Ghosh Abhishek, Sharma Kshitiz, Sood Arshia, Sharma Babita, George Blessy B
Department of Psychiatry, Drug Deaddiction and Treatment Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Psychiatry, Postgraduate Institute of Medical Education and Research Satellite Centre, Sangrur, Punjab, India.
Indian J Psychiatry. 2025 Jun;67(6):560-573. doi: 10.4103/indianjpsychiatry_149_25. Epub 2025 Jun 11.
People with substance use disorders (PLSUD) face significant stigma, impeding treatment. Psychosocial interventions could reduce stigma, but the underlying mechanisms are unclear.
This review analyzed authors' behavioral explanations supporting stigma-reduction outcomes and explored links between these mechanisms and behavior change.
A search was conducted through PubMed, Google Scholar, and a cross-reference search of the published systematic reviews on PLSUD. Inclusion criteria encompassed clinical trials targeting various populations and employing diverse intervention types. Data extraction and thematic analysis were performed using the Theoretical Domain Framework (TDF) to classify emergent themes and codes. The Behavior Change Wheel (BCW) framework was applied to understand the potential behavior change mechanism.
Of the 670 initially identified studies, 29 met the inclusion criteria. Most were from the US. These studies represented diverse intervention types, including social contact, psychoeducation, and peer support programs. Thematic analysis revealed 17 themes. Key themes included awareness building, social contact, and emotion processing. Awareness-building efforts targeted self-awareness, public perceptions, and societal expectations, while social contact interventions focused on direct interactions and sharing lived experiences. Strategies like mindfulness and meta-cognitive approaches were identified to aid emotion processing and cognitive reappraisal. The themes were categorized into ten TDF domains. "Knowledge" was the most common captured domain. The BCW framework surmised the interrelationship within domains and between domains and capability-motivation-opportunity.
Psychosocial interventions for stigma reduction in PLSUD operate through multifaceted mechanisms. Understanding these mechanisms is crucial for designing effective interventions and addressing the complex dynamics of stigma surrounding SUDs.
物质使用障碍患者面临严重的污名化，这阻碍了治疗。心理社会干预可以减少污名，但潜在机制尚不清楚。
本综述分析了作者支持减少污名化结果的行为解释，并探讨了这些机制与行为改变之间的联系。
通过PubMed、谷歌学术进行检索，并对已发表的关于物质使用障碍的系统综述进行交叉引用检索。纳入标准包括针对不同人群并采用多种干预类型的临床试验。使用理论领域框架（TDF）进行数据提取和主题分析，以对出现的主题和代码进行分类。应用行为改变轮（BCW）框架来理解潜在的行为改变机制。
在最初识别的670项研究中，29项符合纳入标准。大多数来自美国。这些研究代表了多种干预类型，包括社会接触、心理教育和同伴支持项目。主题分析揭示了17个主题。关键主题包括意识培养、社会接触和情绪处理。意识培养工作针对自我意识、公众认知和社会期望，而社会接触干预则侧重于直接互动和分享生活经历。正念和元认知方法等策略被确定有助于情绪处理和认知重新评估。这些主题被归类到十个TDF领域。“知识”是最常涉及的领域。BCW框架推测了各领域内以及各领域与能力-动机-机会之间的相互关系。
针对物质使用障碍患者减少污名化的心理社会干预通过多方面机制发挥作用。理解这些机制对于设计有效的干预措施以及应对围绕物质使用障碍的污名化复杂动态至关重要。
