Estigma social hacia la enfermedad mental: factores relacionados y propiedades psicométricas del Cuestionario de Atribuciones-revisado
Publicado
abr 30, 2020
Almetrics
Dimensions
Google Scholar
Ana Rodriguez-Meirinhos
https://orcid.org/0000-0002-1073-8151
Lucía Antolín-Suárez
https://orcid.org/0000-0001-7333-7569
https://orcid.org/0000-0002-1073-8151
Lucía Antolín-Suárez
https://orcid.org/0000-0001-7333-7569
##plugins.themes.bootstrap3.article.details##
Resumen
Este estudio persiguió analizar la estructura interna de la versión española del Cuestionario de Atribuciones-revisado (r-AQ-E) para evaluar el estigma social hacia la enfermedad mental en la adolescencia, así como investigar su relación con la edad, la familiaridad y el conocimiento sobre la enfermedad mental. La muestra estuvo constituida por 861 adolescentes de entre 12 y 16 años (M = 13.91; DE = 1.22). Los análisis factoriales exploratorios y confirmatorios no replicaron la estructura original del r-AQ-E, y revelaron una estructura unidimensional con cinco ítems y adecuada consistencia interna. Los resultados evidenciaron que los chicos mostraban más estigma que las chicas. En ambos casos, los niveles de estigma eran similares entre los 12 y 15 años, siendo inferiores a los 16 años. El estigma social se relacionaba con la familiaridad y el conocimiento sobre las características, la prevalencia y las causas de las enfermedades mentales. Estos resultados enfatizan la necesidad de implementar intervenciones para reducir el estigma mediante la mejora del conocimiento sobre la enfermedad mental y las oportunidades de contacto directo.
Keywords
estigma, enfermedad mental, r-AQ, validez, conocimiento, familiaridadstigma, mental illness, r-AQ, validity, adolescent attitudes
References
Angermeyer, M. C., Beck, M., & Matschinger, H. (2003). Determinants of the public’s preference for social distance from people with schizophrenia. Canadian Journal of Psychiatry, 48, 663-668. https://doi.org/10.1177/070674370304801004
Angermeyer, M. C., & Dietrich, S. (2006). Public beliefs about and attitudes towards people with mental illness: A review of population studies. Acta Psychiatrica Scandinavica, 113, 163-179. https://doi.org/10.1111/j.1600-0447.2005.00699.x
Casados, A. (2017). Reducing the stigma of mental illness: Current approaches and future directions. Clinical Psychology Science and Practice, 24, 306-323. https://doi.org/10.1111/cpsp.12206
Chisholm, K., Patterson, P., Torgerson, C., Turner, E., Jenkinson, D., & Birchwood, M. (2016). Impact of contact on adolescents’ mental health literacy and stigma: The SchoolSpace cluster randomized controlled trial. BMJ Open, 6(2), e009435. https://doi.org/10.1136/bmjopen-2015-009435
Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans-Lacko, S., Bezborodovs, N., & Thornicroft, G. (2015). What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychological Medicine, 45, 11-27. https://doi.org/10.1017/S0033291714000129
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2.ª ed.). Hillsdate, NJ: LEA.
Corrigan, P. Q., & Kosyluk, K. A. (2014). Mental illness stigma: Types, constructs, and vehicles for change. En P. W. Corrigan (Ed.), The stigma of disease and disability: Understanding causes and overcoming injustices (pp. 35-36). Nueva York: American Psychological Association.
