公眾對於憂鬱症患者的態度與信念：心理社會歸因、刻板印象、情緒反應、與求助建議之間的關係

Abstract

研究背景及目的：公眾對於憂鬱症患者的心理社會歸因會增加公眾污名，而公眾污名是憂鬱症患者尋求協助的主要障礙之一。關於憂鬱症心理社會歸因、公眾污名、與求助專業建議彼此間關聯性仍未有定論，本研究旨在探討公眾對於憂鬱症患者的心理社會歸因、刻板印象、情緒反應與求助專業建議之關係。 研究方法：本研究利用電腦輔助電話訪問系統以隨機撥號的方式抽取具全國代表性之資料，針對臺灣20歲至65歲公眾 (n = 800) 進行資料收集。針對所提供的憂鬱症患者案例，詢問關於憂鬱症罹病的心理社會歸因和對於憂鬱症的污名態度，包含：刻板印象、情緒反應，以及尋求專業協助的建議。本研究透過串聯中介分析檢驗心理社會歸因對於尋求專業協助建議之直接效果與間接效果。 研究結果：心理社會歸因對覺察依賴性有正向影響，並進而導致同情的情緒反應，最終增加對心理健康專業的求助建議。心理社會歸因會增加覺察依賴性，並進而導致恐懼的情緒反應，最終增加對其他醫療專業（家醫科醫師及中醫師）的求助建議。 研究結論：本研究結果顯示降低恐懼與增加同情之情緒可能有助於公眾建議憂鬱症患者尋求心理健康專業協助。公眾對憂鬱症的刻板印象和情緒反應在心理社會歸因對心理健康專業求助建議和其他醫療專業求助建議之間的關係中具有不同的串聯中介作用。瞭解這些潛在機制，可提供未來發展及規劃憂鬱症相關介入措施的實徵研究基礎。

Background and Aims: Public stigma is one of the most important barriers for help-seeking of people with depression, which can be predicted by psychosocial causal beliefs. Up to now, evidence for the association between psychosocial causal beliefs, different dimensions of public stigma, and professional help-seeking preferences was either insufficient or largely inconsistent. The present study aimed to explore how psychosocial causal beliefs, stereotypes, and emotional reactions could affect professional help-seeking preferences. Methods: A nationally representative sample of Taiwanese adults aged 20-65 (n = 800) was recruited by random-digit-dialing computer-assisted telephone interviewing system. Participants were asked to answer their psychosocial causal beliefs, stigmatizing attitudes (i.e., stereotypes and emotional reactions), and professional help-seeking preferences for a person with depression described in a case vignette. Serial mediation analyses were conducted to test the direct and indirect effects of psychosocial causal beliefs on professional help-seeking preferences. Results: Psychosocial causal beliefs were positively associated with perceived dependency, which resulted in stronger pity and, in turn, increased help-seeking preferences for mental health professionals. Psychosocial causal beliefs were positively associated with perceived dependency, which resulted in stronger fear and, in turn, increased help-seeking preferences for other medical professionals (i.e., general practitioner, and Chinese medical doctor). Conclusions: This study indicated that reducing negative emotional reactions such as fear and increasing the emotion of pity were likely to be useful in promoting public preferences to seek help frommental health professionals. Stereotypes and emotional reactions toward depression had differential serial mediating effects in the relationships between psychosocial causal beliefs with help-seeking preferences for mental health professionals and for other medical professionals. Understanding these complex associations might enable further work in designing evidence-based interventions for depression.