Perceived humiliation during admission to a psychiatric emergency service and its relation to socio-demography and psychopathology

BMC Psychiatry

Alv A Dahl²  Jim A Nøttestad¹  Marit F Svindseth³ 

[1] Department of Forensic Psychiatry, Brøset, St. Olav’s Hospital, 7440 Trondheim, Norway;University of Oslo, 0316 Oslo, Norway;Aalesund University College, P.O. Box 1517, N-6025 Aalesund, Norway

关键词: Violence;    Psychopathology;    Narcissism;    Psychiatry;    Humiliation;   

Others  :  1123976
DOI  :  10.1186/1471-244X-13-217

 received in 2013-01-19, accepted in 2013-08-27,  发布年份 2013

【 摘 要 】

Background

There is a lack of empirical studies of patients’ level of humiliation during the hospital admission process and its implications for the clinical setting. We wanted to explore associations between self-rated humiliation and socio-demography and psychopathology in relation to admission to a psychiatric emergency unit.

Methods

Consecutively admitted patients (N = 186) were interviewed with several validated instruments. The patients self-rated humiliation by The Cantril Ladder, and 35% of the sample was defined as the high humiliation group.

Results

Final multivariate analysis found significant associations between compulsory admission, not being in paid work, high scores on hostility, and on entitlement, and high levels of humiliation. No significant interactions were observed between these variables, and the narcissism score was not a confounder concerning humiliation.

Conclusions

High level of humiliation during the admission process was mainly related to patient factors, but also to compulsory admission which should be avoided as much as possible protecting the self-esteem of the patients.

【 授权许可】

   
2013 Svindseth et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Lazare A, Levy RS: Apologizing for humiliations in medical practice. Chest 2011, 139:746-759.
• [2]Torres WJ, Bergner RM: Humiliation: its nature, consequences and clinical treatment. Psychotherapy (Chic) 2012, 49(4):492-501.
• [3]Birchwood M, Mason R, MacMillan F, Healy J: Depression, demoralization and control over psychotic illness: a comparison of depressed and non-depressed patients with a chronic psychosis. Psychol Med 1993, 23:387-395.
• [4]Rooske O, Birchwood M: Loss, humiliation and entrapment as appraisals of schizophrenic illness: a prospective study of depressed and non-depressed patients. Br J Clin Psychol 1998, 37:259-268.
• [5]Svindseth MF, Hatling T, Dahl AA: Patients’ experience of humiliation in the admission process to acute psychiatric wards. Nord J Psychiatry 2007, 61:47-53.
• [6]Svindseth MF, Nøttestad JA, Dahl AA: A study of outcome in patients treated at a psychiatric emergency unit. Nord J Psychiatry 2010, 64:363-371.
• [7]Hedlund JL, Vieweg BW: The Brief Psychiatric Rating Scale (BPRS): a comprehensive review. J Operat Psychiatry 1980, 11:48-65.
• [8]Overall JE, Gorham DR: Brief psychiatric rating scale. In Handbook of psychiatric measures. Edited by Task Force for the Handbook of Psychiatric Measures. Washington DC: American Psychiatric Press; 2000:490-494.
• [9]Bjørkly S, Havik O, Løberg T: The interrater reliability of the scale for the prediction of aggression and dangerousness in psychotic patients (PAD). Criminal Just Behav 1996, 23:440-454.
• [10]World Health Organization: The ICD-10 classification of mental and behavioural disorders. Clinical descriptions and diagnostic guidelines. Geneva: World Health Organization; 1992.
• [11]Pedersen G, Hagtvet KA, Karterud S: Generalizability studies of the global assessment of functioning split version. Compr Psychiat 2007, 48:88-94.
• [12]Cantrill H: The pattern of human concern. New Brunswick, NJ: Rutgers University Press; 1965.
• [13]Carpenter JS: Applying the Cantril methodology to study self-esteem: psychometrics of the self-anchoring self-esteem scale. J Nurs Measur 1996, 4:171-189.
• [14]Kansi J: The narcissistic personality inventory: applicability in a Swedish population sample. Scand J Psychol 2003, 44:441-448.
• [15]Svindseth MF, Sørebø O, Nøttestad JA, Roaldset JO, Wallin J, Dahl AA: Psychometric examination and normative data for the narcissistic personality inventory 29 item version. Scand J Psychol 2009, 50:151-159.
• [16]Bjelland I, Dahl AA, Haug TT, Neckelmann D: The validity of the hospital and depression scale. An updated literature review. J Psychosom Res 1992, 52:69-77.
• [17]Lipsey MW, Wilson DB: Practical meta-analysis. Thousand Oaks, CA: Sage; 2001.
• [18]Hojat M, Xu G: A visitor’s guide to effect sizes. Adv Health Sci Edu 2004, 9:241-249.
• [19]Cohen J: A power primer. Psychol Bull 1992, 112:155-159.
• [20]Hiday VA, Swartz MS, Swanson J, Wagner HR: Patient perceptions of coercion in mental hospital admissions. Int J Law Psychiatry 1997, 20:227-241.
• [21]Birchwood M, Zaffer I, Chadwick P, Trower P: Cognitive approach to depression and suicidal thinking in psychosis. Testing the validity of a social ranking model. Br J Psychiatry 2000, 177:522-528.
• [22]Elison J, Harter S: Humiliation. Causes, correlates, and consequences. In The self-conscious emotions. Theory and research. Edited by Tracy JL, Robins RW, Tangney JP. New York: The Guilford Press; 2007.
• [23]Nestor PG: Mental disorder and violence: personality dimensions and clinical features. Am J Psychiatry 2002, 159:1973-1978.
• [24]Adshead G: Commentary: till we have faces–on humiliation. J Am Acad Psychiatry Law 2010, 38(2):205-208.
• [25]Hartling LM, Luchetta T: Humiliation: assessing the impact of derision, degradation, and debasement. J Primary Prev 1999, 19(4):259-278.
• [26]Lincoln TM, Ziegler M, Lüllmann E, Müller MJ, Rief W: Can delusions be self-assessed? Concordance between self- and observer-rated delusions in schizophrenia. Psychiatry Res 2010, 178:249-254.