Corrigan, P. W., Lurie, B., Goldman, H., Slopen, N., Medasani, K., & Phelan, S. (2005). How adolescents perceive the stigma of mental illness and alcohol abuse. Psychiatric Services, 56, 544-550. https://doi.org/10.1176/appi.ps.56.5.544
Corrigan, P. W., Markowitz, F., Watson, A., Rowan, D., & Kubiak, M. A. (2003). An attribution model of public discrimination towards persons with mental illness. Journal of Health and Social Behavior, 44, 162-179. https://doi.org/10.2307/1519806
European Comission. (13 de junio de 2008). European Pact for Mental Health and Well-Being. EU high-level conference together for mental health and wellbeing. Bruselas: Autor. Recuperado de http://ec.europa.eu/health/ph_determinants/life_style/mental/docs/pact_en.pdf
Griffiths, K. M., Carron-Arthur, B., Parsons, A., & Reid, R. (2014). Effectiveness of programs for reducing the stigma associated with mental disorders. A meta-analysis of randomized, controlled trials. World Psychiatry, 13, 161-175. https://doi.org/10.1002/wps.20129
Haslam, N., & Kvaale, E. P. (2015). Biogenetic explanations of mental disorder: The mixed blessings model. Current Directions in Psychological Science, 24, 399-404. https://doi.org/10.1177/0963721415588082
Hinshaw, S. P. (2006). Stigma and mental illness: Developmental issues and future prospects. En D. Cicchetti (Ed.), Developmental psychopatology (Vol. 3, pp. 841-881). Hoboken, NJ: Wiley.
Holman, D. (2015). Exploring the relationship between social class, mental illness stigma and mental health literacy using British national survey data. Health, 19, 413-419. https://doi.org/10.1177/1363459314554316
Horn, J. L. (1965). A rationale and test for the number of factors in a factor analysis. Psychometrika, 30, 179-185. https://doi.org/10.1007/BF02289447
Kline, R. (2011). Principles and practice of structural equation modeling. Nueva York: Guilford.
Lloret, S., Ferreres, A., Hernández, A., & Tomás, I. (2014). El análisis factorial exploratorio de los ítems: una guía práctica, revisada y actualizada. Anales de Psicología, 30, 1151-1169. https://doi.org/10.6018/analesps.30.3.199361
Martínez, A. G., & Hinshaw, S. P. (2016). Mental health stigma: Theory, developmental issues, and research priorities. En D. Cicchetti (Ed.), Developmental psychopathology (3.a ed., pp. 997-1039). New Jersey, NJ: Wiley.
Mukolo, A., Heflinger, C. A., & Wallston, K. (2010). The stigma of childhood mental disorders: A conceptual framework. Journal of the American Academy of Child and Adolescent Psychiatry, 49, 92-198. https://doi.org/10.1016/j.ypsy.2010.10.021
Muñoz, M., Guillén, A. I., Pérez-Santos, E., & Corrigan, P. (2015). A structural equation modeling study of the Spanish Mental Illness Stigma Attribution Questionnaire (AQ-27-E). American Journal of Orthopsychiatry, 85, 243-249. https://doi.org/10.1037/ort0000059
Muthén, L. K., & Muthén, B. O. (2012). Mplus User's Guide Statistical Analysis with Latent Variables (7.a ed.). Los Angeles: Muthén & Muthén.
National Academies of Sciences, Engineering, and Medicine (2017). Approaches to reducing stigma. National Academy of Sciences. In Ending discrimination against people with mental and substance use disorders: The evidence for stigma change (pp. 69-92). National Academies Press.
Navas, M. J., Fidalgo, A. M., Gabriel, C., Suárez, J. C., Brioso, A., Gil, G., … Sarriá, E. (2001). Métodos, diseños y técnicas de investigación psicológica. Madrid: Universidad Nacional de Educación a Distancia.
