本文選題：中國公眾 + 心理疾病觀��； 參考：《華中師范大學(xué)》2015年博士論文

【摘要】：世界范圍內(nèi)心理疾病的高流行率是一個(gè)重要的全球性公共衛(wèi)生問題。公眾關(guān)于心理疾病知識(shí)的缺乏,觀念的誤區(qū)以及污名態(tài)度,不僅極大地阻礙了心理疾病患者的專業(yè)求助,也直接影響了心理疾病患者的生存環(huán)境和疾病康復(fù),甚至阻礙了國家和社會(huì)心理健康服務(wù)事業(yè)的發(fā)展。因此,加強(qiáng)公眾心理疾病觀研究,尋找減少公眾對(duì)心理疾病及其患者污名的有效途徑,成為心理健康服務(wù)領(lǐng)域重要的研究主題。目前心理疾病觀的許多研究都來自西方文化背景。首先,研究問題過于零散,未能深入地分析公眾對(duì)心理疾病和心理疾病患者的觀念二者的結(jié)構(gòu)關(guān)系。其次,公眾的觀念必然受社會(huì)文化的影響,這導(dǎo)致西方以個(gè)人主義文化為特征的社會(huì)背景下的心理疾病觀,可能不適宜于以集體主義文化為特征的中國社會(huì)。基于以上兩點(diǎn),本研究提出了心理疾病觀的層級(jí)結(jié)構(gòu)系統(tǒng)假設(shè)：心理疾病觀包含知識(shí)性內(nèi)容、評(píng)價(jià)性內(nèi)容和對(duì)患者態(tài)度三個(gè)部分,三個(gè)部分是一個(gè)存在層級(jí)結(jié)構(gòu)的系統(tǒng)。在此基礎(chǔ)上,本研究的主要研究目的是描述中國公眾心理疾病觀的內(nèi)容以及內(nèi)部各成分之間的關(guān)系,探尋并驗(yàn)證影響中國公眾對(duì)心理疾病患者態(tài)度的核心維度。研究一采用訪談和開放式問卷的質(zhì)性研究方法,探索公眾心理疾病觀在知識(shí)性內(nèi)容、評(píng)價(jià)性內(nèi)容和對(duì)患者態(tài)度三個(gè)部分上的具體內(nèi)容。共有183名超過18周歲來自不同地域、不同職業(yè)、不同年齡的被試參與了調(diào)查。主要研究發(fā)現(xiàn)如下,在公眾眼里心理疾病與身體疾病不同,其癥狀可以自愈；“心理”問題與“精神”問題是存在本質(zhì)差異的不同類別；對(duì)心理疾病的表征以傳統(tǒng)的“精神病”為原型；心理疾病比身體疾病更可怕,因?yàn)樾睦砑膊”灰暈殡y以掌控的極端異常,會(huì)導(dǎo)致患者不可恢復(fù)的徹底損傷和被社會(huì)拋棄的悲慘命運(yùn)；對(duì)心理疾病患者的態(tài)度表現(xiàn)出包含不同程度的消極的社會(huì)拒絕和積極的社會(huì)接納的多種成分并存的狀況。研究二采用自編的《中國公眾心理疾病觀問卷》探索并驗(yàn)證心理疾病觀知識(shí)性內(nèi)容、評(píng)價(jià)性內(nèi)容和患者態(tài)度三部分各自的維度結(jié)構(gòu)。共有來自全國27個(gè)省市、不同年齡、職業(yè)和社會(huì)階層的1375名被試參與了問卷調(diào)查。結(jié)果發(fā)現(xiàn)：(1)知識(shí)性內(nèi)容中,對(duì)心理疾病患者表現(xiàn)的認(rèn)識(shí)包含社會(huì)破壞行為、言語表現(xiàn)異常、人際關(guān)系異常、外表神情異常、思想觀念異常、情緒異常、思維特點(diǎn)異常,共七個(gè)維度；關(guān)于心理疾病的原因認(rèn)識(shí)包含社會(huì)風(fēng)氣及環(huán)境、挫折打擊及生活壓力、情緒因素、家庭環(huán)境、人際交往、大腦及身體缺陷,共六個(gè)維度；關(guān)于心理疾病后果的認(rèn)識(shí)包括家庭負(fù)擔(dān)及影響、社會(huì)隔離、自我傷害、事業(yè)及生活受挫、情緒痛苦、失去生命安全及意義、危害社會(huì),共七個(gè)維度；關(guān)于心理疾病處理方法的認(rèn)識(shí)包括親友幫助、醫(yī)學(xué)治療、心理治療、社會(huì)幫助、自身活動(dòng)調(diào)節(jié)、自身心理調(diào)節(jié)、自身情緒調(diào)節(jié)、社會(huì)管制,共八個(gè)維度。(2)中國公眾對(duì)心理疾病的評(píng)價(jià)包含整體糟糕、社會(huì)危害嚴(yán)重、行為怪異難預(yù)測、原因難理解、難治療、個(gè)體影響嚴(yán)重、原因復(fù)雜和原因個(gè)人可控,共八個(gè)維度。(3)公眾對(duì)心理疾病患者的情緒感受包含尷尬無奈、壓抑惱火、同情惋惜、緊張害怕,共四個(gè)維度；對(duì)心理疾病患者的行為傾向包含拒絕回避、歧視嘲笑和理解幫助,共三個(gè)維度。研究三采用回歸分析檢驗(yàn)心理疾病觀知識(shí)性內(nèi)容、評(píng)價(jià)性內(nèi)容和患者態(tài)度三個(gè)成分之間的關(guān)系。研究工具為自編的《中國公眾心理疾病觀問卷》,研究對(duì)象為18周歲以上成年人,共有來自23個(gè)省、4個(gè)直轄市的695人參與了問卷調(diào)查。研究發(fā)現(xiàn),三成分各維度之間存在不同程度的相關(guān)。其中知識(shí)性內(nèi)容中關(guān)于心理疾病原因的認(rèn)識(shí)對(duì)評(píng)價(jià)性內(nèi)容的影響較少,而關(guān)于疾病后果和處理方法的認(rèn)識(shí)對(duì)評(píng)價(jià)性內(nèi)容的影響更大。心理疾病的整體糟糕性評(píng)價(jià)主要針對(duì)的是疾病對(duì)患者自身的影響；而社會(huì)危害性評(píng)價(jià)主要針對(duì)的是癥狀表現(xiàn)異常程度高的嚴(yán)重的“精神病”。認(rèn)為心理疾病癥狀表現(xiàn)異常程度高、社會(huì)危害嚴(yán)重、需要社會(huì)管制和醫(yī)學(xué)治療的觀念可以正向預(yù)測對(duì)患者的消極態(tài)度；認(rèn)為心理疾病異常程度低、以情緒因素為主要原因、需要心理治療、自身調(diào)節(jié)和社會(huì)幫助的觀念可以正向預(yù)測對(duì)患者的積極情緒。研究四采用多維尺度分析法探索影響公眾對(duì)心理疾病評(píng)價(jià)的核心維度。根據(jù)疾病診斷標(biāo)準(zhǔn)編寫20種常見心理疾病的案例情景描述材料,將心理疾病評(píng)價(jià)的9個(gè)指標(biāo)設(shè)計(jì)為9個(gè)評(píng)估問題,被試對(duì)每個(gè)案例的9個(gè)問題進(jìn)行評(píng)估。總共有156個(gè)被試,平均年齡35.14歲(SD=12.78)分析結(jié)果發(fā)現(xiàn),心理疾病評(píng)價(jià)的核心維度是心理疾病的嚴(yán)重性和原因個(gè)人可控性,其中嚴(yán)重性包含患者行為不可預(yù)測性、患者對(duì)社會(huì)危害的嚴(yán)重性、疾病對(duì)個(gè)體影響的嚴(yán)重性和疾病難處理的程度及整體糟糕性。研究五采用內(nèi)隱聯(lián)想測驗(yàn)和行為學(xué)實(shí)驗(yàn)檢驗(yàn)心理疾病評(píng)價(jià)核心維度對(duì)心理疾病內(nèi)隱態(tài)度和對(duì)患者幫助行為的作用。