Department of Psychology, Princeton University, Princeton, New Jersey.
Department of Psychiatry, Weill Cornell Medical College, New York, New York.
Am J Addict. 2020 Jul;29(4):305-312. doi: 10.1111/ajad.13023. Epub 2020 Mar 18.
Addiction is increasingly considered a chronic, relapsing brain disease; however, many scholars still disagree with the brain disease model of addiction. We set out to provide evidence of attorneys' and physicians' beliefs regarding the model. First, we asked the following question: do attorneys and physicians affirm the full brain disease model, or its modified form, or do they believe that addiction is driven by deficits in self-control or moral weakness? Second, we evaluated the extent to which such beliefs correspond to attitudes toward individuals with substance use disorders (SUDs).
A questionnaire was sent to resident physicians (N = 301) and criminal defense attorneys (N = 483) practicing in the United States. It was comprised of (i) an attitudes measure, (ii) a measure regarding conceptions of addiction, and (iii) demographic questions.
Attorneys were more likely to believe that individuals with SUDs had "practically no choice" about whether to seek and use, whereas physicians were more likely to believe that such individuals had "genuine choice." For both groups of participants, the rejection of the full brain disease model of addiction was associated with more negative attitudes toward individuals with SUDs.
These results represent an important advance, as past research has neglected attorneys' attitudes and is inconclusive regarding the manner in which beliefs about the brain disease model of addiction are related to attitudes toward individuals with SUDs. Educating practitioners regarding this relationship would raise awareness regarding when and to what extent stigma is likely to be present, which may in turn provide a foundation from which to address stigma. (Am J Addict 2020;00:00-00).
成瘾被越来越多地认为是一种慢性、复发性的脑部疾病;然而,许多学者仍然不同意成瘾的脑部疾病模型。我们旨在提供律师和医生对该模型的信念证据。首先,我们提出以下问题:律师和医生是否肯定完整的脑部疾病模型,或者其修正形式,或者他们是否认为成瘾是由自我控制或道德弱点的缺陷驱动的?其次,我们评估了这些信念与对患有物质使用障碍(SUD)的个体的态度之间的关联程度。
向在美国执业的住院医师(N=301)和刑事辩护律师(N=483)发送了一份问卷。问卷包括(i)态度量表,(ii)成瘾概念量表,和(iii)人口统计学问题。
律师更倾向于认为患有 SUD 的个体在是否寻求和使用方面“几乎没有选择”,而医生更倾向于认为这些个体有“真正的选择”。对于两组参与者来说,拒绝成瘾的完整脑部疾病模型与对患有 SUD 的个体的更负面的态度有关。
这些结果是一个重要的进展,因为过去的研究忽视了律师的态度,并且对于成瘾的脑部疾病模型的信念与对患有 SUD 的个体的态度之间的关联方式没有定论。教育从业者了解这种关系将提高对何时以及在何种程度上可能存在污名的认识,这反过来又可能为解决污名问题提供基础。