O’Driscoll, C., Heary, C., Hennessy, E., & McKeague, L. (2015). Adolescents’ explanations for the exclusion of peers with mental health problems: An insight into stigma. Journal of Adolescent Research, 30, 710-728. https://doi.org/10.1177/0743558414550246
Organización Mundial de la Salud. (2018). Salud mental del Adolescente. Datos y cifras. Recuperado de https://www.who.int/es/news-room/factsheets/detail/adolescent-mental-health
Pascucci, M., Montagna, M., Di Sabatino, D., Stella, E., Nicastro, R., Grandinetti, P., … & Bellomo, A. (2017). Stigma and attitudes towards mental illness: Gender differences in a sample of Italian medical students. European Psyciatry, 41, S739. https://doi.org/10.1016/j.eurpsy.2017.01.1359
Petersen, K., Soegaard, V., Lodahl, B., Vinther, C., & Wind, G. (2014). Recovery from mental illness: A service user perspective on facilitators and barriers. Community Mental Health Journal, 51, 1-13. https://doi.org/10.1007/s10597-014-9779-7
Pettigrew, T. F., & Tropp, L. R. (2008). How does intergroup contact reduce prejudice? Meta-analytic tests of three mediators. European Journal of Social Psychology, 38, 922-934. https://doi.org/10.1002/ejsp.504
Pinto, M., Hickman, R., Logsdon, C., & Burant, C. (2012). Psychometric evaluation of the revised-Attribution Questionnaire (r-AQ) to measure mental illness stigma in adolescents. Journal of Nursing Measurement, 20, 47-58. https://doi.org/10.1891/1061-3749.20.1.47
Quinn, D. M., Williams, M. K., & Weisz, B. M. (2015). From discrimination to internalized mental illness stigma: The mediating roles of anticipated discrimination and anticipated stigma. Psychiatric Rehabilitation Journal, 38, 103-108. https://doi.org/10.1037/prj0000136
Reavley, N., & Jorm, A. (2011). Stigmatizing attitudes towards people with mental disorders: findings from an Australian national survey of mental health literacy and stigma. Australian & New Zealand Journal of Psychiatry, 45, 1086-1093. https://doi.org/10.3109/00048674.2011.621061
Schnittker, J. (2000). Gender and reactions to psychological problems: An examination of social tolerance and perceived dangerousness. Journal of Health and Social Behaviour, 41(2), 224-240. https://doi.org/10.2307/2676307
Schomerus, G., Schwahn, C., Holzinger, A., Corrigan, P. W., Grabe, H. J., Carta, M. G., & Angermeyer, M. C. (2012). Evolution of public attitudes about mental illness: A systematic review and meta-analysis. Acta Psychiatrica Scandinavica, 125, 440-452. https://doi.org/10.1111/j.1600-0447.2012.01826.x
Schomerus, G., Van der Auwera, S., Matschinger, H., Baumeister, S. E., & Angermeyer, M. C. (2015). Do attitudes towards persons with mental illness worsen during the course of life? An age-period-cohort analysis. Acta Psychiatrica Scandinavica, 132, 357-364. https://doi.org/10.1111/acps.12401
Seacat, J. (2014). Mental health stigma update: A review of consequences. Advances in Mental Health, 12, 202-215. https://doi.org/10.1080/18374905.2014.11081898
Simmons, L., Jones, T., & Bradley, E. (2017). Reducing mental health stigma. The relationship between knowledge and attitude change. European Journal of Mental Health, 12, 25-40. https://doi.org/10.5708/EJMH.12.2017.1.2
Van der Graff, J., Carlo, G., Crocetti, E., Koot, H. M., & Branje, S. (2018). Prosocial behavior in adolescence: Gender differences in development and links with empathy. Journal of Youth and Adolescence, 47, 1086-1099. https://doi.org/10.1007/s10964-017-0786-1
van Sonderen, E., Sanderman, R., & Coyne, J. C. (2013). Ineffectiveness of reverse wording of questionnaire items: Let’s learn from cows in the rain. PLOS One, 8(7), e68967. https://doi.org/10.1371/journal.pone.0068967
Vigo, D., Thornicroft, G., & Atun, R. (2016). Estimating the true global burden of mental illness. The Lancet Psychiatry, 3, 171-178. https://doi.org/10.1016/S2215-0366(15)00505-2
Wahl, O. (2002). Children´s views of mental illness: A review of the literature. Psychiatric Rehabilitation Skills, 6, 134-158. https://doi.org/10.1080/10973430208408430
Wainberg, M. L., Scorza, P., Shultz, J., Helpman, L., Mootz, J. J., Johnson, K. A., … Arbuckle, M. (2017). Challenges and opportunities in global mental health: A research-to-practice perspective. Current Psychiatry Reports, 19(5), 28. https://doi.org/10.1007/s11920-017-0780-z
Watson, A., Otey, E., Westbrook, A., Qander, A., Lamb, T., Corrigan, P. W., & Fenton, W. (2004). Changing middle schoolers' attitudes about mental illness through education. Schizophrenia Bulletin. The Journal of Psychoses and Related Disorders, 30(3), 563-572. https://doi.org/10.1093/oxfordjournals.schbul.a007100
Wei, Y., McGrath, P., Hayden, J., & Kutcher, S. (2018). The quality of mental health literacy measurement tools evaluating the stigma of mental illness: A systematic review. Epidemiology and Psychiatric Sciences, 27, 433-462. https://doi.org/10.1017/S2045796017000178
Weiner, B. (1995). Judgements of responsibility: A foundation for a theory of social conduct. Nueva York: Guilford.
