Substance use disorder is one of the most stigmatized health conditions. Stigma internalization is one of the main consequences of the stigmatization process, and it is associated with lower self-esteem and self-efficacy and worse recovery prospects. It may also bring guilt, hopelessness, anxiety, self-devaluation, and depression. This study investigated self-stigma among substance dependents who sought treatment, testing the construction of a psychosocial model for understanding this phenomenon. Individual interviews were conducted at the Psychosocial Care Center for Alcohol and Drugs at Juiz de Fora, Brazil. Data were subjected to exploratory statistical analysis, using descriptive and standard deviation. Three explanatory models of self-stigma were tested: the sociodemographic model, including variables such as gender, religious practice, education, marital status, employment status, and involvement in illicit activities; the psychological model, with variables related to symptoms of depression, self-esteem, and hope; and the psychosocial model, which included all sociodemographic and psychological variables. The sample was composed by 461 individuals. The results supported the hypothesis that the psychosocial model would have greater explanatory power of self-stigma among substance dependents. An association between self-stigma and the sociodemographic variables and the type of substance used was confirmed. Depressive symptoms contributed to higher scores on self-stigma. Stigma may be a barrier to access to health care, treatment, social research, social inclusion, and recovery opportunities. Interventions and treatment models that are able to reduce self-stigma would have the potential to contribute toward a reduction in the negative impacts associated with substance use disorder.
da Silveira, P. S., Casela, A. L. M., Monteiro, É. P., Ferreira, G. C. L., de Freitas, J. V. T., Machado, Nathália Munck, Noto, Ana Regina. Ronzani, T. M.
Stigma and Health, 3(1), 42-52, 2018