195名被試參與了實(shí)驗(yàn)研究,平均年齡28.92歲(SD=11.67)。結(jié)果顯示,疾病的整體糟糕性評(píng)價(jià)越高對(duì)患者的內(nèi)隱評(píng)價(jià)越消極；對(duì)心理疾病原因個(gè)人可控性評(píng)價(jià)越高,對(duì)患者的內(nèi)隱態(tài)度越積極；對(duì)心理疾病個(gè)體影響嚴(yán)重性評(píng)價(jià)越高,對(duì)患者的內(nèi)隱態(tài)度越消極。對(duì)心理疾病的整體糟糕性評(píng)價(jià)會(huì)提升公眾對(duì)心理疾病患者面對(duì)面幫助的意愿,但是會(huì)降低公眾對(duì)心理疾病患者面對(duì)面幫助的時(shí)間長度。對(duì)心理疾病患者行為難預(yù)測的評(píng)價(jià)會(huì)降低公眾對(duì)心理疾病患者面對(duì)面幫助的意愿。在前期五個(gè)研究基礎(chǔ)上,研究六編制了簡化的中國公眾心理疾病觀調(diào)查問卷,以來自全國不同地區(qū)共2222名成年人為樣本進(jìn)行大規(guī)模問卷調(diào)查,分析中國公眾對(duì)心理疾病的整體評(píng)價(jià)和態(tài)度,并以常見的六種心理疾病類型為例,分析中國公眾心理疾病觀的知識(shí)性內(nèi)容。結(jié)果發(fā)現(xiàn),中國公眾對(duì)心理疾病的評(píng)價(jià)是患者表現(xiàn)怪異、行為難預(yù)測、整體糟糕、原因復(fù)雜、個(gè)體影響嚴(yán)重、處理困難、社會(huì)危害嚴(yán)重。對(duì)心理疾病患者的情緒感受中同情惋惜的成分最為突出,同時(shí)也包括歧視、理解幫助和回避拒絕等態(tài)度和行為傾向。公眾認(rèn)為心理疾病的原因是多方面,最突出的后果是個(gè)人情緒痛苦、家庭負(fù)擔(dān)及影響、傷害自我及造成個(gè)體事業(yè)及生活的失敗。心理治療被認(rèn)為是最有效的治療方法,醫(yī)學(xué)治療和社會(huì)管制的用處不大。研究結(jié)論：(1)中國公眾心理疾病觀的內(nèi)容包含知識(shí)性內(nèi)容、評(píng)價(jià)性內(nèi)容和患者態(tài)度三個(gè)部分。知識(shí)性內(nèi)容包含患者表現(xiàn)、疾病原因、后果和處理方法方面的認(rèn)知,中國公眾對(duì)這些方面的認(rèn)知表征以嚴(yán)重的“精神病”為原型,但存在“心理”問題與“精神”問題的區(qū)分；中國公眾從整體糟糕、社會(huì)危害嚴(yán)重、個(gè)體影響嚴(yán)重、患者行為怪異難預(yù)測、難治療、原因復(fù)雜、原因難理解和原因個(gè)人可控八個(gè)方面對(duì)心理疾病進(jìn)行評(píng)價(jià),存在對(duì)心理疾病的消極評(píng)價(jià)；中國公眾對(duì)心理疾病患者的情緒感受包含尷尬無奈、壓抑惱火、同情惋惜和緊張害怕四個(gè)主要成分,同情惋惜最為突出,對(duì)患者的行為傾向包含歧視嘲笑、理解幫助和拒絕回避。(2)心理疾病觀內(nèi)部各成分之間關(guān)系密切,疾病后果的認(rèn)知是心理疾病評(píng)價(jià)的主要依據(jù),也是影響患者態(tài)度最主要的因素。(3)心理疾病觀的核心維度是心理疾病的嚴(yán)重性和原因個(gè)人可控性評(píng)價(jià)兩個(gè)方面,其中嚴(yán)重性評(píng)價(jià)以疾病對(duì)患者及社會(huì)利益的損害程度為主要依據(jù)。這兩個(gè)方面與公眾對(duì)心理疾病的內(nèi)隱態(tài)度相關(guān),可以在一定程度上預(yù)測公眾對(duì)心理疾病患者的幫助行為。
[Abstract]:The high prevalence of psychosocial diseases worldwide is an important global public health problem. The lack of knowledge of psychological diseases, misconceptions and stigma attitudes of the public not only greatly impede the professional help for psychological disease patients, but also directly affect the living environment and disease recovery of patients with psychological diseases, and even impede the disease. The development of mental health service in the state and society, therefore, to strengthen the study of the public psychological disease concept, to find an effective way to reduce the public's mental illness and the stigma of their patients, has become an important research topic in the field of mental health service. The structural relationship between the two ideas of the public to mental illness and mental illness is not thoroughly analyzed. Secondly, the public concept is bound to be influenced by the social culture, which leads to the psychological view of the society under the social background characterized by individualist culture, which may not be suitable for the Chinese society characterized by collectivism. Based on the above two points, this study proposed the hierarchical structure system of psychological disease concept: psychological disease concept includes knowledge content, evaluative content and patient attitude three parts, and the three part is a hierarchical structure system. On this basis, the main purpose of this study is to describe Chinese public psychological disease. The content of the view and the relationship between the internal components, explore and verify the core dimensions that affect the attitude of the Chinese public to mental illness. First, the qualitative research method of interview and open questionnaire is used to explore the three parts of the public psychological disease concept in the knowledge content, the evaluation content and the patient's attitude. 