Angermeyer, M. C., & Dietrich, S. (2006). Public beliefs about and attitudes towards people with mental illness: A review of population studies. Acta Psychiatrica Scandinavica, 113, 163-179. https://doi.org/10.1111/j.1600-0447.2005.00699.x
Casados, A. (2017). Reducing the stigma of mental illness: Current approaches and future directions. Clinical Psychology Science and Practice, 24, 306-323. https://doi.org/10.1111/cpsp.12206
Chisholm, K., Patterson, P., Torgerson, C., Turner, E., Jenkinson, D., & Birchwood, M. (2016). Impact of contact on adolescents’ mental health literacy and stigma: The SchoolSpace cluster randomized controlled trial. BMJ Open, 6(2), e009435. https://doi.org/10.1136/bmjopen-2015-009435
Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans-Lacko, S., Bezborodovs, N., & Thornicroft, G. (2015). What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychological Medicine, 45, 11-27. https://doi.org/10.1017/S0033291714000129
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2.ª ed.). Hillsdate, NJ: LEA.
Corrigan, P. Q., & Kosyluk, K. A. (2014). Mental illness stigma: Types, constructs, and vehicles for change. En P. W. Corrigan (Ed.), The stigma of disease and disability: Understanding causes and overcoming injustices (pp. 35-36). Nueva York: American Psychological Association.
Corrigan, P. W., Lurie, B., Goldman, H., Slopen, N., Medasani, K., & Phelan, S. (2005). How adolescents perceive the stigma of mental illness and alcohol abuse. Psychiatric Services, 56, 544-550. https://doi.org/10.1176/appi.ps.56.5.544
Corrigan, P. W., Markowitz, F., Watson, A., Rowan, D., & Kubiak, M. A. (2003). An attribution model of public discrimination towards persons with mental illness. Journal of Health and Social Behavior, 44, 162-179. https://doi.org/10.2307/1519806
European Comission. (13 de junio de 2008). European Pact for Mental Health and Well-Being. EU high-level conference together for mental health and wellbeing. Bruselas: Autor. Recuperado de http://ec.europa.eu/health/ph_determinants/life_style/mental/docs/pact_en.pdf
Griffiths, K. M., Carron-Arthur, B., Parsons, A., & Reid, R. (2014). Effectiveness of programs for reducing the stigma associated with mental disorders. A meta-analysis of randomized, controlled trials. World Psychiatry, 13, 161-175. https://doi.org/10.1002/wps.20129
Haslam, N., & Kvaale, E. P. (2015). Biogenetic explanations of mental disorder: The mixed blessings model. Current Directions in Psychological Science, 24, 399-404. https://doi.org/10.1177/0963721415588082
Hinshaw, S. P. (2006). Stigma and mental illness: Developmental issues and future prospects. En D. Cicchetti (Ed.), Developmental psychopatology (Vol. 3, pp. 841-881). Hoboken, NJ: Wiley.
Holman, D. (2015). Exploring the relationship between social class, mental illness stigma and mental health literacy using British national survey data. Health, 19, 413-419. https://doi.org/10.1177/1363459314554316
Horn, J. L. (1965). A rationale and test for the number of factors in a factor analysis. Psychometrika, 30, 179-185. https://doi.org/10.1007/BF02289447
Kline, R. (2011). Principles and practice of structural equation modeling. Nueva York: Guilford.
