Services, United States Government.
New Freedom Commission on Mental Health. (2003). Achieving the promise: Transforming mental health care in America. Final Report. Rockville, MD: Department of Health and Human Services. Publication SMA-03-3832.
World Health Organization. (2008). The global burden of disease: 2004 update. Geneva: World Health Organization.
Mak, W. W. S., Chong, E. S. K., & Wong, C. C. Y. (2014). Beyond attributions—Understanding public stigma of mental illness with the common sense model. American Journal of Orthopsychiatry, 84, 173–181.
Tsang, H. W. H., Tam, P. K. C., Chan, F., & Cheung, W. M. (2003). Stigmatizing attitudes towards individuals with mental illness in Hong Kong: Implications for their recovery. Journal of Community Psychology, 31, 383–396. CrossRef
Corrigan, P. W., & Watson, A. C. (2002). The paradox of self-stigma and mental illness. Clinical Psychology: Science and Practice, 9, 35–53.
Mak, W. W. S., & Cheung, R. Y. M. (2010). Self-stigma among concealable minorities in Hong Kong: Conceptualization and unified measurement. American Journal of Orthopsychiatry, 80, 263–277. CrossRef
Lysaker, P. H., Roe, D., & Yanos, P. T. (2007). Toward understanding the insight paradox: Internalized stigma moderates the association between insight and social functioning, hope, and self-esteem among people with schizophrenia spectrum disorders. Schizophrenia Bulletin, 33, 192–199. PubMedCrossRefPubMedCentral
Gunnmo, P., & Fatouros Bergman, H. (2011). What do individuals with schizophrenia need to increase their well-being. International Journal of Qualitative Studies on Health and Well-Being, 6, 5412. CrossRef
Davidson, L., & Roe, D. (2007). Recovery from versus recovery in serious mental illness: One strategy for lessening the confusion plaguing recovery. Journal of Mental Health, 16, 459–470. CrossRef
Angermeyer, M. C., & Kilian, R. (1997). Theoretical models of quality of life for mental disorders. In N. Sartorius (Ed.), Quality of life in mental disorders (pp. 19–30). Chichester: Wiley.
Lambert, M., Schimmelmann, B. G., Schacht, A., Karow, A., Wagner, T., Wehmeier, P. M., et al. (2009). Long-term patterns of subjective wellbeing in schizophrenia: Cluster, predictors of cluster affiliation, and their relation to recovery criteria in 2842 patients followed over 3 years. Schizophrenia Research, 107, 165–172. PubMedCrossRef
Priebe, S., & Fakhoury, W. (2008). Quality of life. In K. Mueser & D. Jeste (Eds.), The clinical handbook of schizophrenia. New York: Guilford.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders: DSM-IV (4th ed.). Washington, DC: American Psychiatric Association.
Chan, K. K. S., & Mak, W. W. S. (2014). The effects of self-stigma content and process on subjective quality of life in people with schizophrenia. Schizophrenia Research, 153 (Suppl 1), S282–S283.
Mak, W. W. S., Pang, I. H. Y., Chung, N. Y. L., Yau, S. S. W., & Tang, J. P. S. (unpublished manuscript). Effectiveness of wellness recovery action planning (WRAP) for Chinese with mental illness in Hong Kong.
Joreskob, K. G., & Sorbom, D. (1981). LISREL V: Analysis of linear structural relationships by the method of maximum likelihood. Chicago: National Educational Resources.
Bentler, P. M., & Bonnett, D. G. (1980). Significance test and goodness of fit in the analysis of covariance structures. Psychological Bulletin, 88, 588–606. CrossRef
Browne, M. W., & Cudeck, R. (1993). Alternative ways of assessing model fit. In K. A. Bollen & J. S. Long (Eds.), Testing structural equation models (pp. 136–162). Newbury Park, CA: Sage.
Carmines, E. G., & McIver, J. P. (1981). Analyzing models with unobserved variables. In G. M. Bohrnstedt & E. F. Borgatta (Eds.), Social measurement: Current issues (pp. 63–115). Beverly Hills: Sage.
Kline, R. B. (1998). Principles and practice of structural equation modeling. New York: Guilford.
Hoyle, R. H., & Panter, A. T. (1995). Writing about structural equation models. In R. H. Hoyle (Ed.), Structural equation modeling: Concepts, issues, and applications (pp. 158–176). Thousand Oaks, CA: Sage.
Bentler, P. M. (2003). EQS for windows (Version 6.1) [Computer software]. Encino, CA: Multivariate Software.
Davidson, L. (2003). Living outside mental illness: Qualitative studies of recovery in schizophrenia. New York: New York University Press.
Roe, D., & Ben-Yishai, A. (1999). Exploring the relationship between the person and the disorder among individuals hospitalized for psychosis. Psychiatry, 62, 370–380. PubMed
Copeland, M. E. (2002). Wellness Recovery Action Plan: A system for monitoring, reducing and eliminating uncomfortable or dangerous physical symptoms and emotional feelings. Occupational Therapy in Mental Health, 17, 127–150. CrossRef
Holzinger, A., Dietrich, S., Heitmann, S., & Angermeyer, M. C. (2008). Evaluation zielgruppenorientierter Interventionen zur Reduzierung des Stigmas psychischer Krankheit. Eine systematische Ubersicht [Evaluation of target-group oriented interventions aimed at reducing the stigma surrounding mental illness. A systematic review]. Psychiatrische Praxis, 35, 376–386. PubMedCrossRef
Hayes, S. C., Strosahl, K. D., & Wlison, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York: Guilford Press.
Luoma, J. B., Kohlenberg, B. S., Hayes, S. C., Bunting, K., & Rye, A. K. (2008). Reducing self-stigma in substance abuse through acceptance and commitment therapy: Model, manual development, and pilot outcomes. Addiction Research & Theory, 16, 149–165. CrossRef
Davidson, L., Chinman, M. J., Kloos, B., Weingarten, R., Stayner, D. A., & Tebes, J. K. (2005). Peer support among individuals with severe mental illness: A review of the evidence (pp. 412–450). Boston: Boston University Center for Psychiatric Rehabilitation.
- The mediating role of self-stigma and unmet needs on the recovery of people with schizophrenia living in the community
Kevin K. S. Chan
Winnie W. S. Mak
- Springer International Publishing