The labels and models used to describe problematic substance use impact discrete elements of stigma: A registered report.
Open accessAbstract
OBJECTIVES: Problematic substance use is one of the most stigmatized health conditions leading research to examine how the labels and models used to describe it influence public stigma. Two recent studies examine whether beliefs in a disease model of addiction influence public stigma but result in equivocal findings-in line with the mixed-blessings model, Kelly et al. (2021) found that while the label "chronically relapsing brain disease" reduced blame attribution, it decreased prognostic optimism and increased perceived danger and need for continued care; however, Rundle et al. (2021) conclude absence of evidence. This study isolates the different factors used in these two studies to assess whether health condition (drug use vs. health concern), etiological label (brain disease vs. problem), and attributional judgment (low vs. high treatment stability) influence public stigma toward problematic substance use. METHOD: Overall, 1,613 participants were assigned randomly to one of the eight vignette conditions that manipulated these factors. They completed self-report measures of discrete and general public stigma and an indirect measure of discrimination. RESULTS: Greater social distance, danger, and public stigma but lower blame were ascribed to drug use relative to a health concern. Greater (genetic) blame was reported when drug use was labeled as a "chronically relapsing brain disease" relative to a "problem." Findings for attributional judgment were either inconclusive or statistically equivalent. DISCUSSION: The labels used to describe problematic substance use appear to impact discrete elements of stigma. We suggest that addiction is a functional attribution, which may explain the mixed literature on the impact of etiological labels on stigma to date. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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The brain-disease model can reduce blame but may also decrease hope for recovery and increase perceptions of dangerousness.
“Other studies caution that while the brain-disease model can reduce blame, it may also decrease hope for recovery and increase perceptions of dangerousness.”
From Beyond Stigma–Integrating Neurobiology, Genetics, and Awareness Integration Theory in Addiction Recovery (2026) · cites this paper as [89]
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- Authors
- Pennington, C. R., Monk, R. L., Heim, D., Rose, A. K., Gough, T., Clarke, R., Knibb, G., Patel, R., Rai, P., Ravat, H., Ali, R., Anastasiou, G., Asgari, F., Bate, E., Bourke, T., Boyles, J., Campbell, A., Fowler, N., Hester, S., Neil, C., McIntyre, B., Ogilvy, E., Renouf, A., Stafford, J., Toothill, K., Wong, H. K., & Jones, A.
- Affiliations
- Aston University (GB)
- Edge Hill University (GB)
- University of Liverpool (GB)
- Liverpool John Moores University (GB)
- Liverpool Hope University (GB)
- Corresponding author
- Pennington, Charlotte R.
- ORCID
- Venue
- Psychology of Addictive Behaviors
- Published
- 2023-05-11
- Volume
- 37
- Issue
- 6
- Pages
- 723-733
- ISSN
- 0893-164X (ISSN-L)
- 1939-1501
- OpenAlex
- W4376132705
- Cited by
- 22
- References
- 72
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 7 · 2023: 6
- FWCI
- 4.39
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Psychology of Addictive Behaviors (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Edge Hill University Research Information Repository (Edge Hill University) (publishedVersion, cc-by-nc-nd)
- Aston Publications Explorer (Aston University) (acceptedVersion)
- Liverpool John Moores University (submittedVersion)
- PsyArXiv (OSF Preprints) (submittedVersion, cc-by)
- OSF Preprints (OSF Preprints) (submittedVersion)
- PsyArXiv (OSF Preprints) (submittedVersion)
- Funders
- Aston University
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Keywords
- problematic substance use, public stigma, disease model of addiction, blame attribution, social distance, perceived danger
- MeSH terms
- Brain Diseases, Humans, Social Perception, Stereotyping, Substance-Related Disorders, Social Stigma
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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