183 people over 18 years of age from different regions, different professions and different ages have participated in the investigation. The main findings are as follows. The main findings are as follows: the symptoms can be recovered from the psychological and physical diseases in the public, and the "psychological" and "mental" problems are different types of differences in nature, and the representation of psychological diseases is transmitted. The archetype of the "psychosis" of the unification; psychological diseases are more fearful than physical diseases, because psychological diseases are regarded as extreme exceptions that are uncontrolled, which can lead to unrecoverable and unrecoverable damage and the tragic fate of discarded by the society; the attitudes of patients with psychological diseases include negative social refuses and positive Societies. The status of the coexistence of various components. Two the study was conducted to explore and verify the knowledge content of psychological disease concept, evaluation content and three parts of the attitude of patient's attitude. There were 1375 subjects from 27 provinces and cities in China, and 1375 subjects of different ages, professions and social classes participated in the study. The results are as follows: (1) in the knowledge content, the knowledge of psychological diseases includes social destructive behavior, abnormal speech expression, abnormal interpersonal relationship, abnormal appearance, abnormal ideas, abnormal emotions, abnormal thinking characteristics and seven dimensions, and the understanding of psychological diseases includes social atmosphere and environment. A total of six dimensions, such as folding strike and life stress, emotional factors, family environment, interpersonal communication, brain and body defects, including family burden and influence, social isolation, self injury, frustrations of career and life, emotional pain, loss of life safety and significance, endangering society, seven dimensions; about psychology The understanding of the methods of disease treatment includes the help of relatives and friends, medical treatment, psychological treatment, social help, self adjustment, self adjustment, self emotion regulation, social control, and eight dimensions. (2) the public assessment of psychological diseases in China includes the whole bad, the social harm is serious, the behavior is difficult to predict, the cause is difficult to understand, difficult to treat, and difficult to treat. The influence of the body is serious, the cause is complicated and the cause is controlled by individual. There are eight dimensions. (3) the public's emotional feelings of psychological disease patients include embarrassment, repression, pity, tension and fear, and there are four dimensions. The behavior tendency of patients with psychological