Method: Adult participants (n=215) who responded to advertisements in community-based programs for families affected by addition, such as Families Against Narcotics, answered an on-line survey containing sociodemographic questions (gender, age, and race), questions from the Caregiver Self-Stigma (Girma et al., 2014) and Significant Other Support (Power, Champion, & Aris, 1988) scales, items about participation in psychological and medical treatment modalities, as well as questions from the Hopefulness-Hopelessness Questionnaire (Micallef, 1995). We tested hypotheses using structural equation modeling (SEM; StataCorp, 2015). The adequacy of the SEM model was evaluated using the chi-square statistic, the comparative fit index (CFI), Tucker-Lewis index (TLI), and the root mean squared error of approximation (RMSEA). The recommended cutoff value for CFI and TLI is .95 while for RMSEA, the cutoff of .05 represents a good fit (Acock, 2013).
Results: Lower stigma (β=-.27, z =-3.48, p<.01), higher treatment involvement (β=.24, z =2.22, p< 0.05) and social support (β=.22, z = 2.70, p< 0.01), and self-identifying with White race (β=.14, z =2.04, p< 0.05) had positive direct effects on perceived hopefulness. Additionally, lower stigma had a direct positive effect on perceived social support (β= -.23, z = -3.08, p< 0.01). The direct relationships between stigma and treatment was not statistically significant. Stigma had a significant standardized indirect effect, mediated by social support on hopefulness (β=-.032, z =-2.21, p< 0.05). The model provided a good fit for the data: χ2(57, N=215) =86.80, p< 0.01, CFI = 0.976, TLI = 0.969, RMSEA =0.049 and explained 87% of the total variance (Bentler & Raykov, 2000).
Discussion: These results suggest the need to further explore the racial disparities in emotional processes among family members of individuals with OUD. Future studies should examine whether increasing treatment involvement, reducing self-stigma, enhancing support for family members and elevating a sense of hopefulness improves overall functioning of the families and contributes to the recovery of individuals with OUD.