Lloret, S., Ferreres, A., Hernández, A., & Tomás, I. (2014). El análisis factorial exploratorio de los ítems: una guía práctica, revisada y actualizada. Anales de Psicología, 30, 1151-1169. https://doi.org/10.6018/analesps.30.3.199361
Martínez, A. G., & Hinshaw, S. P. (2016). Mental health stigma: Theory, developmental issues, and research priorities. En D. Cicchetti (Ed.), Developmental psychopathology (3.a ed., pp. 997-1039). New Jersey, NJ: Wiley.
Mukolo, A., Heflinger, C. A., & Wallston, K. (2010). The stigma of childhood mental disorders: A conceptual framework. Journal of the American Academy of Child and Adolescent Psychiatry, 49, 92-198. https://doi.org/10.1016/j.ypsy.2010.10.021
Muñoz, M., Guillén, A. I., Pérez-Santos, E., & Corrigan, P. (2015). A structural equation modeling study of the Spanish Mental Illness Stigma Attribution Questionnaire (AQ-27-E). American Journal of Orthopsychiatry, 85, 243-249. https://doi.org/10.1037/ort0000059
Muthén, L. K., & Muthén, B. O. (2012). Mplus User's Guide Statistical Analysis with Latent Variables (7.a ed.). Los Angeles: Muthén & Muthén.
National Academies of Sciences, Engineering, and Medicine (2017). Approaches to reducing stigma. National Academy of Sciences. In Ending discrimination against people with mental and substance use disorders: The evidence for stigma change (pp. 69-92). National Academies Press.
Navas, M. J., Fidalgo, A. M., Gabriel, C., Suárez, J. C., Brioso, A., Gil, G., … Sarriá, E. (2001). Métodos, diseños y técnicas de investigación psicológica. Madrid: Universidad Nacional de Educación a Distancia.
O’Driscoll, C., Heary, C., Hennessy, E., & McKeague, L. (2015). Adolescents’ explanations for the exclusion of peers with mental health problems: An insight into stigma. Journal of Adolescent Research, 30, 710-728. https://doi.org/10.1177/0743558414550246
Organización Mundial de la Salud. (2018). Salud mental del Adolescente. Datos y cifras. Recuperado de https://www.who.int/es/news-room/factsheets/detail/adolescent-mental-health
Pascucci, M., Montagna, M., Di Sabatino, D., Stella, E., Nicastro, R., Grandinetti, P., … & Bellomo, A. (2017). Stigma and attitudes towards mental illness: Gender differences in a sample of Italian medical students. European Psyciatry, 41, S739. https://doi.org/10.1016/j.eurpsy.2017.01.1359
Petersen, K., Soegaard, V., Lodahl, B., Vinther, C., & Wind, G. (2014). Recovery from mental illness: A service user perspective on facilitators and barriers. Community Mental Health Journal, 51, 1-13. https://doi.org/10.1007/s10597-014-9779-7
Pettigrew, T. F., & Tropp, L. R. (2008). How does intergroup contact reduce prejudice? Meta-analytic tests of three mediators. European Journal of Social Psychology, 38, 922-934. https://doi.org/10.1002/ejsp.504
Pinto, M., Hickman, R., Logsdon, C., & Burant, C. (2012). Psychometric evaluation of the revised-Attribution Questionnaire (r-AQ) to measure mental illness stigma in adolescents. Journal of Nursing Measurement, 20, 47-58. https://doi.org/10.1891/1061-3749.20.1.47
Quinn, D. M., Williams, M. K., & Weisz, B. M. (2015). From discrimination to internalized mental illness stigma: The mediating roles of anticipated discrimination and anticipated stigma. Psychiatric Rehabilitation Journal, 38, 103-108. https://doi.org/10.1037/prj0000136
