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2008 273-290 心理計量特性研究論文精神疾病污名感受量表及其短版之韓德彥陳淑惠研究目的 : 研究方法 : 25 255 34 研究結果

1 心理計量特性研究論文精神疾病污名感受量表及其短版之韓德彥陳淑惠研究目的 : 研究方法 : 研究結果 : 研究結論 : 關鍵詞 : Emory shchen@ntu.edu.tw

2 一前言 (Chung & Wong, 2004; Fabrega, 1991; Lee, Chiu, Tsang, Chui, & Kleinman, 2006) (illness behavior) ( ) (Lin, Inui, Kleinman, & Womack, 1982) Tsai Teng Sue(1981) Sue Sue(1974) MMPI (1996) (Murray & Lopez, 1996; Takeuchi et al., 1998) (bipolar disorder) 0.3% 0.4% 1.5% 1.5% 2.9% 19.0% (Weissman et al., 1996) 274 中華心理衛生學刊第二十一卷三期

3 Goffman(1963) (Ritsher & Phelan, 2004) (1991) (1994) (Corrigan & Lundin, 2001; Link, Cullen, Struening, Shrout, & Dohrenwend, 1989; Ritsher, Otilingam, & Grajales, 2003) 精神疾病污名感受量表及其短版之心理計量特性 275

4 ( 2002) Kleinman (1995) 80 (1) (2) (3) Kleinman Raguram Weiss Channabasavanna Devins(1996) Link Cullen Struening Shrout Dohrenwend(1989) (Modified Labeling Theory) Link 6 2 (Link, Struening, Neese-Todd, Asmussen, & Phelan, 2001) Ritsher (2003) ( Corrigan, Watson, & Barr, 2006; Ritsher & Phelan, 2004; Watson, Corrigan, Larson, & Sells, 2007) Rosenberg Self- Esteem Scale(Rosenberg, 1979) Link (1989; 2001) Ritsher (2003) Watson (2007) Rosenberg Self-Esteem Scale 276 中華心理衛生學刊第二十一卷三期

5 ( 一 ) 受試者二研究方法 255 ( ) ( ) ( ) 34 Rosenberg Self-Esteem Scale ( 二 ) 研究工具 Kleinman (1995) ( ) 25 精神疾病污名感受量表及其短版之心理計量特性 277

6 表一臨床樣本人口學變項分佈情形 % (13 ) (10 12 ) (7 9 ) (6 ) ( ) 中華心理衛生學刊第二十一卷三期

7 (Likert s scale) 1 4 Rosenberg Self-Esteem Scale Rosenberg 4 ( ) (Cronbach s α.83) ( 三 ) 資料分析 SPSS for Windows(10.01) (Chronbach s alpha) ( intra-class correlation) (maximum likelihood) ( 1995) ( 1995) t 三研究結果 ( ) 25 精神疾病污名感受量表及其短版之心理計量特性 279

8 表二精神污名量表項目平均值標準差及項目總分相關中華心理衛生學刊第二十一卷三期

9 Cronbach s α intra-class correlation (eigenvalue) 1.0 (promax) 50.7% 48.4% Kleinman (1995) Cronbach s α (t 3.12, p.01) (t 3.99, p.001) (t 2.26, p.05) 精神疾病污名感受量表及其短版之心理計量特性 281

10 表三精神污名量表之因素結構及因素負荷量中華心理衛生學刊第二十一卷三期

11 Rosenberg Self-Esteem Scale ( 34 ) -.44(p.01) -.49(p.01) -.31(p. 06) -.43(p.05) % Cronbach s α Cronbach s α (t 2.61, p.01) (t 3.84, p.001) Rosenberg Self-Esteem Scale -.38(p.05) -.43(p.05) -.31(p. 07) -.43(p.05) 四討論 Kleinman (1995) ( ) 精神疾病污名感受量表及其短版之心理計量特性 283

12 Kleinman Kleinman (1995) (Corrigan & Lundin, 2001; Link et al., 1989; Ritsher et al., 2003) Goffman(1963) (physical) (conduct) (tribal) (creditable) (discreditable) Page(1984) 284 中華心理衛生學刊第二十一卷三期

