title: Stigma and social support in substance abuse: Implications for mental health and well-being.
abstract: Individuals with substance abuse may suffer from severe public and internalized stigma. Little is known about how social support can reduce stigma and improve mental health and well-being for them. This research examined how perceived stigma influences individuals in treatment for substance abuse, and whether internalized stigma and shame are mechanisms which link social support with better mental health and well-being. Sixty-four participants in treatment for substance abuse (alcohol, drugs), aged between 18 and 64, completed an online survey measuring perceived stigma, internalized stigma, shame, perceived social support, and mental health and well-being (self-esteem, depression and anxiety, sleep). We found that perceived stigma was associated with lower self-esteem, higher depression and anxiety, and poorer sleep. Furthermore, perceived social support followed the opposite pattern, and was associated with higher self-esteem, lower depression and anxiety, and better sleep. The effects of perceived stigma and of perceived social support on our outcome measures were mediated by internalized stigma and by internalized shame. Helping individuals with substance abuse to utilize their social support may be fruitful for combatting the negative impact of internalized stigma and shame on mental health and well-being.
authors.affiliation: School of Psychology, University of Surrey, Guildford GU2 7XH, UK. Electronic address: dr.michele.birtel@gmail.com.
authors.forename: Michèle D
authors.initials: MD
authors.lastname: Birtel
authors.affiliation: Inpatient and Acute Directorate, North East London NHS Foundation Trust, Goodmayes Hospital, Barley Lane, Ilford IG3 8XJ, UK; School of Psychological Sciences, University of Manchester, Manchester M13 9PL, UK.
authors.forename: Lisa
authors.initials: L
authors.lastname: Wood
authors.affiliation: School of Psychological Sciences, University of Manchester, Manchester M13 9PL, UK.
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Kempa
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D012649:Self Concept; D012752:Shame; D012893:Sleep Wake Disorders / Q000523:psychology; D057545:Social Stigma; D012944:Social Support; D019966:Substance-Related Disorders / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Depression; Internalized stigma; Self-esteem; Shame; Sleep; Substance use disorders