Family Support Decreases Self-Stigma about Substance Use Problems Among Participants in Collegiate Recovery Programs By Reducing the Stigma They Perceive from Others

Background and Purpose: Those who misuse substances often encounter significant stigma in their lives, which can adversely affect their paths to recovery. People in recovery often experience perceived stigma, shaped by public negative stereotypes, which influences their internal beliefs, such as shame, inferiority, and disappointment in oneself, known as self-stigma. Perceived stigma can contribute to the development of self-stigma and worsen an individual's mental health. Family support is recognized for its ability to reduce self-stigma for individuals with substance use disorders, potentially influencing their willingness to seek help and their progress in recovery. However, the impact of perceived stigma on family support and the development of self-stigma among individuals in recovery, especially among emerging adults, remains relatively unexplored. The study examined the interplay between family support, perceived stigma, and self-stigma among individuals in recovery, aiming to identify potential mechanisms through which these factors influence each other.

Methods: A total of 221 participants from the National Longitudinal Collegiate Recovery Study recruited from 58 collegiate recovery programs in the US, Canada, and England completed follow-up surveys between 2020 and 2023.

This study used measures from the first follow-up survey from 5 cohorts. Perceived stigma was measured by the Perceived Stigma of Substance Abuse Scale. Self-stigma was measured by a subscale in the Substance Abuse Self-Stigma Scale. Family support was measured by the question, "Who in your family is supportive of your recovery?" with answer options ranging from "Most" (scored as 2) to "None of their family members” (scored as 0). A mediation path analysis was conducted using Mplus 1.8.10 (Muthen & Muthen, 2023).

Results: Perceived stigma was tested as the mediator between family support and self-stigma. Family support decreased self-stigma and perceived stigma. Family support had a negative direct effect on self-stigma (unstandardized β=-1.94, p=.034). The level of family support also had a negative direct effect on perceived stigma (unstandardized β=-2.27, p<.001). Perceived stigma had a significant positive direct effect on self-stigma (unstandardized β=.49, p<.001). The indirect effect was β=-1.11 (p=.004) from family support to self-stigma via perceived stigma, supporting the mediational role of perceived-stigma in the model.

Conclusion: This study shows that college-engaged emerging adults in recovery who experience higher levels of family support tend to have lower scores in self-stigma and perceived stigma, and that perceived stigma mediates the effect of family support. While other studies found that family support mediates the relationship between perceived stigma and self-stigma, emerging adults are developmentally transitioning from family to peers as their primary societal resource, making family support a precedent to perceptions of stigma. These results highlight the importance of family interventions that increase recovery support for young adults in reducing stigma. Collegiate recovery programs can incorporate psychoeducation for families around this relationship and the positive impact of reducing stigma on their loved-one’s recovery.