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Background: Self-stigma is a result of internalizing negative stereotypes by the affected person. Research on self-stigma in substance use disorders (SUD) is still scarce, especially regarding the role of childhood trauma and subsequent posttraumatic disorders. Objectives: The present study investigated the progressive model of self-stigma in women...
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Previous research has found language used to describe individuals with a substance use disorder (SUD;e.g., “addict,” “substance abuser”) contributes to and elicits negative bias among the general public and health care professionals. However, the prevalence in which recovering individuals use these labels to self-identify and the impact of such lab...
Citations
... Aukeratutako ikerketen artean aldakortasun handia aurkitu da haien laginaren tamainan. Hain zuzen, hiru ikerketak 150 pertsonatik beherako lagina dute (Brown et al., 2015;Vilus eta Perich, 2021;Wiechelt eta Sales, 2001), sei ikerketak 200 eta 600 artekoa (Braun et al., 2023;Tomás-Dols et al., 2007;Green, 2011;Grigg et al., 2023;Melchior et al., 2019;Zemore et al., 2009) eta beste bi ikerketak 600 pertsonatik gorakoa (Ransome et al., 2017;Small et al., 2010). ...
... Generoari dagokionez, lau ikerketaren lagina soilik emakumez osatuta dago (Braun et al., 2023;Melchior et al., 2019;Ransome et al., 2017;Wiechelt eta Sales, 2001) eta beste zazpi lanetan emakumez eta gizonez (Brown et al., 2015;Tomás-Dols et al., 2007;Green, 2011;Grigg et al., 2023;Small et al., 2010;Vilus eta Perich, 2021;Zemore et al., 2009). Generoaren araberako parte-hartzaileei dagokienez, lagin mistoko bi ikerketatan, emakumeak gizonen bikoitza izan dira (Green, 2011;Vilus eta Perich, 2021). ...
... Adinari helduz, ikerketetan laginaren gehiengoa 30 eta 45 urte artean egon da (Braun et al., 2023;Brown et al., 2015;Tomás-Dols et al., 2007;Green, 2011;Grigg et al., 2023;Melchior et al., 2019;Small et al., 2010;Vilus eta Perich, 2021;Wiechelt eta Sales, 2001). ...
Azken urteotan emakumeen alkohol-kontsumoa areagotu egin da, zeinak eragin negatiboa daukan, besteak beste, haien antsietate- eta depresio-mailetan, autokontzeptuan eta tratamendu-bilaketan. Honenbestez, lan honen helburu nagusia da alkoholarekin arazoak dituzten emakumeekiko estigmak haien buru-osasunean eta tratamendu-bilaketan izan dezakeen eraginaren berrikuspen sistematiko eguneratua egitea (PRISMA metodoarekin). Emaitzen arabera, tratamendua bilatzeko oztopoen artean emakumeek estigma-maila altuagoak dituzte eta autoestigma depresioarekin eta osasun-maila urriarekin lotuta dagoela ikusi da. Hortaz, estigma motak emakumeen ongizatean zer-nolako inpaktua duen jakitea oso lagungarri izan daiteke prebentzio-programak garatzeko eta emakumeei zuzendutako tratamendu indibidualizatu zein talde-mailakoak diseinatu, inplementatu eta ebaluatzeko.
... Specifically, stigma could dampen the willingness to seek treatment [8] and negatively influence treatment adherence [9][10][11]. Furthermore, stigma also causes other psychological disorders, such as depression, anxiety, and post-traumatic stress disorder [12][13][14]. ...
Purpose
In China, individuals with substance use disorders (SUD) face severe stigma, but reliable stigma assessment tool is lacking. Therefore, this study aimed to validate the Chinese version of the Substance Use Stigma Mechanism Scale (SU-SMS-C) and set its cut-off point.
Methods
We recruited 1005 individuals with SUDs from Chinese rehabilitation centers. These participants completed a battery of questionnaires that included the SU-SMS-C, The Multidimensional Scale of Perceived Social Support (MSPSS), Center for Epidemiologic Studies Depression Scale (CES-D), General Self-Efficacy Scale (GSES), and Perceived Devaluation and Discrimination (PDD). Confirmatory factor analysis was used to assess the construct validity of the scale. Additionally, the Naive Bayes classifier was used to establish the cut-off point for the SU-SMS-C. We additionally explored the correlation between patient demographic characteristics and stigma.
