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Spata A, Gupta I, Lear MK, Lunze K, Luoma JB. Substance use stigma: A systematic review of measures and their psychometric properties. DRUG AND ALCOHOL DEPENDENCE REPORTS 2024; 11:100237. [PMID: 38779475 PMCID: PMC11108807 DOI: 10.1016/j.dadr.2024.100237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 03/27/2024] [Accepted: 04/24/2024] [Indexed: 05/25/2024]
Abstract
Background Instruments to measure substance use stigma are emerging, however little is known regarding their psychometric properties. While research has evolved to view substance use stigma as a context sensitive international phenomenon that is embedded within cultures, validated self-report measures are lacking and comprehensive reviews of the existing measures are extremely limited. In this systematic review of substance use stigma and shame measures, we aim to contextualize results from existing research, lay the groundwork for future measurement development research, and provide a thorough resource for research scientists currently designing studies to measure substance use stigma. Methods We searched three databases using Boolean search terms for psychometric evaluations of measures of substance use stigma and shame and evaluated the quality/psychometric properties using an adaptation of the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) systematic review guidelines. Results We identified 18 measures of substance use stigma. Overall, most measures had minimal psychometric assessments and none of the measures met all domains of the COSMIN measure quality criteria. However, most studies reported satisfactory factor analyses and internal consistency scores. Conclusions Most measures of substance use stigma and shame had psychometric assessment across a limited range of criteria and no measures of structural substance use stigma were found. The most reported psychometric properties were structural validity and convergent validity. We suggest future researchers investigate test-retest reliability and cross-cultural validity for existing substance use stigma measures, as well as develop and evaluate novel measures assessing structural stigma of substance use.
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Affiliation(s)
- Angelica Spata
- Portland Psychotherapy Clinic, Research, and Training Center, Portland, OR, USA
| | - Ishita Gupta
- Dr. Rajendra Prasad Governmental Medical College, Tanda, India
| | - M. Kati Lear
- Portland Psychotherapy Clinic, Research, and Training Center, Portland, OR, USA
| | - Karsten Lunze
- Boston University Aram V. Chobanian & Edward Avedisian School of Medicine, Boston, MA, USA
| | - Jason B. Luoma
- Portland Psychotherapy Clinic, Research, and Training Center, Portland, OR, USA
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Hao Y, Wu Q, Wang X, Ma Y, Wang Y, Peng P, Wang X, Yang Q, Liu Y, Li M, He L, Wang Q, Zhou Y, Liu T, Chen S. Stigmatizing attitudes toward mental illness among caregivers of patients with mental disorders in China. Front Public Health 2023; 11:1071954. [PMID: 37427283 PMCID: PMC10325790 DOI: 10.3389/fpubh.2023.1071954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 03/22/2023] [Indexed: 07/11/2023] Open
Abstract
Objective This study aimed to investigate stigmatizing attitudes toward depression, schizophrenia, and general anxiety disorder (GAD) among caregivers of patients with mental disorders in China. Methods A cross-sectional study was conducted among 607 caregivers in China, using vignettes that described three mental illnesses. Data on the caregivers' attitudes and other people's attitudes toward individuals with mental disorders and their willingness to come in contact with people with mental disorders were collected. Results In the three vignettes, caregivers agreed that positive outcomes outnumbered negative outcomes. The top two statements endorsing the stigma were "the person could snap out of the problem" and "people with this problem are dangerous." In the section for perceived stigma, caregivers in the GAD vignette agreed that most people believed this problem is not a real medical illness, compared to schizophrenia. The rates of the statement endorsing unpredictability were significantly different in the schizophrenia (57.2%) and depression (45.5%) vignette, in comparison to the GAD (45.6%) vignette. For personal stigma, the caregivers tended to avoid people described in the depression vignette more often than in the GAD vignette. The caregivers were most unwilling to let the person described in the vignettes marry into their family, especially in the schizophrenia vignette. Conclusion Despite the stigma and desire for social distance associated with schizophrenia, depression, and GAD, caregivers often expect positive outcomes. Actions should be taken to improve caregivers' knowledge about mental health and reduce the stigma.
