Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, United States.
Int J Drug Policy. 2010 May;21(3):202-7. doi: 10.1016/j.drugpo.2009.10.010. Epub 2009 Dec 14.
Stigma is a frequently cited barrier to help-seeking for many with substance-related conditions. Common ways of describing individuals with such problems may perpetuate or diminish stigmatizing attitudes yet little research exists to inform this debate. We sought to determine whether referring to an individual as "a substance abuser" vs. "having a substance use disorder" evokes different judgments about behavioral self-regulation, social threat, and treatment vs. punishment.
A randomized, between-subjects, cross-sectional design was utilized. Participants were asked to read a vignette containing one of the two terms and to rate their agreement with a number of related statements. Clinicians (N=516) attending two mental health conferences (63% female, 81% white, M age 51; 65% doctoral-level) completed the study (71% response rate). A Likert-scaled questionnaire with three subscales ["perpetrator-punishment" (alpha=.80); "social threat" (alpha=.86); "victim-treatment" (alpha=.64)] assessed the perceived causes of the problem, whether the character was a social threat, able to regulate substance use, and should receive therapeutic vs. punitive action.
No differences were detected between groups on the social threat or victim-treatment subscales. However, a difference was detected on the perpetrator-punishment scale. Compared to those in the "substance use disorder" condition, those in the "substance abuser" condition agreed more with the notion that the character was personally culpable and that punitive measures should be taken.
Even among highly trained mental health professionals, exposure to these two commonly used terms evokes systematically different judgments. The commonly used "substance abuser" term may perpetuate stigmatizing attitudes.
污名是许多与物质相关的疾病患者寻求帮助的常见障碍。描述有此类问题的个体的常见方式可能会延续或减少污名化态度，但几乎没有研究可以为此类辩论提供信息。我们试图确定将个体称为“滥用药物者”与“患有物质使用障碍”是否会引起对行为自我调节、社会威胁以及治疗与惩罚的不同判断。
采用随机、受试者间、横断面设计。要求参与者阅读包含两个术语之一的小插曲，并对与许多相关陈述的一致程度进行评分。参加两个心理健康会议的临床医生（N=516；女性占 63%，白人占 81%，平均年龄为 51 岁；65%为博士学位）完成了这项研究（响应率为 71%）。一个由三个子量表组成的李克特量表问卷评估了问题的原因、该人物是否构成社会威胁、是否能够调节物质使用以及应该接受治疗性还是惩罚性措施：“施害者-惩罚”（alpha=.80）；“社会威胁”（alpha=.86）；“受害者-治疗”（alpha=.64）。
在社会威胁或受害者治疗子量表上，两组之间没有差异。然而，在施害者-惩罚量表上存在差异。与“物质使用障碍”条件下的参与者相比，“滥用药物者”条件下的参与者更同意该人物有个人责任并且应该采取惩罚性措施的观点。
即使是在受过高度训练的心理健康专业人员中，接触这两个常用术语也会引起系统地不同的判断。常用的“滥用药物者”术语可能会延续污名化态度。
