Perceived Alcohol Stigma: Factor Structure and Construct Validation

Abstract

Introduction There has been an increasing interest in studying the stigma of alcohol use disorders (AUDs) yet scant research has evaluated the conceptualization and measurement of alcohol stigma. This study examined the measurement properties (i.e. factor structure) and validity of the alcohol-adapted Perceived Devaluation-Discrimination scale (PDD), which assesses the construct of perceived alcohol stigma (PAS). Materials and Methods Our sample included 34,386 respondents from the Wave 2 assessment in the National Epidemiologic Survey on Alcohol and Related Conditions, a population-representative survey of noninstitutionalized United States adults. Analytic procedures included confirmatory factor analysis and structural equation modeling. Results One factor (perceived devaluation-discrimination) and two factor (perceived devaluation, perceived discrimination) confirmatory factor analytic models fit the data well (CFI=0.958, TLI=0.942, RMSEA=0.056; CFI=0.962, TLI=0.946, RMSEA=0.054; respectively) when adjusting for item wording effects with a latent method factor. Despite having a better fit to the data (χ2(1) = 542, p < 0.0001), the two factors were highly correlated (r=0.90), which led us to favor a one-factor model. Structural equation models found that the inverse relationship between PAS and perceived interpersonal social support was strongest for persons with a stigmatized-labeling status. The same was not true in analyses predicting social network involvement. Conclusions A one-factor solution of perceived alcohol stigma had superior parsimony. The alcohol-adapted PDD appears to be a psychometrically sound measure and exhibits relationships that are consistent with modified labeling theory.

Psychosocial Stressors and Alcohol use, Severity, and Treatment Receipt across Human Immunodeficiency virus (HIV) Status in a Nationally Representative Sample of US Residents

“…About one-sixth of the population reported experiences of discrimination, and overall mean stress and stigma scores were consistent with general population averages 55 (Table 2). A greater proportion of PLWH than those without HIV reported experiences of discrimination, and PLWH reported higher levels of perceived stress than those without HIV (Table 2; p-values both <0.05).…”

Alcohol problem recognition and help seeking in adolescents and young adults at varying genetic and environmental risk

“…Current findings suggest that the presence or lack of help seeking for alcohol problems within one’s family may play a role in the evaluation of one’s own alcohol problems. It is possible that knowledge of treatment seeking for drinking among family members may bring an otherwise stigmatized issue (Glass et al, 2013a, 2013b; Keyes et al, 2010) out in the open, allowing younger persons to acknowledge their own problem drinking. Because our assessments of help seeking were based on each family member’s self-report, offspring may not have been aware of their family member’s history.…”

Alcohol Screening and Intervention Among United States Adults who Attend Ambulatory Healthcare

“…With exceptions, 39 prior studies have found women to be less likely to obtain various alcohol-related services. [40][41][42] Because the stigma of alcohol misuse [43][44][45] may be higher among women, 46 they may be more likely to under-report their alcohol use and conceal the severity of their alcohol problems.…”