13 (Saetermoe, Scattone, & Kim, 2001) (perceive) ( 2002) (Link et al., 1989) ( ) ( ) ( 精神疾病污名感受量表及其短版之心理計量特性 285

14 2004) (Perlick et al., 2001; Ritsher & Phelan, 2004; Sirey et al., 2001) 誌謝 [89-H-FA (89-5-2)] 參考文獻 (1985) (1985) (1995) (1996) 286 中華心理衛生學刊第二十一卷三期

15 (2004) (2002) (1983) (1997) (1994) (1991) Corrigan, P. W., & Lundin, R. K. (2001). Don t call me nuts: Coping with the stigma of mental illness. Tinley Park, IL: Recovery Press. Corrigan, P. W., Watson, A. C., & Barr, L. (2006). The self-stigma of mental illness: Implications for self-esteem and self-efficacy. Journal of Social & Clinical Psychology, 25, Chung, K. F., & Wong, M. C. (2004). Experience of stigma among Chinese mental health patients in Hong Kong. Psychiatric Bulletin, 28, Fabrega, H. (1991). Psychiatric Stigma in Non-Western Societies. Comprehensive Psychiatry, 32, Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. Englewood Cliffs, NJ: Prentice-Hall. Kleinman, A., Wang, W. Z., Li, S. C., Cheng, X. M., Dai, X. Y., Li, K. T., & Kleinman, J. (1995). The social course of epilepsy: chronic illness as social experience in interior China. Social Science and Medicine, 40, Lee, S., Chiu, M. Y. L., Tsang, A., Chui, H., & Kleinman, A. (2006). Stigmatizing experi- 精神疾病污名感受量表及其短版之心理計量特性 287

16 ence and structural discrimination associated with the treatment of schizophrenia in Hong Kong. Social Science and Medicine, 62, Lin, K. M., Inui, T. S., Kleinman A. M., & Womack, W. M. (1982). Sociocultural determinants of the help-seeking behavior of patients with mental illness. Journal of Nervous and Mental Disease, 170, Link, B. G., Cullen, F. T., Struening, E., Shrout, P. E., & Dohrenwend, B. P. (1989). A modified labeling theory approach to mental disorders: an empirical assessment. American Sociology Review, 54, Link, B. G., Struening, E. L., Neese-Todd, S., Asmussen, S., & Phelan, J. C. (2001). The consequences of stigma for the self-esteem of people with mental illnesses. Psychiatry Services, 52, Murray, C. J., & Lopez, A. D. (1996). The Global Burden of Disease. Cambridge, MA: Harvard University Press. Page, R. (1984). Stigma. London: Routledge & Kegan Paul plc. Perlick, D. A., Rosenheck, R. A., Clarkin, J. F., Sirey, J. A., Salahi, J., Struening, E. L., & Link B. G. (2001). Stigma as a barrier to recovery: Adverse effects of perceived stigma on social adaptation of persons diagnosed with bipolar affective disorder. Psychiatric Services, 52, Raguram, R., Weiss, M. G., Channabasavanna, S. M., & Devins, G. M. (1996). Stigma, depression, and somatization in South India. American Journal of Psychiatry, 153, Ritsher, J. B., Otilingam, P. G., & Grajales, M. (2003). Internalized stigma of mental illness: Psychometric properties of a new measure. Psychiatry Research, 121, Ritsher, J. B., & Phelan, J. C. (2004). Internalized stigma predicts erosion of morale among psychiatric outpatients. Psychiatry Research, 129, Rosenberg, M. (1979). Conceiving the Self. New York: Basic Books. Saetermoe, C. L., Scattone, D. S., & Kim K. H. (2001). Ethnicity and the stigma of disabili- 288 中華心理衛生學刊第二十一卷三期

