Schizophrenia stigma and mental disability：moderated mediation analysis

doi:10.12114/j.issn.1007-9572.2019.00.749

Abstract

Abstract: Background　Stigma is one of the important factors that cause mental disability in patients with schizophrenia.Previous studies have shown that stigma and hope are significantly correlated with mental disability of resilience，but the interaction mechanism between these factors is not yet clear.Objective　To explore the relationships among appearance comparison on stigma，mental disability，hope and resilience in schizophrenia.Methods　In Harbin BaiYuPao Psychiatric Hospital and the Third Hospital of Daqing，patients with schizophrenia were selected from September to December 2018 by convenient sampling method.WHO-DASⅡ，Internalized Stigma of Mental Illness Scale，Schizophrenia Hope Scale，Connor-Davidson Resilience Scale were used in this survey.Results　A total of 310 questionnaires were sent out and 304 valid questionnaires were returned，with valid response rate of 98.06%.Moderated mediation effect analysis suggested that，stigma positively predicted mental disability（P<0.01）.Both stigma and hope significant predicted mental disability（P<0.01）；and stigma significant predicted hope（P<0.01），hope affect partially mediated the relationship between stigma and mental disability.The product term of hope and resilience significant predicted mental disability（P<0.01），the mediating effect of hope was moderated by resilience.Conclusion　The stigma of schizophrenia not only has a mediated effect through hope but also a moderated effect through resilience on mental disability.

Key words: Schizophrenia, Mentally handicapped, Hope, Resilience, Stigma, Mediating effect, Predictive function

摘要： 背景　病耻感是造成精神分裂症患者精神残疾的重要影响因素之一，既往研究表明病耻感和希望、心理韧性、精神残疾呈显著相关关系，但各因素间相互作用机制尚未明确。目的　探讨病耻感与精神残疾的关系，以及希望与心理韧性的内在作用机制。方法　采用方便取样法，选取2018年9—12月哈尔滨市精神专科白渔泡医院和大庆市第三医院住院的精神分裂症患者。采用世界卫生组织残疾评定量表、精神疾病内在化病耻感量表、心理韧性量表、精神分裂症患者希望量表对患者进行调查。结果　共发放问卷310份，回收有效问卷304份，有效回收率为98.06%。有调节的中介效应分析表明，病耻感可显著正向预测精神残疾（P<0.01）；病耻感和希望对精神残疾的预测作用均显著（P<0.01），病耻感对希望的预测作用亦显著（P<0.01），希望在病耻感对精神残疾的影响中发挥部分中介作用；希望与心理韧性的乘积项对精神残疾的预测作用显著（P<0.01），心理韧性可在希望对精神残疾的预测作用中产生调节效应。结论　精神分裂症患者病耻感通过希望的中介作用和心理韧性的调节作用对精神残疾产生影响。

关键词: 精神分裂症, 精神残疾, 希望, 心理韧性, 病耻感, 中介效应, 预测作用

MAO Yingying,WANG Weiliang,LI Ci, et al. Schizophrenia stigma and mental disability：moderated mediation analysis[J]. Chinese General Practice, 2020, 23(20): 2509-2513. DOI: 10.12114/j.issn.1007-9572.2019.00.749.
毛英莹,王伟梁,李辞等. 精神分裂症患者病耻感与精神残疾的关系：有调节的中介效应分析[J]. 中国全科医学, 2020, 23(20): 2509-2513. DOI: 10.12114/j.issn.1007-9572.2019.00.749.

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