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Affiliation(s)
- Yuzhu Hao
- National Clinical Research Center on Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Qiuxia Wu
- National Clinical Research Center on Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xuyi Wang
- National Clinical Research Center on Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yuejiao Ma
- National Clinical Research Center on Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yunfei Wang
- National Clinical Research Center on Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Pu Peng
- National Clinical Research Center on Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xin Wang
- National Clinical Research Center on Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Qian Yang
- National Clinical Research Center on Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yueheng Liu
- National Clinical Research Center on Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Manyun Li
- National Clinical Research Center on Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Li He
- National Clinical Research Center on Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Qianjin Wang
- National Clinical Research Center on Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yanan Zhou
- National Clinical Research Center on Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
- Department of Psychiatry, Hunan Brain Hospital (Hunan Second People’s Hospital), Changsha, China
| | - Tieqiao Liu
- National Clinical Research Center on Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Shubao Chen
- National Clinical Research Center on Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
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Cuadros DF, Branscum AJ, Moreno CM, MacKinnon NJ. Narrative minireview of the spatial epidemiology of substance use disorder in the United States: Who is at risk and where? World J Clin Cases 2023; 11:2374-2385. [PMID: 37123313 PMCID: PMC10131000 DOI: 10.12998/wjcc.v11.i11.2374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/31/2023] [Accepted: 03/20/2023] [Indexed: 04/06/2023] Open
Abstract
Drug overdose is the leading cause of death by injury in the United States. The incidence of substance use disorder (SUD) in the United States has increased steadily over the past two decades, becoming a major public health problem for the country. The drivers of the SUD epidemic in the United States have changed over time, characterized by an initial heroin outbreak between 1970 and 1999, followed by a painkiller outbreak, and finally by an ongoing synthetic opioid outbreak. The nature and sources of these abused substances reveal striking differences in the socioeconomic and behavioral factors that shape the drug epidemic. Moreover, the geospatial distribution of the SUD epidemic is not homogeneous. The United States has specific locations where vulnerable communities at high risk of SUD are concentrated, reaffirming the multifactorial socioeconomic nature of this epidemic. A better understanding of the SUD epidemic under a spatial epidemiology framework is necessary to determine the factors that have shaped its spread and how these patterns can be used to predict new outbreaks and create effective mitigation policies. This narrative minireview summarizes the current records of the spatial distribution of the SUD epidemic in the United States across different periods, revealing some spatiotemporal patterns that have preceded the occurrence of outbreaks. By analyzing the epidemic of SUD-related deaths, we also describe the epidemic behavior in areas with high incidence of cases. Finally, we describe public health interventions that can be effective for demographic groups, and we discuss future challenges in the study and control of the SUD epidemic in the country.
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Affiliation(s)
- Diego F Cuadros
- Digital Futures, University of Cincinnati, Cincinnati, OH 45206, United States
| | - Adam J Branscum
- Department of Biostatistics, Oregon State University, Corvallis, OR 97331, United States
| | - Claudia M Moreno
- Department of Physiology and Biophysics, University of Washington, Seattle, WA 98195, United States
| | - Neil J MacKinnon
- Department of Population Health Sciences, Augusta University, Augusta, GA 30912, United States
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Chen X, Liao Z, Huang S, Huang Q, Lin S, Li Y, Shao T, Tang Y, Hao J, Qi J, Cai Y, Wang M, Shen H. Stigmatizing Attitudes Toward COVID-19 Among Patients, Their Relatives and Healthy Residents in Zhangjiajie. Front Public Health 2022; 10:808461. [PMID: 35719634 PMCID: PMC9201051 DOI: 10.3389/fpubh.2022.808461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 04/25/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction In July 2021, Zhangjiajie City became the new epicenter of the COVID-19 outbreak. Aside from the physical manifestations of COVID-19, patients are also victims of severe social stigmatization. Stigma affects not only COVID-19 patients or survivors, but also individuals associated with them. This study aims to describe and assess the COVID-19-related stigma between patients, their relatives, and healthy local residents. Methods The study included 43 COVID-19 patients, 68 relatives, and 75 healthy residents from Zhangjiajie. Demographic data was collected, including gender, age, marital status, and educational level. Stigma attitudes toward COVID-19 were measured using the Stigma Scale and Social Distance Scale. Frequencies and percentages were described for each item of the scales, and differences among the three groups were examined using the chi-square test. Results With regards to personal and perceived stigma, most participants agreed that patients with COVID-19 "could snap out of the problem" and that "they were dangerous." For social distance, over 30% of participants from the three groups agreed with the item "unwillingness to marry into the family of someone with COVID-19." In all groups, there were significant statistical differences in the belief that "the problem is not a real medical illness" and the desire to "spend the evening socializing." Conclusion Although the outbreak was well-contained in Zhangjiajie, stigmatizing attitudes toward COVID-19 and desire for social distance to such patients were common among patients, their relatives and healthy local residents. Our study's results suggest that public education, anti-stigma interventions, and policies are necessary for people living in Zhangjiajie in order to effectively curtail the spread of COVID-19 and provide a useful strategy for a tourist city like Zhangjiajie to recover sooner from economic decline.