Results
A confirmatory factor analysis was utilized, revealing a second-order five-factor model. Based on the Naive Bayes classifier, the area under the receiver operating characteristic (AUCROC) of 0.746, the cut-off point for the SU-SMS-C was established at 44.5. The prevalence of stigma observed in the study population was 49.05%. Significant disparities were observed in the distribution of stigma across genders, with males experiencing more pronounced stigma than females. Moreover, patients consuming different primary substances reported diverse levels of stigma. Notably, those primarily using heroin endured a higher degree of stigma than users of other substances.
Conclusion
The study is the first to identify a cut-off point for the SU-SMS-C by Naive Bayes classifier, bridging a major gap in stigma measurement research. SU-SMS-C may help treat and manage SUDs by reducing stigma.
... Además, el número de personas que padecen trastornos por consumo de drogas se ha disparado hasta los 39,5 millones, lo que supone un aumento del 45% en 10 años 2,3 . La prevalencia del abuso de drogas en la población es difícil de establecer, sobre todo en mujeres, debido a distintos estigmas asociados a este consumo 4 . Según el último informe de Word Drug Report, el cannabis es la droga más consumida después del alcohol etílico. ...
Background. The prevalence of street drug abuse is difficult to establish in women because of stigma associated with the practice. The main objective of this study was to analyze possible differences between men and women in a sample of patients attended for emergencies due to acute poisonings. The secondary aim was to identify variables associated with severe poisonings defined arbitrarily as requiring intensive care for more than 12 hours after hospital admission.
Methods. Retrospective study in 2 hospital EDs. We included patients over the age of 18 years attended for street drug poisonings between July 1, 2020, and July 31, 2023. Epidemiologic, clinical, and laboratory variables were analyzed.
Results. A total of 1032 patients were studied; 191 (18.5%) were women. The mean (SD) age was 35 years, and the prevalences of acute mental illness and HIV infection were high at 32.2% and 35.7%, respectively. Drug use was recreational in most cases (90.9%). Cocaine, alcohol, and methamphetamines were the substances most often used. Multivariate analysis showed that the factors associated with the seriousness of poisoning were age, with an odds ratio (OR) of 1.03 (95% CI, 1.01-1.05; P = .003); HIV (OR, 2.10; 95% CI, 1.29-3.41; P = .003); use of benzodiazepines
(OR, 3.48; 95% CI, 2.14-5.66; P < .0001); and suicidal ideations (OR, 1.82; 95% CI, 1.25-3.79; P = .004).
Conclusions. Differences in poisoning characteristics in women were found, probably related to the younger ages of men in the sample and their higher frequency of alcohol consumption. Public health policies and campaigns to
prevent drug abuse should take gender differences into consideration in order to adapt messages to the target populations
... Speci cally, stigma could dampen the willingness to seek treatment [8] and negatively in uence treatment adherence [9][10][11]. Furthermore, stigma also causes other psychological disorders, such as depression, anxiety, and post-traumatic stress disorder [12][13][14]. ...
Purpose: Due to the lack of reliable stigma assessment tools and the stigma faced by people with substance use disorders (SUDs), especially in China. Therefore, this study aimed to validate the Chinese version of the Substance Use Stigma Mechanism Scale (SU-SMS-C) and set its cut-off point.
Methods: We recruited 1005 individuals with SUDs from Chinese rehabilitation centers. These participants completed a battery of questionnaires that included the SU-SMS-C, MSPSS, CES-D, GSES, and PDD. Confirmatory factor analysis was used to assess the construct validity of the scale. Additionally, the Naive Bayes Classifier was used to establish the cut-off point for the SU-SMS-C. We additionally explored the correlation between patient demographic characteristics and stigma.
