Self-Stigma in Substance Abuse: Development of a New Measure

“Section 1: Self-Devaluation As anticipated, a scree plot in a principle components factor analysis (Cortina 1993) confirmed that items from the selfdevaluation section loaded on a single factor.”

“…shows that when a person who identifies with a stigmatized group enters a situation with perceived potential for devaluation based on this identity (Steele 1997; Steele et al. 2002), he or she typically adopts avoidancefocused goals (Brodish and Devine 2009; Quinn et al. 2004) and engages in…”

“Research suggests that experiential avoidance is broadly problematic and contributes to many behavioral problems such as substance misuse, depression, anxiety, psychosis, burnout, and adjustment to chronic medical conditions (for reviews, see Chawla and Ostafin 2007; Hayes et al. 2006).”

“As recommended in Clark and Watson (1995), we examined the intercorrelation matrix and found mostly moderate correlations (r0.”

“This scale has well established reliability and validity (Zimet et al. 1990).”

“…a person who identifies with a stigmatized group enters a situation with perceived potential for devaluation based on this identity (Steele 1997; Steele et al. 2002), he or she typically adopts avoidancefocused goals (Brodish and Devine 2009; Quinn et al. 2004) and engages in thought…”

“Our efforts to understand stereotyping and stigma are based on a modern behavior-analytic theory of language and cognition called Relational Frame Theory (RFT; Hayes et al. 2001).”

“Self-Esteem The Rosenberg Self-Esteem Scale (RSES; α0 .88; Rosenberg 1965) is a commonly used (e.g., Blascovich and Tomaka 1991) 10-item measure of global self-esteem.”

“Thus, model fit was examined using a chi-square statistic utilizing bootstrap adjusted p values (Bollen and Stine 1993).”

“Self-stigma involves two types of cognitive content: 1) self-devaluation, which reflects internalized stereotypes and judgments (Ritsher et al. 2003; Corrigan 2002), and 2) fear of being the target of enacted stigma, for example in the form of loss of housing opportunities (Cunningham et al. 1993;…”

“1998), which can lead to disengagement from such areas as treatment seeking (Livingston and Boyd 2010) or searching for employment (Stuart 2004).”

“…potential for devaluation based on this identity (Steele 1997; Steele et al. 2002), he or she typically adopts avoidancefocused goals (Brodish and Devine 2009; Quinn et al. 2004) and engages in thought suppression (Schmader et al. 2008), which ultimately interferes with optimal performance.”

“Studies of individuals with serious mental illness and co-occurring disorders (Link and Phelan 2006) have shown that selfstigma is associated with delays in treatment seeking or avoidance of treatment (Fung et al. 2008; Livingston and Boyd 2010), diminished self-esteem/self-efficacy (Corrigan et…”

“In the case of substance misuse, the types of categories (i.e., stereotypes) that tend to dominate are extremely pejorative and negative (Crisp et al. 2000).”

“…that selfstigma is associated with delays in treatment seeking or avoidance of treatment (Fung et al. 2008; Livingston and Boyd 2010), diminished self-esteem/self-efficacy (Corrigan et al. 2006), increased mental health symptoms (Ritsher and Phelan 2004), and lower quality of life (Rosenfeld 1997).”

“Stigma-Related Rejection The Stigma-Related Rejection Scale (SRS; α0 .82; Luoma et al. 2007) is a nine-item survey of ongoing experiences of personal rejection related to enacted stigma adapted from a measure originally used in a mentally ill sample (Wahl 1999).”

“People misusing substances tend to engage in secrecy and social withdrawal to avoid rejection from others, which exacerbates the negative psychosocial outcomes associated with substance dependence (Ahern et al. 2007; Luoma 2010; Rusch et al. 2006).”

“Research suggests that experiential avoidance is broadly problematic and contributes to many behavioral problems such as substance misuse, depression, anxiety, psychosis, burnout, and adjustment to chronic medical conditions (for reviews, see Chawla and Ostafin 2007; Hayes et al. 2006).”

“…that selfstigma is associated with delays in treatment seeking or avoidance of treatment (Fung et al. 2008; Livingston and Boyd 2010), diminished self-esteem/self-efficacy (Corrigan et al. 2006), increased mental health symptoms (Ritsher and Phelan 2004), and lower quality of life (Rosenfeld 1997).”

“This scale has shown good reliability and validity in previous studies (Larson and Chastain 1990).”