Reavley, N., & Jorm, A. (2011). Stigmatizing attitudes towards people with mental disorders: findings from an Australian national survey of mental health literacy and stigma. Australian & New Zealand Journal of Psychiatry, 45, 1086-1093. https://doi.org/10.3109/00048674.2011.621061
Schnittker, J. (2000). Gender and reactions to psychological problems: An examination of social tolerance and perceived dangerousness. Journal of Health and Social Behaviour, 41(2), 224-240. https://doi.org/10.2307/2676307
Schomerus, G., Schwahn, C., Holzinger, A., Corrigan, P. W., Grabe, H. J., Carta, M. G., & Angermeyer, M. C. (2012). Evolution of public attitudes about mental illness: A systematic review and meta-analysis. Acta Psychiatrica Scandinavica, 125, 440-452. https://doi.org/10.1111/j.1600-0447.2012.01826.x
Schomerus, G., Van der Auwera, S., Matschinger, H., Baumeister, S. E., & Angermeyer, M. C. (2015). Do attitudes towards persons with mental illness worsen during the course of life? An age-period-cohort analysis. Acta Psychiatrica Scandinavica, 132, 357-364. https://doi.org/10.1111/acps.12401
Seacat, J. (2014). Mental health stigma update: A review of consequences. Advances in Mental Health, 12, 202-215. https://doi.org/10.1080/18374905.2014.11081898
Simmons, L., Jones, T., & Bradley, E. (2017). Reducing mental health stigma. The relationship between knowledge and attitude change. European Journal of Mental Health, 12, 25-40. https://doi.org/10.5708/EJMH.12.2017.1.2
Van der Graff, J., Carlo, G., Crocetti, E., Koot, H. M., & Branje, S. (2018). Prosocial behavior in adolescence: Gender differences in development and links with empathy. Journal of Youth and Adolescence, 47, 1086-1099. https://doi.org/10.1007/s10964-017-0786-1
van Sonderen, E., Sanderman, R., & Coyne, J. C. (2013). Ineffectiveness of reverse wording of questionnaire items: Let’s learn from cows in the rain. PLOS One, 8(7), e68967. https://doi.org/10.1371/journal.pone.0068967
Vigo, D., Thornicroft, G., & Atun, R. (2016). Estimating the true global burden of mental illness. The Lancet Psychiatry, 3, 171-178. https://doi.org/10.1016/S2215-0366(15)00505-2
Wahl, O. (2002). Children´s views of mental illness: A review of the literature. Psychiatric Rehabilitation Skills, 6, 134-158. https://doi.org/10.1080/10973430208408430
Wainberg, M. L., Scorza, P., Shultz, J., Helpman, L., Mootz, J. J., Johnson, K. A., … Arbuckle, M. (2017). Challenges and opportunities in global mental health: A research-to-practice perspective. Current Psychiatry Reports, 19(5), 28. https://doi.org/10.1007/s11920-017-0780-z
Watson, A., Otey, E., Westbrook, A., Qander, A., Lamb, T., Corrigan, P. W., & Fenton, W. (2004). Changing middle schoolers' attitudes about mental illness through education. Schizophrenia Bulletin. The Journal of Psychoses and Related Disorders, 30(3), 563-572. https://doi.org/10.1093/oxfordjournals.schbul.a007100
Wei, Y., McGrath, P., Hayden, J., & Kutcher, S. (2018). The quality of mental health literacy measurement tools evaluating the stigma of mental illness: A systematic review. Epidemiology and Psychiatric Sciences, 27, 433-462. https://doi.org/10.1017/S2045796017000178
Weiner, B. (1995). Judgements of responsibility: A foundation for a theory of social conduct. Nueva York: Guilford.
Cómo citar
Rodriguez-Meirinhos, A., & Antolín-Suárez, L. (2020). Estigma social hacia la enfermedad mental: factores relacionados y propiedades psicométricas del Cuestionario de Atribuciones-revisado. Universitas Psychologica, 19, 1–13. https://doi.org/10.11144/Javeriana.upsy19.esem
Sección
Artículos