Results: A confirmatory factor analysis was utilized, revealing a second-order five-factor model. Based on the Naive Bayes Classifier, the Area Under the Receiver Operating Characteristic (AUCROC) of 0.746, the cut-off point for the SU-SMS-C was established at 44.5. The prevalence of stigma observed in the study population was 49.05%. Significant disparities were observed in the distribution of stigma across genders, with males experiencing more pronounced stigma than females. Moreover, patients consuming different primary substances reported diverse levels of stigma. Notably, those primarily using heroin endured a higher degree of stigma than users of other substances.
Conclusion: The study is the first to identify a cut-off point for the SU-SMS-C by Naive Bayes Classifier, bridging a major gap in stigma measurement research. SU-SMS-C may help treat and manage SUDs by reducing stigma.
... Substance use is also further complicated during pregnancy and breastfeeding [92,93]. Pregnant women using drugs, including tobacco and alcohol, can pass those drugs to their developing fetuses with harmful consequences. ...
Sex and gender have been gaining ever greater attention due to their associated risks, dynamics, patterns and protective factors underlying substance abuse and addiction. Such differentiations and the clarification of complexities thereof take on even greater relevance in light of drug abuse scope worldwide. According to the 2022 World Drug Report released by the United Nations Office on Drugs and Crime (UNODC), in 2020 an estimated 284 million people worldwide aged 15–64 had used a drug within the last 12 months. The authors have set out to shed a light on determinants and contributing factors of drug abuse based on sex and gender and outline policy and medicolegal remarks aimed at delineating sex- and gender-based approaches towards drug abuse therapeutic interventions that are both therapeutically and ethically/legally viable and grounded in an evidence-based set of standards. Neurobiological data suggest that estrogen may facilitate drug taking by interacting with reward- and stress-related systems. In animal research, the administration of estrogen increases drug taking and facilitates the acquisition, escalation, and reinstatement of cocaine-seeking behavior. From a medicolegal perspective, it is of utmost importance to take into account the whole picture constituting each patient profile, which certainly includes gender factors and contributors, when outlining a therapeutic approach. Failure to do so could lead to negligence-based malpractice allegations, in light of the scientific findings representing best practices with which clinicians need to comply when caring for SUD patients.
... Internalized narratives become predictive as individuals with SUD anticipate stigmatizing and judgmental treatment when interacting with providers and healthcare systems; ultimately leading to poorer health outcomes (16,49) and retention and follow-up care challenges (50). Impacts of self-stigma on psychological well-being, self-efficacy and resultant treatment outcomes for those with substance use disorders are well-documented (51)(52)(53)(54). The downstream mental health consequences of self-stigma may itself be a determinant for continued substance use. ...
Substance use disorders are a common and treatable condition among pregnant and parenting people. Social, self, and structural stigma experienced by this group represent a barrier to harm reduction, treatment utilization, and quality of care. We examine features of research dissemination that may generate or uphold stigmatization at every level for pregnant and parenting individuals affected by substance use disorder and their children. We explore stigma reduction practices within the research community that can increase uptake of evidence-based treatment programs and prevent potential harm related to substance use in pregnant and parenting people. The strategies we propose include: (1) address researcher stereotypes, prejudice, and misconceptions about pregnant and parenting people with substance use disorder; (2) engage in interdisciplinary and transdisciplinary collaborations that engage with researchers who have lived experience in substance use; (3) use community-based approaches and engage community partners, (4) address stigmatizing language in science communication; (5) provide contextualizing information about the social and environmental factors that influence substance use among pregnant and parenting people; and (6) advocate for stigma-reducing policies in research articles and other scholarly products.
... Once normality, collinearity, sphericity, and homogeneity of variance were tested and approved, we performed parametric tests. To assess the validity of the four-step model, we replicated analyses performed in previous studies (Melchior et al., 2019), namely a repeated-measures analysis of variance (ANOVA) with post hoc testing, correlation analysis, and a multiple regression analysis. Finally, to assess the role of shame and guilt within processes, we conducted a multiple hierarchical regression analysis. ...
... We found higher correlations among proximal stages than with distal stages, and the correlation between the first and second stage (as well as between the third and fourth) were higher than the correlation between the first and last stage. Accordingly, all of our results are in line with the original and preexisting studies (Corrigan et al., 2005;Melchior et al., 2019;Schomerus et al., 2011). Moreover, having tested the involvement of the reflexive emotions of shame and guilt within this process, we cannot confirm the role of guilt, but the shame involvement seems clearer. ...
