Stigma; Depression; Qualitative research; Phenomenology; Chinese adults
病耻感; 抑郁症; 质性研究; 现象学; 中国成人
Abstract:
Stigma is a pivotal socio-psychological barrier deterring Chinese adults with depression from professional help-seeking, yet its experience is situational rather than static. Drawing on semistructured in-depth interviews with 15 employed adults aged 25 to 55 diagnosed with moderate-to-major depression, this phenomenological study delineates the dynamic contours of stigma and the protective factors that mitigate it. The findings indicate that high stigma manifests as workplace labelling, social withdrawal, self-deprecation, and treatment avoidance; the dynamic experience of low stigma unfolds in three phases: from ignorance to understanding, from avoidance to participation, and from silence to being “seen”. Three interacting protective factors sustain low stigma: individual psychological resilience, supportive sociocultural environments, and accessible, privacy-protected healthcare. The stigma of adult depression patients must be understood within an interactive framework of public stigma and self-stigma; interventions should simultaneously weaken structural stigma and mobilize intersubjective resources.
病耻感被认为是阻碍中国成人抑郁症患者求助的关键社会心理机制,但其体验并非静止,而是随情境波动。本文采用质性研究方法,通过对15名25~55岁的中国成人抑郁症患者的半结构式深度访谈,探究他们病耻感的动态构成与低病耻感的保护因素。研究发现,高病耻感表现为职场标签化、社会关系回避、自我贬低及治疗回避;低病耻感的动态体验则表现为从未知到理解、从逃避到参与、从缄默到“被看见”。个体心理韧性、社会文化环境支持及医疗可及性与隐私保护,是维持低病耻感的三大保护性因素。成人抑郁症患者的病耻感需置于公众污名和自我污名的互动框架中理解,干预需同时削弱结构性污名并激活主体间性资源。