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Affiliation(s)
- Xinxin Chen
- National Clinical Research Center for Mental Disorders and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,Institute of Mental Health of Central South University, Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha, China
| | - Zhenjiang Liao
- National Clinical Research Center for Mental Disorders and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,Institute of Mental Health of Central South University, Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha, China
| | - Shucai Huang
- Department of Psychiatry, The Fourth People's Hospital of Wuhu, Wuhu, China
| | - Qiuping Huang
- National Clinical Research Center for Mental Disorders and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,Institute of Mental Health of Central South University, Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha, China
| | - Shuhong Lin
- National Clinical Research Center for Mental Disorders and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,Institute of Mental Health of Central South University, Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha, China
| | - Yifan Li
- National Clinical Research Center for Mental Disorders and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,Institute of Mental Health of Central South University, Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha, China
| | - Tianli Shao
- Department of Psychiatry, Comorbid Somatic Diseases, Kangning Hospital of Shenzhen, Shenzhen, China
| | - Ying Tang
- National Clinical Research Center for Mental Disorders and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,Institute of Mental Health of Central South University, Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha, China
| | - Jingyue Hao
- National Clinical Research Center for Mental Disorders and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,Institute of Mental Health of Central South University, Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha, China
| | - Jing Qi
- Department of Psychiatry, Brain Hospital of Hunan Province, Changsha, China
| | - Yi Cai
- Department of Psychiatry, Comorbid Somatic Diseases, Kangning Hospital of Shenzhen, Shenzhen, China
| | - Mingming Wang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China.,Zhangjiajie People's Hospital Designated for COVID-19 Treatment, Zhangjiajie, China
| | - Hongxian Shen
- National Clinical Research Center for Mental Disorders and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,Institute of Mental Health of Central South University, Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha, China.,Zhangjiajie People's Hospital Designated for COVID-19 Treatment, Zhangjiajie, China
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Cheung M, Leung P, Chen W, Gearing RE, Brewer KB, Chen X, Li X, He X. Public stigma on substance users in China. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.1953163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Monit Cheung
- Graduate College of Social Work, University of Houston, Houston, Texas, USA
| | - Patrick Leung
- Graduate College of Social Work, University of Houston, Houston, Texas, USA
| | - Wanzhen Chen
- School of Social and Public Administration, East China University of Science & Technology, Shanghai, China
| | - Robin E. Gearing
- Graduate College of Social Work, University of Houston, Houston, Texas, USA
| | - Kathryne B. Brewer
- Department of Social Work, University of New Hampshire, Durham, New Hampshire, USA
| | - Xin Chen
- School of Social Sciences, Soochow University, Suzhou, China
| | - Xiao Li
- School of Social and Public Administration, East China University of Science & Technology, Shanghai, China
| | - Xuesong He
- School of Social and Public Administration, East China University of Science & Technology, Shanghai, China
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Chang CC, Chang KC, Hou WL, Yen CF, Lin CY, Potenza MN. Measurement invariance and psychometric properties of Perceived Stigma toward People who use Substances (PSPS) among three types of substance use disorders: Heroin, amphetamine, and alcohol. Drug Alcohol Depend 2020; 216:108319. [PMID: 33027709 DOI: 10.1016/j.drugalcdep.2020.108319] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 09/17/2020] [Accepted: 09/20/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The 8-item self-report Perceived Stigma toward Substance Users Scale (PSAS) is a commonly used instrument to assess stigma for people with substance use disorders. This study aimed to develop and validate the Taiwan version of the PSAS entitled Perceived Stigma toward People who use Substances - Taiwan version (PSPS-TV) among individuals with substance use disorders. METHODS Patients with substance use disorders (N = 300; mean age = 45.22; 255 males) completed the PSPS-TV, Self-Stigma Scale-Short (SSS-S), Taiwan Depression Questionnaire (TDQ), and Rosenberg Self-Esteem Scale (RSES). Confirmatory factor analysis was used to test the construct validity and the measurement invariance of the PSPS-TV. Concurrent validity was tested using the correlations between PSPS-TV and SSS-S, TDQ, and RSES scores. RESULTS The confirmatory factor analysis supported the construct validity and measurement invariance of the PSPS-TV. SSS-S scores explained 13 %, TDQ scores explained 10 % and RSES scores explained 17 % of the PSPS-TV score variance with moderate standardized coefficients (0.38, 0.32 and -0.42, respectively; all p < 0.001). CONCLUSIONS The PSPS-TV is an appropriate instrument to assess perceived stigma for individuals residing in Taiwan who have substance use disorders. Taiwan healthcare providers may thus consider using the PSPS-TV to assess perceived stigma relating to substance use in Taiwan.
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Affiliation(s)
- Chih-Cheng Chang
- Department of Psychiatry, Chi Mei Medical Center, Tainan, Taiwan; Department of Health Psychology, Chang Jung Christian University, Tainan, Taiwan
| | - Kun-Chia Chang
- Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan; Department of Natural Biotechnology, NanHua University, Chiayi, 622, Taiwan
| | - Wen-Li Hou
- College of Nursing, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, 80756, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, 80708, Taiwan; Department of Psychiatry, School of Medicine, and Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
| | - Marc N Potenza
- Departments of Psychiatry and Neuroscience and the Child Study Center, School of Medicine, Yale University, New Haven, CT, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA; Connecticut Mental Health Center, New Haven, CT, USA
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