Department of Psychiatry and Psychotherapy, Medical Faculty, University of Leipzig, Leipzig, Germany.
Department of Psychiatry and Psychotherapy, Medical Center, University of Leipzig, Leipzig, Germany.
BMC Psychiatry. 2024 Oct 25;24(1):735. doi: 10.1186/s12888-024-06187-z.
Self-stigma is associated with low self-esteem, high shame and reduced drinking-refusal self-efficacy in people with alcohol use disorder (AUD). The Self-Stigma in Alcohol-Dependence Scale-Short Form (SSAD-SF) was designed to enable a brief, but valid assessment of AUD self-stigma.
We reduced the 64-item SSAD, originally derived from 16 stereotypes towards people with AUD, by removing the most offensive items based on perspectives of people with lived experience. The newly created scale was then assessed and validated in a cross-sectional study involving 156 people reporting alcohol issues in various treatment settings.
The 20-item SSAD-SF includes five stereotypes, with good internal consistency for each subscale and the overall scale. It reflects the four-stage progressive model of self-stigmatization with decreasing scores over the stages awareness of stereotypes, agreement with stereotypes, self-application of stereotypes, and harmful consequences for self-esteem, and highest correlations between adjacent stages. The subscales apply and harm were associated with internalized stigma, shame, reduced self-esteem, and lower drinking-refusal self-efficacy, as supported by multivariate regression models.
The SSAD-SF is a valid instrument for measuring the process of self-stigmatization in people with AUD. Self-stigma is a consistent predictor of reduced self-esteem, higher shame and lower drinking-refusal self-efficacy in people with AUD. We discuss merits of the progressive model for understanding and addressing self-stigma in AUD.
自我污名与酒精使用障碍（AUD）患者的自尊心低、羞耻感高和拒绝饮酒的自我效能感降低有关。《酒精依赖自我污名量表-短版》（SSAD-SF）旨在通过评估 AUD 患者的自我污名情况，提供一种简短而有效的评估方法。
我们从最初的 16 种针对 AUD 患者的刻板印象中删除了最冒犯的项目，基于有过实际经验的患者的观点，对 64 项 SSAD 进行了简化。然后，在一项涉及各种治疗环境中报告有饮酒问题的 156 人的横断面研究中，对新创建的量表进行了评估和验证。
20 项 SSAD-SF 包括五个刻板印象，每个子量表和总体量表的内部一致性都很好。它反映了自我污名化的四阶段渐进模型，随着阶段的进展，分数逐渐降低，依次为：意识到刻板印象、同意刻板印象、将刻板印象应用于自身、以及对自尊心产生的有害后果，相邻阶段之间的相关性最高。应用和伤害子量表与内化污名、羞耻感、自尊心降低以及拒绝饮酒的自我效能感降低有关，这得到了多元回归模型的支持。
SSAD-SF 是一种有效的工具，可用于测量 AUD 患者自我污名化的过程。自我污名化是 AUD 患者自尊心降低、羞耻感升高和拒绝饮酒的自我效能感降低的一致预测因素。我们讨论了渐进模型在理解和解决 AUD 中的自我污名方面的优点。