Self-stigma, defined as the internalization of stereotypes, is well documented among people suffering from mental illness, including people with alcohol use disorders (AUDs). Progressive model of self-stigma states that alcohol users internalized stigma through four successive steps: awareness, agree, application, and harm. Simultaneously, people with AUDs are subject to shame and guilt. Even if any consensus appears, it seems that shame improves alcohol consumption, whereas guilt acts as a protective factor. Although many studies have emerged over the past decades regarding self-stigma, few have studied the implications of emotions in the process of self-stigma. Moreover, no study has been conducted with alcohol users in France. This quantitative study aims to explore the relations between self-stigma process, guilt, and shame in AUD. One hundred fourteen participants recruited in an addiction care center near Paris, France took part in the study. Participants responded through seven preexisting self-report scale investigated alcohol dependence, drugs dependence, depression and anxiety symptoms, perceived stigma, self-stigma, guilt, and shame. Through hierarchical multiple regression, the implications of guilt and shame in the process of self-stigma were highlighted. While internalization of stigma occurs in successive stages, according to theoretical model, shame seems to predict each stage. In contrast, guilt is not linked to any stage of self-stigma. The results suggest a deleterious role of shame toward alcohol consumption as well as the internalization of stigma. Moreover, the progress of research on the involvement of reflexive emotions in self-stigma makes it possible to think about a global and adapted therapeutic accompaniment for people with AUDs.
... These findings comport with extant research linking depression to internalized stigma in people with substance use disorders (SUD) (Brown et al., 2015;da Silveira et al., 2018;Schomerus, Corrigan, et al., 2011) and women with SUD and hazardous drinking (Melchior et al., 2019;Vilus & Perich, 2021), while extending findings to women with a history of SAV who report unhealthy levels of drinking and endorse drinking to cope with negative affect. Indeed, average AUDIT scores Table 3 Regression models predicting depressive symptoms from internalized alcohol stigma and self-compassion, reporting unstandardized (B) and standardized beta's (β) and standard errors (SE). ...
... T.D. Braun et al. were classified as hazardous or harmful in the overall sample, with over a quarter of women reaching the cut-point for moderate to severe AUD. While much of the research on alcohol stigma and depression in women is in its infancy, and ours is among the first works to our knowledge to examine this association among survivors of SAV, internalized substance use stigma has been reported greater among women with more severe SUD (Melchior et al., 2019). Although we controlled for the AUDIT, increasing confidence in our findings irrespective of AUD severity, this finding raises the possibility that the observed magnitude of studied effects may be better elucidated when examined in groups of women with either hazardous/harmful drinking or AUD, rather than combined. ...
... We elected to examine the direct link between depression and alcohol self-stigma given that depression has been implicated in drinking to cope and the development of alcohol problems in women (e.g., Crum et al., 2013;Holahan et al., 2003), including in women with a history of SAV (Brockdorf et al., 2021;Lindgren et al., 2012;Ullman et al., 2013). Moreover, recent research suggests that depression is more strongly associated with alcohol self-stigma than PTSD among women with substance use disorders (Melchior et al., 2019), and some research suggests depressive rather than PTSD symptoms may more proximally associate with alcohol use among survivors of SAV (Creech & Borsari, 2014;Kelley et al., 2013). Nonetheless, in our sample PTSD accounted for the vast majority of variance in depression symptoms, consistent with evidence of high comorbidity and overlap between these clinical syndromes among survivors of SAV (Langdon et al., 2016). ...
Background
Depression is strongly implicated in drinking to cope and the development of alcohol use disorders (AUD) in women, particularly among women with a history of sexual assault victimization (SAV). Alcohol use in women is heavily stigmatized, and substance use stigma is associated with depression. This study examined the link between internalized alcohol stigma (AS) and depression and tested whether self-compassion buffered (i.e., moderated) this association in a sample of women with a history of SAV and unhealthy drinking to cope.