diseases includes three dimensions. A regression analysis was used to test the knowledge content of mental illness, the relationship between the evaluative content and the three components of the patient's attitude. The research tool was made up of a self compiled questionnaire for public mental illness in China. The subjects were adults over 18 years of age, from 23 provinces, and 695 of the 4 municipalities. The research found that three components were different. There are different degrees of correlation between the dimensions. Among the knowledge content, the understanding of the causes of psychological disease has less influence on the evaluative content, and the understanding of the consequences of the disease and the understanding of the treatment methods have greater impact on the evaluative content. The overall bad evaluation of mental diseases mainly focuses on the effect of the disease on the patient itself; The social harmfulness evaluation is mainly aimed at the serious "psychosis" with high abnormal symptoms. It thinks that the symptoms of psychological diseases are highly abnormal and the social harm is serious. The concept of social control and medical treatment can predict the negative attitude towards the patients. For the main reason, psychosocial treatment, self-regulation and social help can predict positive emotions to patients. Study four multidimensional scale analysis is used to explore the core dimensions of public assessment of psychological diseases. According to the standard of disease diagnosis, 20 kinds of case description materials for common mental diseases are written, and psychological diseases will be used. The 9 indicators of the disease evaluation were designed to be 9 assessment problems. The subjects were evaluated for 9 problems in each case. A total of 156 subjects, with a mean age of 35.14 years (SD=12.78), found that the core dimension of psychological disease evaluation was the severity of mental illness and the personal controllability of the cause, of which the severity of the disease included the unpredictability of the patient's behavior. The severity of the damage to the society, the severity of the disease, the degree of the difficulty of the disease and the overall bad nature of the disease. Study five the implicit association test and the behavior test were used to test the core dimension of psychological disease evaluation on the implicit attitude of mental illness and the role of.195 in the patient's help. All 28.92 years old (SD=11.67). The results showed that the higher the overall evaluation of the disease was more negative to the implicit evaluation of the patients; the higher the personal controllability of the causes of mental illness, the more active the implicit attitude of the patients; the higher the assessment of the individual impact on the individual psychological disease, the more negative the implicit attitude to the patients. Overall poor assessment will enhance the public's willingness to face face-to-face assistance to mental illness, but reduce the length of the public's face-to-face assistance to patients with mental illness. The assessment of the difficult behavior of patients with mental illness will reduce the public's