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Self-stigma in alcohol dependence: consequences for drinking-refusal self-efficacy.

Georg Schomerus1, Patrick W Corrigan, Thomas Klauer

  • 1Department of Psychiatry, Ernst-Moritz-Arndt University Greifswald, Rostocker Chaussee 70, 18437 Stralsund, Germany. georg.schomerus@uni-greifswald.de

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Self-stigma, the internalization of negative stereotypes, was measured in alcohol dependence using the Self-Stigma in Alcohol Dependence Scale (SSAD). Findings indicate self-stigma is linked to reduced self-efficacy in refusing alcohol.

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Area of Science:

  • Psychiatry and Behavioral Sciences
  • Clinical Psychology
  • Addiction Medicine

Background:

  • Self-stigma, internalizing negative perceptions, is a facet of mental illness stigma.
  • It is known to decrease self-efficacy in general.
  • Self-stigma has not been previously examined in individuals with alcohol dependence, a highly stigmatized condition.

Purpose of the Study:

  • To develop and validate the Self-Stigma in Alcohol Dependence Scale (SSAD).
  • To examine the stages and correlates of self-stigma in patients with alcohol dependence.
  • To investigate the relationship between self-stigma and drinking-refusal self-efficacy.

Main Methods:

  • Developed the SSAD based on the Self-Stigma in Mental Illness Scale (SSMI) and focus groups.
  • The SSAD comprises four subscales measuring stereotype awareness, agreement, self-concurrence, and self-esteem decrement.
  • Administered the SSAD to 153 hospitalized patients undergoing alcohol detoxification to assess reliability and validity.

Main Results:

  • The SSAD demonstrated good reliability (Cronbach's alpha, 0.86-0.93) and validity.
  • The four stages of self-stigma were reliably measured and sequentially associated.
  • Self-stigma stages (agreement, self-concurrence, harm) were linked to desire for social distance, drinking problem duration, and depressive symptoms.
  • Both self-concurrence and self-esteem decrement stages were significantly associated with reduced drinking-refusal self-efficacy, even after controlling for covariates.

Conclusions:

  • The SSAD is a valid and reliable measure for assessing self-stigma stages in individuals with alcohol dependence.
  • Self-stigma is significantly associated with diminished self-efficacy in refusing alcohol.
  • These findings highlight the impact of internalized stigma on recovery efforts in alcohol dependence.