Luoma Jason B, Kulesza Magdalena, Hayes Steven C, Kohlenberg Barbara, Larimer Mary
Portland Psychotherapy Clinic, Research, & Training Center , Portland, OR .
Am J Drug Alcohol Abuse. 2014 May;40(3):206-12. doi: 10.3109/00952990.2014.901337.
Stigma has been suggested as a possible contributor to the high rates of treatment attrition in substance-dependent individuals, but no published empirical studies have examined this association.
The present paper assessed the relationship between baseline stigma variables and length of treatment stay in a sample of patients in a residential addictions treatment unit.
The relationship between baseline stigma variables (self-stigma, enacted stigma, and shame) and length of stay for participants (n=103) in a residential addictions treatment unit was examined.
Higher self-stigma predicted longer stay in residential addictions treatment, even after controlling for age, marital status, race, overall mental health, social support, enacted stigma, and internalized shame. However, other stigma variables (i.e. internalized shame, stigma-related rejection) did not reliably predict length of treatment stay.
These results are consistent with other findings suggesting that people with higher self-stigma may have a lowered sense of self-efficacy and heightened fear of being stigmatized and therefore retreat into more protected settings such as residential treatment, potentially resulting in higher treatment costs. Specialized clinical interventions may be necessary to help participants cope with reduced self-efficacy and fear of being stigmatized.
耻辱感被认为可能是导致物质依赖个体治疗中断率高的一个因素，但尚无已发表的实证研究探讨这种关联。
本文评估了一家住院成瘾治疗机构中患者样本的基线耻辱感变量与治疗停留时间之间的关系。
研究了一家住院成瘾治疗机构中参与者（n = 103）的基线耻辱感变量（自我耻辱感、实际耻辱感和羞耻感）与停留时间之间的关系。
即使在控制了年龄、婚姻状况、种族、总体心理健康、社会支持、实际耻辱感和内化羞耻感之后，较高的自我耻辱感仍预示着在住院成瘾治疗中的停留时间更长。然而，其他耻辱感变量（即内化羞耻感、与耻辱感相关的排斥）并不能可靠地预测治疗停留时间。
这些结果与其他研究结果一致，表明自我耻辱感较高的人可能自我效能感较低，且对被污名化的恐惧加剧，因此会退缩到更受保护的环境中，如住院治疗，这可能导致更高的治疗成本。可能需要专门的临床干预措施来帮助参与者应对自我效能感降低和对被污名化的恐惧。
