期刊
AMERICAN JOURNAL OF EPIDEMIOLOGY
卷 172, 期 12, 页码 1364-1372出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kwq304
关键词
alcohol drinking; alcoholics anonymous; alcoholism; mental disorders; psychiatric therapeutic processes; shame; therapeutics; United States
资金
- National Institute on Alcoholism and Alcohol Abuse [K05 AA014223]
- National Institute on Drug Abuse [RO1 DA018652, R21 DA020667, F31-DA026689]
- New York State Psychiatric Institute
Among a nationally representative sample of adults with an alcohol use disorder, the authors tested whether perceived stigmatization of alcoholism was associated with a lower likelihood of receiving alcohol-related services. Data were drawn from a face-to-face epidemiologic survey of 34,653 adults interviewed in 2004-2005 who were aged 20 years or older and residing in households and group quarters in the United States. Alcohol abuse/dependence was diagnosed by using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, version (AUDADIS-IV). The stigma measure used was the Perceived Devaluation-Discrimination Scale. The main outcome was lifetime intervention including professional services and 12-step groups for alcohol disorders. Individuals with a lifetime diagnosis of an alcohol use disorder were less likely to utilize alcohol services if they perceived higher stigma toward individuals with alcohol disorders (odds ratio = 0.37, 95% confidence interval: 0.18, 0.76). Higher perceived stigma was associated with male gender (beta = -0.75; P < 0.01), nonwhite compared with non-Hispanic white race/ethnicity, lower income (beta = 1.0; P < 0.01), education (beta = 1.48; P < 0.01), and being previously married (beta = 0.47; P = 0.02). Individuals reporting close contact with an alcohol-disordered individual (e.g., relative with an alcohol problem) reported lower perceived stigma (beta = -1.70; P < 0.01). A link between highly stigmatized views of alcoholism and lack of services suggests that stigma reduction should be integrated into public health efforts to promote alcohol treatment.
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