Pennington Charlotte R, Monk Rebecca L, Heim Derek, Rose Abigail K, Gough Thomas, Clarke Ross, Knibb Graeme, Patel Roshni, Rai Priya, Ravat Halimah, Ali Ramsha, Anastasiou Georgiana, Asgari Fatemeh, Bate Eve, Bourke Tara, Boyles Jayme, Campbell Alix, Fowler Nic, Hester Sian, Neil Charlotte, McIntyre Beth, Ogilvy Ellie, Renouf Amie, Stafford Joni, Toothill Katie, Wong Hin Kok, Jones Andrew
School of Psychology, College of Health and Life Sciences, Aston University.
Department of Psychology, Edge Hill University.
Psychol Addict Behav. 2023 Sep;37(6):723-733. doi: 10.1037/adb0000919. Epub 2023 May 11.
Problematic substance use is one of the most stigmatized health conditions leading research to examine how the labels and models used to describe it influence public stigma. Two recent studies examine whether beliefs in a disease model of addiction influence public stigma but result in equivocal findings-in line with the mixed-blessings model, Kelly et al. (2021) found that while the label "chronically relapsing brain disease" reduced blame attribution, it decreased prognostic optimism and increased perceived danger and need for continued care; however, Rundle et al. (2021) conclude absence of evidence. This study isolates the different factors used in these two studies to assess whether health condition (drug use vs. health concern), etiological label (brain disease vs. problem), and attributional judgment (low vs. high treatment stability) influence public stigma toward problematic substance use.
Overall, 1,613 participants were assigned randomly to one of the eight vignette conditions that manipulated these factors. They completed self-report measures of discrete and general public stigma and an indirect measure of discrimination.
Greater social distance, danger, and public stigma but lower blame were ascribed to drug use relative to a health concern. Greater (genetic) blame was reported when drug use was labeled as a "chronically relapsing brain disease" relative to a "problem." Findings for attributional judgment were either inconclusive or statistically equivalent.
The labels used to describe problematic substance use appear to impact discrete elements of stigma. We suggest that addiction is a functional attribution, which may explain the mixed literature on the impact of etiological labels on stigma to date. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
问题性物质使用是最受污名化的健康状况之一，这促使研究去考察用于描述它的标签和模型如何影响公众污名。最近的两项研究探讨了成瘾疾病模型的信念是否会影响公众污名，但结果并不明确——与利弊共存模型一致，凯利等人（2021年）发现，虽然“慢性复发性脑病”这一标签减少了责备归因，但它降低了预后乐观度，增加了感知到的危险和对持续护理的需求；然而，朗德尔等人（2021年）得出了缺乏证据的结论。本研究分离了这两项研究中使用的不同因素，以评估健康状况（药物使用与健康问题）、病因标签（脑部疾病与问题）和归因判断（低治疗稳定性与高治疗稳定性）是否会影响公众对问题性物质使用的污名。
总体而言，1613名参与者被随机分配到操纵这些因素的八个 vignette 条件之一。他们完成了离散和一般公众污名的自我报告测量以及歧视的间接测量。
与健康问题相比，药物使用被赋予了更大的社会距离、更大的危险性和公众污名，但责备程度更低。当药物使用被标记为“慢性复发性脑病”而非“问题”时，报告的（基因）责备更大。归因判断的结果要么没有定论，要么在统计学上相当。
用于描述问题性物质使用的标签似乎会影响污名的不同要素。我们认为成瘾是一种功能性归因，这可能解释了迄今为止关于病因标签对污名影响的文献存在分歧的原因。（PsycInfo 数据库记录（c）2023 美国心理学会，保留所有权利）
