Stigma Associated with a High-Risk State for Psychosis

与精神病高风险状态相关的耻辱

• 批准号: 8644936
• 负责人: LAWRENCE H YANG
• 金额: $ 49.09万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-05-22 至 2017-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8644936
• 关键词: Achievement; Address; Adolescent and Young Adult; Adult; Affect; Attitude; Behavior; Benchmarking; Clinical Research; Costs and Benefits; Country; Data; Development; Diagnosis; Diagnostic and Statistical Manual of Mental Disorders; Early Diagnosis; Early identification; Family; Family member; Goals; Hospitalization; Individual; Intervention; Investigation; Life; Measures; Outcome; Perception; Phase; Policies; Psychotic Disorders; Recovery; Relative (related person); Research; Research Personnel; Risk; Schizoaffective Disorders; Schizophrenia; Schools; Severities; Social Functioning; Social Network; Source; Staging; Symptoms; Time; comparison group; experience; follow-up; high risk; peer; prevent; psychologic; psychological outcomes; response; social; social stigma; treatment adherence

PROJECT SUMMARY We propose the first study to systematically examine any potential effects of stigma associated with the new 'high risk for psychosis' ('HRP') designation, a groundbreaking development in the earliest identification of psychotic signs that enables efforts to prevent psychosis. Concerns of stigma towards the new HRP status have been expressed because this designation has the potential to activate the same severe social ramifications known to be associated with an identification of 'psychosis'. Stigma may be an unnecessary risk especially because the majority of those identified as HRP even in the absence of intervention do not go on to develop psychosis. Further, the HRP designation is being used in over 6 countries (including the U.S.) and there is current debate to include it officially within the DSM 5 in 2013. Because no evidence exists regarding stigma of the HRP, we bring together expertise from two well-established research teams that have experience in treating and following HRP individuals and their family members with that of recognized researchers in stigma and the early course of psychosis. We propose a comprehensive approach to assessing stigma experiences among a HRP group (n= 196) and associated 'family attitudes' among family members (n= 155) at initial HRP identification and then at 6 months follow-up. We compare the stigma experiences of the HRP group with that of a first episode non-affective psychosis group (FEP; n= 100) who act as a benchmark for severe stigma. We examine stigma of the HRP designation at baseline, how any stigma may increase or decrease over time, and how this stigma compares with that of an FEP group. We further assess longitudinal impacts of HRP stigma and 'family attitudes' upon changes in psychological, social, and developmental outcomes in the HRP group. This research promises to greatly inform interventions to counter stigma at its earliest stages and maximize opportunities for people at HRP to attain developmental goals leading to adulthood. Further, removing or ameliorating this concern of stigma is crucial, as HRP identification is a potentially transformative means of preventing and treating schizophrenia, thus reducing burden for psychosis worldwide.

项目概要 我们提出第一项研究来系统地检查与新的耻辱相关的任何潜在影响 “精神病高风险”（“HRP”）称号，这是最早识别精神病的突破性发展 精神病症状有助于预防精神病。对新 HRP 地位的耻辱担忧 已被表达，因为这一指定有可能激活同样严重的社会 已知与“精神病”鉴定相关的后果。耻辱可能是不必要的风险 特别是因为大多数被确定为 HRP 的人即使在没有干预的情况下也不会继续 发展精神病。此外，HRP 名称正在超过 6 个国家/地区（包括美国）使用，并且 目前存在关于 2013 年将其正式纳入 DSM 5 的争论。因为没有证据表明 HRP 的耻辱，我们汇集了两个经验丰富的知名研究团队的专业知识 与公认的研究人员一起治疗和跟踪 HRP 个人及其家庭成员 耻辱和精神病的早期病程。我们提出了一种评估耻辱感的综合方法 HRP 小组 (n= 196) 的经历以及家庭成员 (n= 155) 的相关“家庭态度” 最初的 HRP 鉴定，然后是 6 个月的随访。我们比较 HRP 的耻辱经历 组与首发非情感性精神病组（FEP；n=100）作为基准 严重的耻辱。我们在基线时检查 HRP 指定的耻辱，任何耻辱可能如何增加或 随着时间的推移而减少，以及这种耻辱与 FEP 群体相比如何。我们进一步评估纵向 HRP 耻辱和“家庭态度”对心理、社会和发展变化的影响 HRP 组的结果。这项研究有望为消除其耻辱感的干预措施提供重要信息 尽早为 HRP 人员提供最大机会，以实现发展目标，从而 成年期。此外，消除或改善这种耻辱感至关重要，因为 HRP 鉴定是 预防和治疗精神分裂症的潜在变革性手段，从而减轻精神分裂症的负担 全世界的精神病。