Date of Award

8-2024

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

School

Psychology

Committee Chair

Dr. Nora E. Charles

Committee Chair School

Psychology

Committee Member 2

Dr. Kelsey Bonfils

Committee Member 2 School

Psychology

Committee Member 3

Dr. Daniel Capron

Committee Member 3 School

Psychology

Committee Member 4

Dr. Donald Sacco

Committee Member 4 School

Psychology

Abstract

Data from the 2020 National Survey on Drug Use and Health (NSDUH) indicate that nearly three-quarters of adults in the United States have used alcohol or illicit drugs in the past year. Given the overall prevalence of use as well as concern surrounding an increase in prevalence during the pandemic, it is essential to identify potential barriers for individuals seeking treatment for substance use or misuse. The literature demonstrates that self-stigma is related to reduced help-seeking in individuals with mental health and substance use disorders. However, as the concept of self-stigma has developed, research within the field has been inconsistent in how it measures self-stigma, often incorporating multiple stigma constructs within a single measure. The Mental Illness Stigma Framework proposed three mechanisms of stigma (i.e., experienced, anticipated, and internalized (self-) stigma) from the perspective of the stigmatized. However, these distinct stigma constructs have rarely been examined all together. The current study sought to address this gap by exploring the relationships and directionality of each stigma mechanism on mental health help-seeking attitudes and intentions within a serial mediation model and alternative parallel model. Results showed support for a complex relationship between stigma, help-seeking attitudes and intentions, and substance use. Specifically, the relationship between experienced stigma and help-seeking may not be mediated sequentially through anticipated and internalized stigma as hypothesized but instead may be occurring at the same time. However, further examination and replication of these pathways are needed in future research to make definitive claims. Additionally, models that used the Everyday Discrimination Scale (EDS) for the experienced stigma predictor variable were stronger than those that used the Multifaceted Stigma Experiences Scale (MSES). Establishing relationships between each stigma mechanism, which measures are most appropriate to assess them, and how they impact treatment-seeking among adult substance users is an essential step in helping to inform future research in the stigma and substance use field and has the potential to help inform specifically targeted anti-stigma intervention programs.

ORCID ID

https://orcid.org/0000-0003-4915-8506

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Available for download on Friday, January 01, 2027

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