Society for Social Work and Research

Sixteenth Annual Conference Research That Makes A Difference: Advancing Practice and Shaping Public Policy
11-15 January 2012 I Grand Hyatt Washington I Washington, DC

16785 The Influence of Alcohol Stigma On Perceptions of Treatment Need and Help Seeking: Results From a Nationally Representative Sample

Sunday, January 15, 2012: 9:45 AM
Roosevelt (Grand Hyatt Washington)
* noted as presenting author
Joseph E. Glass, MSW, NIDA Predoctoral Fellow, Washington University in Saint Louis, University City, MO
Sean D. Kristjansson, PhD, Research Instructor, Washington University in Saint Louis, St. Louis, MO
Kathleen K. Bucholz, PhD, Professor, Washington University in Saint Louis, St. Louis, MO
Background and Purpose: Stigmatizing attitudes towards those with alcohol use disorders (AUDs) include beliefs that alcohol-affected individuals are unpredictable, dangerous, irresponsible, and at fault for their illness. Recent findings suggest that those with AUDs who have stronger perceptions of public stigma towards alcoholism are at risk for not seeking alcohol treatment. We sought to identify specifically how perceived alcoholism stigma interferes with the pathways to help seeking. We were interested in whether stigma is associated with (1) decreased perceptions of treatment need, or (2) reductions in help seeking among those who perceive a need for treatment.

Methods: Our data source was the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). We included 7,143 participants who met criteria for lifetime alcohol abuse or dependence, completed interviews at waves 1 and 2, and had at least one period in their lifetime of weekly at-risk drinking (4 or 5 drinks per day or 7 or 14 drinks per week, for women and men, respectively). The alcohol-adapted Perceived Devaluation-Discrimination scale assessed perceived alcoholism stigma at wave 2. We summed its 12 items to create a continuous variable. Our first logistic regression model examined the relationship between stigma and perceptions of treatment need for alcohol problems. We conducted a second logistic regression among those who had ever perceived a need for treatment (n=1,871) to determine if stigma was associated with alcohol treatment. Models took into account the complex design of NESARC and adjusted for sociodemographic characteristics (sex, age, race/ethnicity, and marital status) and alcohol problem severity (a count of lifetime alcohol problems).

Results: Stigma was inversely related to perceptions of treatment need (OR=0.91, 95% CI=0.87-0.95) when adjusting for sociodemographic characteristics and alcohol problem severity. Stigma was also inversely related to seeking help among those who perceived a need for it (OR=0.87, 95% CI=0.76-0.99).

Conclusions and Implications: Our findings suggest that perceived alcoholism stigma may play a role in both decreasing perceptions of treatment need as well as reducing help seeking among those who perceive a need for it. Interventions to facilitate treatment entry should boost awareness of treatment options and their effectiveness.

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