willingness to help patients with mental illness face-to-face. On the basis of the previous five studies, Six a simplified Chinese public psychological disease survey questionnaire was compiled. A large scale questionnaire survey was conducted with 2222 adults from different regions of the country to analyze the overall evaluation and attitude of the Chinese public on psychological diseases. The knowledge content of the public mental disease concept in China was analyzed with the six common types of psychological diseases. The results showed that the evaluation of mental illness in the Chinese public is that the patient's behavior is weird, the behavior is difficult to predict, the whole is bad, the cause is complex, the individual influence is serious, the treatment is difficult, and the social harm is serious. The public believes that the cause of mental illness is multifaceted. The most prominent consequences are personal emotional pain, family burden and impact, injury to self and the failure of individual career and life. Psychotherapy is considered to be the most effective treatment, medical treatment and social management are not useful. Conclusions: (1) Chinese public heart The content of the concept of physical disease includes three parts: knowledge content, evaluative content and patient attitude. The knowledge contains the cognition of patient performance, disease causes, consequences and treatment methods. The Chinese public's cognitive representation of these aspects is the original type of serious "psychosis", but there is "psychological" and "mental" problems. The Chinese public from the overall bad, the serious social harm, the serious individual influence, the abnormal behavior of the patient, the difficult to treat, the cause complex, the reason difficult to understand and the individual controllable eight aspects to evaluate the psychological disease, the negative evaluation of the psychological disease; the Chinese public's emotional feelings about the psychological disease patients include The four main components of embarrassment, embarrassment, oppression, pity and tension are the most prominent, the sympathy of the patient is most prominent, the behavior tendency of the patient includes discrimination mockery, understanding of help and refusal to avoid. (2) the relationship between the internal components of the psychological disease concept is closely related, and the recognition of the consequences of the disease is the main basis for the evaluation of mental illness and the influence of the patient's state. The main factors of degree. (3) the core dimension of psychological disease concept is the two aspects of the severity of mental illness and the personal controllability evaluation of the cause, among which the severity evaluation is based on the damage degree of the disease to the patients and the social interests. These two aspects are related to the implicit attitude of the public to the psychological disease, and can be pretreated to a certain extent. Measure the public's help to patients with mental illness.
【學(xué)位授予單位】：華中師范大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2015
【分類號(hào)】：B844
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本文編號(hào)：2093167