17 ties. Psychology and Health, 16, Sirey, J. A., Bruce, M. L., Alexopoulos, G. S., Perlick, D. A., Raue, P., Friedman, S. J., & Meyers, B. S. (2001). Perceived stigma as a predictor of treatment discontinuation in young and older outpatients with depression. American Journal of Psychiatry, 158, Sue, S., & Sue, D. W. (1974). MMPI comparisons between Asian-Amerian and non-asian students utilizing a student health psychiatric clinic. Journal of Counseling Psychology, 21, Takeuchi, D T., Chung, R. C-Y., Lin, K-M., Shen, H., Kurasaki, K., Chun, C-A., & Sue, S. (1998). Lifetime and twelve-month prevalence rates of major depressive episodes and dysthymia among Chinese Americans in Los Angeles. American Journal of Psychiatry, 155, Tsai, M., Teng, L. N., & Sue, S. (1981). The mental health of the Chinese-Americans. In A. Kleinman & T. Y. Lin (Eds.), Normal and abnormal behaviour in Chinese culture (pp ). London: D. Reidel. Watson, A. C., Corrigan, P., Larson, J. E., & Sells, M. (2007). Self-stigma in people with mental illness. Schizophrenia Bulletin, Jan 25, Epub ahead of print. Weissman, M. M., Bland, R. C., Canino, G. J., Faravelli, C., Greenwald, S., Hwu, H-G., Joyce, P. R., Karam, E. G., Lee, C-K., Lellouch, J., Lepine, J-P., Newman, S. C., Rubio- Stipec, M., Wells, E., Wickramaratne, P. J., Wittchen, H-U., & Yeh, E-K. (1996). Crossnational epidemiology of major depression and bipolar disorder. Journal of American Medical Association, 276, 精神疾病污名感受量表及其短版之心理計量特性 289

18 Psychometric Properties of the Perceived Psychiatric Stigma Scale and Its Short Version Der-Yan Han, Sue-Huei Chen Purpose: The psychiatric stigma greatly affects symptom manifestation and illness behaviors of Chinese patients. However, there is still lacking a self-report scale that may be helpful for empirical research. Methods: Through literature review and case interviews, the present study aimed to embrace the Chinese characteristics into assessment tool and developed a 25-item Perceived Psychiatric Stigma Scale. Data of 255 psychiatric outpatients and 34 inpatients were used to establish reliability and validity of the scale. Results: The Cronbach s α was.94 and test-retest reliability with 1-week interval was.90. Moreover, factor analysis yielded three factors, i.e., fear of social ostracism, concerns over marital preclusion, and self-deprecation. The averaged scale score was higher in the outpatients with severe psychiatric illnesses than those with mild psychiatric illnesses, and the perceived stigma of inpatients could predict low self-esteem assessed 1 week later. The 12-item short version of the scale formed based on factor loadings was also noted to have satisfactory reliability and validity. Conclusions: To sum up, this scale and its short version are applicable to assess the perceived psychiatric stigma in Chinese societies for both clinical service and psychopathological research. Key words: perceived psychiatric stigma scale, mental disease, illness behavior, stigma Der-Yan Han: Ph.D. Candidate, Department of Psychology, National Taiwan University. Clinical Psychologist, Department of Psychiatry, Taoyuan Veterans Hospital. Sue-Huei Chen: Associate Professor, Department of Psychology, National Taiwan University. (Corresponding Author; shchen@ntu.edu.tw) 290 中華心理衛生學刊第二十一卷三期

. 運用社交技巧訓練於一位重鬱症役男之護理經驗. 壹前言憂鬱症是本世紀四大重要疾病之一, 其後遺症會造成調適能力人際關係職業能力社會角色和認知行為下降, 增加社會

. 運用社交技巧訓練於一位重鬱症役男之護理經驗. 壹前言憂鬱症是本世紀四大重要疾病之一, 其後遺症會造成調適能力人際關係職業能力社會角色和認知行為下降, 增加社會 . 弘光學報 54 期. 運用社交技巧訓練於一位重鬱症役男之護理經驗蔡佩玲光田綜合醫院收到日期 :97.1.17 修訂日期 :97.5.5 接受日期 :97.5.15 摘要憂鬱症發生的頻率在年輕族群中逐漸增加, 而在台灣服役, 不同於歐美國家的募兵制,

一 前 言 (Chung & Wong, 2004; Fabrega, 1991; Lee, Chiu, Tsang, Chui, & Kleinman, 2006) (illness behavior) ( ) (Lin, Inui, Kleinman, & W

一前言 (Chung & Wong, 2004; Fabrega, 1991; Lee, Chiu, Tsang, Chui, & Kleinman, 2006) (illness behavior) ( ) (Lin, Inui, Kleinman, & W