研究背景：心理諮商專業致力於探討精神疾病患者的疾病辨識與復原，相關研究指出精神疾病污名化對於患者帶來的負面影響，並證實家屬與精神疾病患者共同承受強烈的公眾污名。當公眾污名被家屬接受便逐漸內化成為自我污名，亦會帶給家屬極大的心理負擔，影響其心理適應情形。
研究目的：本研究以精神疾病患者之家屬所經歷的自我污名為起始點，了解自我污名如何影響其心理適應，同時透過自我概念的理論，重新檢視家屬經歷自我污名的心理歷程。本研究可作為心理專業人員評估精神疾病患者家庭，與家屬需求之介入依據，日後政府相關政策發展亦可參酌研議，以提供家屬更有效的資源與支持。
研究問題：（1）污名如何對嚴重精神疾病患者家屬產生影響；（2）陪伴不同診斷嚴重精神疾病患者時，其家屬的自我污名與心理適應有何差異？且不同角色的家屬，在陪伴其嚴重精神疾病患者時，家屬的自我污名與心理適應有何差異；（3）探討嚴重精神疾病患者家屬自我污名、自我概念與心理適應之間的關係。
研究方法：本研究採取量化研究設計，採用問卷調查法，透過網路問卷於網路社群立意取樣，總計回收142份有效問卷。資料透過描述性統計、獨立樣本t檢定與階層式迴歸進行分析。
研究結果：（1）嚴重精神疾病患者家屬自我污名影響社會自我概念；（2）嚴重精神疾病患者家屬自我污名影響幸福感與憂鬱；（3）嚴重精神疾病患者家屬社會自我概念影響幸福感與憂鬱；（4）社會自我概念為嚴重精神疾病患者家屬自我污名影響幸福感與憂鬱之中介變項。

Background: Counseling psychology professionals endeavor to explore ways of recognizing mental illness and its recovery. Relevant studies indicated that stigmas around mental illness impact patients with mental illness negatively. Research also showed that caregivers of patients with severe mental illness, refer as caregivers, share these stigmas. It becomes a huge psychological burden and affects caregivers’ psychological adjustment as they internalize these stigmas gradually.
Purpose: The study first explored the relationship between caregivers’ self-stigma and psychological adjustment. Then reexamine caregivers’ psychological process of self-stigma through theory of self-concept. Results of this study can provide implications for mental health professionals and policymakers to better support, evaluate, and intervene family and caregivers of severe mental illness.
Research questions: 1) How does stigma impact caregivers? 2) How does self-stigma impact differently on the psychological adjustment of caregivers with different kinds of severe mental illness? And how do different family roles impact on caregivers’ self-stigma and psychological adjustment differently? 3) What is the relationship between caregivers’ self-stigma, self-concept, and psychological adjustment?
Method: This study used a quantitative research design. The data was collected through online survey. Purposive sampling was adapted in this research and received 142 valid responses. The data was analyzed with descriptive statistics, t-test, and hierarchical regression.
Results: 1) Caregivers’ self-stigma impacted their social self-concept; 2) Caregivers’ self-stigma affected their well-being and depression; 3) Caregivers’ social self-concept influenced their well-being and depression; (4) Social self-concept is the moderator that affected self-stigma, well-being and depression of caregivers of people with mental illness.

中文摘要 i
Abstract ii
目錄 v
表目錄 vii
圖目錄 viii
第一章 緒論 1
第一節 研究動機與目的 1
第二節 名詞界定 4
第二章 文獻探討 6
第一節 精神疾病 6
第二節 精神疾病患者家屬的處境與負擔 7
第三節 精神疾病與污名 10
第四節 自我概念 15
第五節 心理適應 19
第六節 研究假設與研究架構 21
第三章 研究方法 23
第一節 研究設計 23
第二節 研究程序與研究對象 23
第三節 研究工具 25
第四節 研究倫理 28
第四章 研究結果 31
第一節 描述統計分析 31
第二節 主要研究結果 37
第五章 討論與建議 44
第一節 研究結果討論 44
第二節 研究限制與建議 52
參考文獻 55
一、 中文部分 55
二、 英文部分 57
附錄 63
附錄一、 倫理審查核可證明 63
附錄二、 量表使用授權書 64
附錄三、 參與同意書 67
附錄四、 調查問卷 68

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