Graduate Institute of Social Work, National Taiwan Normal University, No. 162, Sec. 1, He-Ping East Rd., Daan Dist., Taipei 106209 Taiwan.
Department of Medical Research, E-Da Hospital, I-Shou University, No.1, Yida Rd., Yanchao Dist., Kaohsiung 824005, Taiwan.
Addict Behav. 2023 Dec;147:107807. doi: 10.1016/j.addbeh.2023.107807. Epub 2023 Jul 22.
Guided by the Interaction of Person-Affect-Cognition-Execution (I-PACE) model and a self-stigma framework, this study aimed to investigate relationships between cognitive and affective self-stigma and behavioral self-stigma, problematic use of internet (PUI), and problematic smartphone use (PSU) among people with substance use disorders (SUDs). It also examined mediating roles for affective self-stigma in the relationships between cognitive self-stigma and behavioral self-stigma/PUI/PSU.
Using a cross-sectional design, 530 participants diagnosed with SUDs in Taiwan were recruited from a psychiatric center in Taiwan. Mediation models were investigated using the Hayes' Process Macro Model 4.
Mediation analyses indicated that cognitive self-stigma was directly associated with behavioral self-stigma (p < 0.001), but not with either types of PUI or PSU (p-values ranging from 0.41 to 0.76). Affective self-stigma was directly related to behavioral self-stigma (p < 0.001), two types of PUI, and PSU (β = 0.24-0.30; all p < 0.001); cognitive self-stigma was indirectly associated with behavioral self-stigma (β = 0.53; 95 % bootstrapping CI = 0.46, 0.60), two types of PUI, and PSU (β = 0.20-0.25; 95 % bootstrapping CI = 0.08-0.14, 0.31-0.37) via a mediating effect of affective self-stigma.
Findings support the I-PACE model in a self-stigma context. The findings also suggest that addressing affective self-stigma may help prevent or reduce behavioral self-stigma, PUI, and PSU among people with SUDs. Longitudinal studies are warranted to investigate over time relationships between self-stigma and PUI/PSU in people with SUDs.
本研究以互动的人-情感-认知-执行（I-PACE）模型和自我污名化为理论框架，旨在探讨物质使用障碍（SUD）患者认知和情感自我污名与行为自我污名、互联网使用问题（PUI）和智能手机使用问题（PSU）之间的关系。还检验了情感自我污名在认知自我污名与行为自我污名/PUI/PSU 之间关系中的中介作用。
采用横断面设计，从台湾的一家精神科中心招募了 530 名被诊断为 SUD 的参与者。使用 Hayes 的 Process Macro Model 4 模型分析了中介模型。
中介分析表明，认知自我污名与行为自我污名直接相关（p<0.001），但与任何类型的 PUI 或 PSU 无关（p 值范围为 0.41 至 0.76）。情感自我污名与行为自我污名（p<0.001）、两种类型的 PUI 和 PSU 直接相关（β=0.24-0.30；均 p<0.001）；认知自我污名通过情感自我污名的中介作用间接与行为自我污名（β=0.53；95%bootstrap CI=0.46，0.60）、两种类型的 PUI 和 PSU 相关（β=0.20-0.25；95%bootstrap CI=0.08-0.14，0.31-0.37）。
研究结果支持自我污名情境下的 I-PACE 模型。研究结果还表明，解决情感自我污名可能有助于预防或减少 SUD 患者的行为自我污名、PUI 和 PSU。需要进行纵向研究，以调查 SUD 患者自我污名与 PUI/PSU 之间的随时间变化关系。