Method
Women sexual assault survivors (N=288; 82% White, 91.2% Non-Hispanic, 20.2% sexual minority) reporting unhealthy drinking (Alcohol Use Disorders Inventory Test-C≥4) and drinking to cope (Drinking Coping Motives Questionnaire-Revised≥2) completed online self-report surveys. Hierarchical regression analyses tested associations between internalized-AS and self-compassion with depression after controlling for covariates (age, income, education, AUD symptoms, and posttraumatic stress disorder) and then, whether self-compassion moderated the Internalized-AS and depression link.
Results
Internalized-AS accounted for 1.4% of variance in depression (p<.01); self-compassion accounted for added variance when subsequently modeled (8.2%, p<.001). Moderation analyses revealed self-compassion to buffer the internalized-AS and depression link. Among participants reporting high levels of self-compassion, there was no association between internalized-AS and depression (p=.894).
Discussion
While findings are modest, they align with the previously observed link between internalized-AS and depression and extend these findings to women with a history of SAV endorsing elevated coping motives and unhealthy drinking. Self-compassion may protect against this link, pending further research sampling greater diversity of participants and longitudinal and controlled designs.
... The variables of mental health (the temptation to use drugs, depression, anxiety, and life quality) in connection with persons who use drugs (PWUDs) have the strongest relationship with self-stigma (7). Although there are a number of stigmas attached to PWUDs, all people dealing with substance abuse do not experience the same number of stigmas (8). The results of the study conducted by Stringer showed that married parents suffer from the highest level of self-stigma, and the family member of PWUDs suffer from the greatest mental pressure exerted by stigma (9). ...
Background
Substance use disorder (SUD) and its related problems take a toll on the individual, family, and society. This study was conducted to determine the psychometric properties of the self-stigma scale in the families of persons who use drugs (PWUDs) in Iran.
Methods
This was a methodological and psychometric study. The study population consisted of 311 family members of PWUDs visiting outpatient and inpatient addiction treatment centers in Kermanshah who were selected using convenience sampling. The 14-item Self-Stigma Inventory for Families (SSI-F), which was developed by Yildiz et al. in 2019 using interviews and scales connected with stigma, was applied. The ten steps developed by Wilde et al. were used in this study for cultural validation. The exploratory factor analysis (EFA) (140 samples) and confirmatory factor analysis (CFA) (311 subjects) were used to confirm the construct validity, and the test-retest method was used to confirm the reliability of the tools. Cronbach's alpha was also used to test the internal consistency of the tools.
Findings
The results of EFA and CFA scales in families of PWUDs were confirmed with three factors and 14 items. The reliability degree of the tools was confirmed as 0.891 and the Cronbach's alpha was confirmed as 0.879 using the test-retest method. Pearson's correlation coefficient indicated a positive and significant status between the scale's items/factors and the scale itself.
Conclusion
Generally, the results showed that the PWUDs SSI-F scale in Iranian families was valid and reliable with three factors and 14 items, and it can be used to conduct relevant studies.
... Research has shown that female intoxication and addiction are policed more harshly (Dragišić Labaš, 2016;Eldridge, 2010). This is also mirrored in higher self-stigmatization among women with alcohol dependence in comparison to men (Melchior et al., 2019;Moore et al., 2020). When it comes to women and pregnancy, public stigma is particularly intense (Corrigan et al., 2018). ...
Qualitative research methods, primarily interviews, have become more common in the field of addiction research. Other data sources were often neglected, although sources such as social media can offer insights into the realities of people, since social media also plays a relevant role in today's living environments. This article examines the use of online forums as an underutilized data source in contrast to telephone interviews, to identify methodological opportunities and challenges. We analyzed nine discussion threads and seven interviews about ‘alcohol consumption during pregnancy’. Discursive comparison of the results was performed with a focus on sampling issues, comparability and risks for participants and researchers. Key issues were present in both data sources. People with different opinions were openly hostile in forums, while tolerance was more often expressed in interviews. The interviews showed a rather mild communication style, which could be attributed to social desirability. In the forum discussions, the participants often expressed themselves very directly. To comprehensively grasp the subject matter of the research, it is important to recognize the types of communication promoted by different data sources. These results have implications for research about female substance use. Knowledge of the issues will bestow a valuable contribution to researchers working in the field of substance use to help develop appropriate research approaches, as they engage in research into this highly stigmatized and controversial area.
