Preliminary predictors of self-stigma among individuals in a telehealth-based treatment program for alcohol use...

Several facets of substance use self-stigma have been identified, and these constructs may be important within the specific context of alcohol use disorder (AUD) treatment. Gaining a better understanding of self-stigma among individuals who are seeking treatment for AUD may help inform treatment approaches and ultimately could improve treatment to help reduce AUD-related self-stigma.

We recruited 121 participants (52.9% women, 46.3% men) who were primarily White (84.2%) and not Hispanic identifying (90.0%), with a mean age of 44.4 years (SD = 10.3) from a telehealth AUD treatment program. Participants completed an online survey and self-reported demographic information, family history of drinking problems, AUD severity, drinking goals (coded as abstinent or non-abstinent), and three facets of self-stigma (self-devaluation, fear of enacted stigma, and stigma avoidance). Bivariate associations between gender and self-stigma facets were examined via t-tests. Preliminary predictors of each facet of self-stigma were examined using regression analyses. Given mixed prior findings on the association between gender and self-stigma, we also examine interactions of gender with significant predictors of self-stigma.

Women reported higher levels of self-devaluation (p = 0.02) and stigma avoidance (p = 0.02) compared to men. Ordinal logistic regression analyses with Holm correction showed that higher levels of AUD severity predicted greater stigma avoidance (OR = 1.80 [95% CI: 1.23, 2.63], Holm p = 0.021). No other variables were predictive of stigma following correction. Gender did not interact with AUD severity in predicting stigma.

Findings suggest that higher AUD severity is associated with greater stigma avoidance. Consequently, to effectively address self-stigma, telehealth interventions should be tailored to the specific experiences and needs of people with higher AUD severity.