Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany,
Center for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany,
Eur Addict Res. 2019;25(1):20-29. doi: 10.1159/000496113. Epub 2019 Jan 9.
Self-stigma is a result of internalizing negative stereotypes by the affected person. Research on self-stigma in substance use disorders (SUD) is still scarce, especially regarding the role of childhood trauma and subsequent posttraumatic disorders.
The present study investigated the progressive model of self-stigma in women with SUD and posttraumatic stress disorder (PTSD), and the predictive value of PTSD severity and childhood trauma experiences on self-stigma.
In a cross-sectional study with 343 women with SUD and PTSD, we used the Self-Stigma in Alcohol Dependency Scale, the Childhood Trauma Questionnaire (CTQ), the PTSD Symptom Scale Interview (PSS-I), and to control for SUD severity and depression, the Addiction Severity Index Lite and the Beck Depression Inventory-II. Hierarchical regression analyses were conducted for each stage of self-stigma (aware-agree-apply-harm).
The interrelated successive stages of self-stigma were largely confirmed. In the regression models, no significant effects of the PSS-I- and the CTQ-scores were observed at any stage of self-stigma. Agreeing with negative stereotypes was solely predicted by younger age, applying these stereotypes to oneself was higher in women with younger age, higher depression and SUD severity, and suffering from the application (harm) was only predicted by depression.
The progressive model of self-stigma could be confirmed in women with SUD and PTSD, but PTSD severity and childhood trauma did not directly affect this process. Self-stigma appears to be related to depression in a stronger way than PTSD is related to women with SUD and PTSD.
自我污名是受影响者内化负面刻板印象的结果。物质使用障碍(SUD)中的自我污名研究仍然很少,特别是关于童年创伤和随后的创伤后障碍的作用。
本研究调查了 SUD 和创伤后应激障碍(PTSD)女性自我污名的渐进模型,以及 PTSD 严重程度和童年创伤经历对自我污名的预测价值。
在一项横断面研究中,共纳入 343 名 SUD 和 PTSD 女性,使用酒精依赖自我污名量表、童年创伤问卷(CTQ)、创伤后应激障碍症状量表访谈(PSS-I),为了控制 SUD 严重程度和抑郁,使用成瘾严重程度指数精简版和贝克抑郁量表-II。对自我污名的每个阶段(意识到-同意-应用-伤害)进行分层回归分析。
自我污名的相互关联的连续阶段在很大程度上得到了证实。在回归模型中,PSS-I 和 CTQ 评分在自我污名的任何阶段都没有显著影响。同意负面刻板印象仅由年龄较小预测,将这些刻板印象应用于自己是年龄较小、抑郁和 SUD 严重程度较高的女性,遭受应用(伤害)仅由抑郁预测。
在 SUD 和 PTSD 女性中,可以证实自我污名的渐进模型,但 PTSD 严重程度和童年创伤并没有直接影响这个过程。自我污名与抑郁的关系比 PTSD 与 SUD 和 PTSD 女性的关系更为密切。