“…two types of cognitive content: 1) self-devaluation, which reflects internalized stereotypes and judgments (Ritsher et al. 2003; Corrigan 2002), and 2) fear of being the target of enacted stigma, for example in the form of loss of housing opportunities (Cunningham et al. 1993; Luoma et al. 2007).”

“2006), increased mental health symptoms (Ritsher and Phelan 2004), and lower quality of life (Rosenfeld 1997).”

“Similarly, people tend to cope with the fear of enacted stigma by withdrawing from or discounting the importance of the life domains associated with stereotypes (Major et al. 1998), which can lead to disengagement from such areas as treatment seeking (Livingston and Boyd 2010) or searching for employment (Stuart 2004).”

“Paradoxically, this strategy may serve to exacerbate selfdevaluation and fear of enacted stigma (Smart and Wegner 1999; Wenzlaff and Wegner 2000).”

“Interventions for self-stigma in substance dependence have begun to be evaluated (Luoma et al. 2008; Luoma et al. 2012), but the lack of self-stigma measures has limited progress.”

“Both aspects of self-stigma have been shown to be prevalent in people with stigmatized conditions (Luoma et al. 2007; Scambler 1998; Taylor and Cert 2001).”

“Interventions for self-stigma in substance dependence have begun to be evaluated (Luoma et al. 2008; Luoma et al. 2012), but the lack of self-stigma measures has limited progress.”

“…two types of cognitive content: 1) self-devaluation, which reflects internalized stereotypes and judgments (Ritsher et al. 2003; Corrigan 2002), and 2) fear of being the target of enacted stigma, for example in the form of loss of housing opportunities (Cunningham et al. 1993; Luoma et al. 2007).”

“Stigma-Related Withdrawal An eight-item scale measuring a tendency to withdraw from or avoid others who do not share a history of addiction was adapted from a measure originally used in a mentally ill sample (SRW; α0 .65; Link et al. 2002).”

“Studies of individuals with serious mental illness and co-occurring disorders (Link and Phelan 2006) have shown that selfstigma is associated with delays in treatment seeking or avoidance of treatment (Fung et al. 2008; Livingston and Boyd 2010), diminished self-esteem/self-efficacy (Corrigan et al.”

“Perceived Stigma The Perceived Stigma of Addiction Scale (PSAS; α0 .71; Luoma et al. 2010) is an eight-item questionnaire measuring perceptions of the prevalence of 226 J Psychopathol Behav Assess (2013) 35:223–234”

“People misusing substances tend to engage in secrecy and social withdrawal to avoid rejection from others, which exacerbates the negative psychosocial outcomes associated with substance dependence (Ahern et al. 2007; Luoma 2010; Rusch et al. 2006).”

“…perceived potential for devaluation based on this identity (Steele 1997; Steele et al. 2002), he or she typically adopts avoidancefocused goals (Brodish and Devine 2009; Quinn et al. 2004) and engages in thought suppression (Schmader et al. 2008), which ultimately interferes with optimal…”

“1998), which can lead to disengagement from such areas as treatment seeking (Livingston and Boyd 2010) or searching for employment (Stuart 2004).”

“…potential for devaluation based on this identity (Steele 1997; Steele et al. 2002), he or she typically adopts avoidancefocused goals (Brodish and Devine 2009; Quinn et al. 2004) and engages in thought suppression (Schmader et al. 2008), which ultimately interferes with optimal performance.”

“Psychological Flexibility for Substance Abusers The Acceptance and Action Questionnaire – Substance Abuse (AAQ-SA; Luoma et al. 2011) is an 18-item scale designed to measure psychological flexibility in substance misusing populations and has preliminary evidence for good psychometric properties using the same sample a…”

“Both aspects of self-stigma have been shown to be prevalent in people with stigmatized conditions (Luoma et al. 2007; Scambler 1998; Taylor and Cert 2001).”

“To further evaluate method variance, we needed to introduce a variable strongly related to stigma-related psychological flexibility but weakly related to method effects (cf., Hazlett-Stevens et al. 2004).”

“Measure development Stigma refers to a social process in which a perceived attribute marks an individual to be socially sanctioned and devalued (Luoma 2010).”

“A project was initiated to develop a self-report measure of self-stigma based on a psychological flexibility model (Masuda et al. 2009).”

“Self-stigma involves two types of cognitive content: 1) self-devaluation, which reflects internalized stereotypes and judgments (Ritsher et al. 2003; Corrigan 2002), and 2) fear of being the target of enacted stigma, for example in the form of loss of housing opportunities (Cunningham et al. 1993;…”

“39 Research by Schomerus et al. partially validated the above model of self-stigma for people with alcohol dependence.”