Identifying Stigma Phenotypes in Social Media Narratives of Substance Use: Observational Study

Area of Science:

• Social Science
• Public Health
• Digital Humanities

Background:

• Substance use disorders are associated with significant social stigma.
• Understanding specific contexts and manifestations of stigma (stigma phenotypes) is crucial for developing effective interventions.

Purpose of the Study:

• To identify stigma phenotypes within social media narratives concerning substance use.
• To analyze the similarities and differences among these phenotypes using a social ecological framework.

Main Methods:

• Analysis of Reddit posts related to alcohol, cannabis, and opioid use.
• Application of machine learning and content analysis to extract stigma phenotypes based on mechanism, substance, setting, and actors.
• Statistical analysis to compare phenotypes across social ecological factors.

Main Results:

• Seven distinct stigma phenotypes were identified, categorized into internalized, anticipated, enacted, and mixed types.
• Internalized stigma phenotypes focused on self-perception, while enacted stigma phenotypes involved specific social actors and settings.
• Anticipated stigma phenotypes showed a high prevalence of opioid use and healthcare setting references.
• Mixed-stigma phenotypes frequently involved family and home settings, with multiple stigma mechanisms.

Conclusions:

• The identified stigma phenotypes offer a nuanced understanding of substance use stigma.
• These findings support the development of tailored interventions addressing specific phenotypic characteristics and social ecological contexts.