Stigma and Treatment for Alcohol Disorders in the United States
Stigma and Treatment for Alcohol Disorders in the United States
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DOI：
10.1093/aje/kwq304
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发表时间：
2010-12-15
影响因子：
5
通讯作者：
Hasin, D.
中科院分区：
文献类型：
--
作者：
Keyes, K. M.;Hatzenbuehler, M. L.;Hasin, D.
在一个具有全国代表性的酒精使用障碍成年人样本中，作者测试了对酒精中毒的污名化是否与接受酒精相关服务的可能性较低有关。数据来自2004-2005年对34,653名成年人进行的面对面流行病学调查，这些成年人年龄在20岁或以上，居住在美国的家庭和团体宿舍。使用《酒精使用障碍和相关残疾访谈时间表-精神障碍诊断和统计手册，第四版》（AUDADIS-IV）诊断酒精滥用/依赖。所使用的污名测量是感知贬值-歧视量表。主要结果是终身干预，包括专业服务和酒精障碍的12步小组。终身诊断为酒精使用障碍的个体如果对酒精障碍个体感到更高的耻辱感，则不太可能使用酒精服务（优势比= 0.37,95%置信区间：0.18,0.76）。较高的耻辱感与男性性别（β = -0.75; P < 0.01）、非白人（与非西班牙裔白人相比）、较低的收入（β = 1.0; P < 0.01）、教育（β = 1.48; P < 0.01）和是否结过婚（β = 0.47; P = 0.02）相关。报告与酒精障碍个体（例如，有酒精问题的亲属）有密切接触的个体报告了较低的耻辱感（β = -1.70; P < 0.01）。高度污名化的酗酒观点与缺乏服务之间的联系表明，应将减少污名化纳入公共卫生努力，以促进酒精治疗。
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.