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Bibliometric Review of the Repertory Grid Technique : — By default, SPSS uses only Kaiser criterion to extract components, which includes all components with an eigenvalue greater than 1. Additionally, the scree plot was regarded. Component loadings greater than 0. Univariate regression and univariate analysis of variance as appropriate were performed to explore the relationship of demographic and clinical variables with SR.
Furthermore, a covariance analysis including the variables that were statistically significant in the univariate analyses, controlling for age, gender, and education, was conducted on the SR subscale to determine whether variables accounted for independent variance in the corresponding variable. The dependent variable was SR; the independent variables included were age, gender, education, patient status, family status, social network, and perceived devaluation and discrimination, as well as the latent variable feeling good comprised of depression, self-esteem, empowerment, and psychological QOL see below.
Demographic and clinical characteristics are shown in table 1. Participants were typical for the schizophrenia population and showed considerable social and vocational impairments: They were mostly single, almost half of them living alone, only about a quarter having a partner, and hardly anyone having paid work. First of all, the theoretically assumed 1-component solution of the ISMI Scale by Ritsher et al 9 was tested, before other criteria for component extraction were regarded.
With this calculation, only one item of the SR subscale had a loading greater than 0.
Regarding Kaiser criterion, 7 components had eigenvalues greater than 1. The scree plot suggested a 2-component solution, as did the parallel analysis. The MAP test calculated a 3-component result. Due to the fact that 2 criteria suggested 2 components and that 2-dimensionality was assumed in the theoretical considerations, a principal component analysis of the ISMI items specifying 2 components was performed table 2. It showed 2 concepts, SR and internalized stigma. All items sorted onto the expected component. The calculation of a 3-component solution, according to the MAP test, which is not included in table 2 , achieved the same result regarding SR as a separate construct.
Again, all SR items loaded onto one component. As shown in table 3 , almost two-thirds of participants had a mean score higher than the midpoint of 2. The 5 subscales showed the following mean scores and SDs: SR, 2. SR was negatively correlated with the Devaluation-Discrimination Scale, and all ISMI subscales except for the subscale discrimination experience, which did not correlate with SR table 4.
Correlations of SR with all 4 ISMI subscales measuring internalized stigma were lower compared with the correlations of these subscales to each other. Correlations of SR with other constructs are shown in table 5. As expected, SR correlated positively with self-esteem, the overall empowerment score, and all empowerment subscales apart from the subscale righteous anger, which did not correlate with SR.
SR also correlated positively with all QOL domains. Depression was negatively associated with SR. Univariate regression and variance analyses were performed to explore the relationship of demographic and clinical variables with SR. Sex, age, living situation, work status, level of education, diagnosis, number of hospitalizations, age at onset of illness, age at first admission, and years of illness had no significant impact on SR.
In each calculation, the variances of the groups were not significantly different. Covariance analyses were conducted on the SR subscale to determine whether variables accounted for independent variance in the corresponding variable table 6. Without this computation, the findings in the covariance analysis would be difficult to interpret because one variable would be significant whereas the others, although measuring something related, would apparently have no effect on SR.
Social network, perceived devaluation and discrimination, and demographic variables did not account for any additional significant variance. The homogeneity of variance assumption was not broken. This question has, however, not yet been specifically addressed in stigma research. As expected, SR correlated negatively with all stigma measures including the Devaluation-Discrimination Scale. These results indicate that a lesser extent of internalized stigma and being unaware or denying stigmatizing public beliefs might be protective, while the belief that others actually treat one differently might not exert much influence on SR.
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Though unexpected, this latter finding has already been reported previously. Another possibility is that SR makes one less vulnerable to internalize stigmatizing beliefs, while it does not show any influence on the actual experience of discrimination, which is probably mainly influenced by environmental factors.
Inpatients and day clinic patients showed lower SR than outpatients. This could be due to hospitalization itself. Being in a hospital represents a clear break with normal life, possibly implying loss of autonomy and self-determination. Another possibility for the lower SR of hospital patients could be their more acute symptomatology.
However, Lysaker et al 11 found no relationship between severity of psychopathological symptoms and SR. Though our study does not contain data on symptom severity, we did find that all other clinical variables did not show any association with SR. A third explanation could be that people with low SR seek more help including hospitalization.
As could be expected, individuals with a high sense of empowerment showed high SR. A notable exception concerns the empowerment subscale righteous anger, which did not correlate significantly. This might indicate SR being a quality independent of a specific response to perceived injustice. Other factors indicative of high SR in our study were protective factors like having a sufficient number of friends, being single or married in contrast to being separated, as well as high self-esteem and empowerment, high QOL, and not being depressed. Due to measurement overlap between empowerment and QOL 25 and QOL and depression 37 and due to the fact that depression, self-esteem, empowerment, and QOL were clearly related to each other, the newly designed latent variable feeling good has been integrated into the covariance analysis.
Thus, other factors not measured in this study, such as personality structures, might also influence stigma-resisting attitudes. Also, it would be interesting to consider SR as an independent variable in designs investigating determinants of the above mentioned variables, ie, social life and well-being.
SR emerged as a separate construct in this study. SR is also distinguishable from self-esteem, empowerment, and QOL. Similar to these constructs, SR represents a positive attitude to life and personal strength but includes a clear reference to mental illness.
This study is exploratory and has several limitations with the main limitation being the measurement of SR: All SR items are phrased in a positive direction, contrary to the other ISMI items. It is possible that the different formulation has an effect on the response behavior. Secondly, even though participants came from different treatment settings, they may not be representative of all people with schizophrenia.
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As stated above, data on psychopathology are missing, but demographic and clinical characteristics, self-esteem, QOL, and perceived devaluation-discrimination are typical for patients with severe mental illness. Results: The severity of childhood abuse was associated with posttraumatic stress disorder PTSD and suicide attempts in females and with PTSD, social phobia, agoraphobia, and dysthymia in males. Among men, multiple logistic regression models showed that CPA and CDA were not independently associated with any of the examined comorbid disorders or with suicide attempts.
For the presence of comorbid affective disorders mainly major depression and suicide attempts, maternal dysfunctioning was particularly important. CSA also independently contributed to the number of comorbid diagnoses. For females, small sample size precluded the use of multivariate analyses. Conclusion: Childhood abuse is an important factor in understanding clinical impairment in treated alcoholics, especially regarding comorbid phobic anxiety disorders, PTSD, and suicidality.
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