The mediating role of perceived social support in the relationship between perceived stigma and depression among individuals diagnosed with substance use disorders

Abstract

Accessible Summary What is known on the subject? Individuals diagnosed with substance use disorders may perceive stigma and suffer from mental health problems. Perceived stigma is related to poor mental health among individuals diagnosed with substance use disorders. The social support deterioration deterrence model proposes that stressors (e.g. perceived stigma) negatively affect mental health via reduced perceived social support. To the best of the present authors’ knowledge, the model has never been tested in the context of perceived stigma among individuals diagnosed with substance use disorders. What the paper adds to existing knowledge? The paper used structural equation modelling to show that the social support deterioration deterrence model could explain the relationship between perceived stigma and depression among individuals diagnosed with substance use disorders. Perceived support from family and perceived support from friends are mediators in the association between perceived stigma and depression among individuals diagnosed with substance use disorders. What are the implications for practice? Psychosocial interventions to increase perceived support from family and friends would be helpful in addressing perceived stigma effects on mental health. Abstract IntroductionAlthough the relationship between perceived stigma and mental health outcomes is documented in the existing literature, very few studies have investigated the mechanism linking perceived stigma and mental health outcomes among individuals diagnosed with substance use disorders. To the best of the present authors’ knowledge, the social support deterioration deterrence model has never been tested in the context of perceived stigma among individuals diagnosed with substance use disorders. Aim/QuestionGuided by the social support deterioration deterrence model, the present study investigated the mediating role of perceived support from three types of social network members (i.e. significant others, family members, and friends) in the association between perceived stigma and depression in individuals diagnosed with substance use disorders. MethodThe study employed a cross‐sectional survey design comprising 300 participants diagnosed with substance use disorders in Taiwan. ResultsResults of a structural equation modelling analysis indicated that perceived stigma was significantly associated with depression. The relationship between perceived stigma and depression was partially mediated by perceived family support and perceived friend support. DiscussionConsistent with the prediction of the social support deterioration deterrence model, the negative effect of perceived stigma on depression for individuals diagnosed with substance use disorders is through the mediating effect of social support. Implications for practicesBased on the present study's results, psychosocial interventions to increase perceived support from family and friends would be helpful in addressing negative effects of perceived stigma on mental health among individu...

Stigma and Quality of Life in Women With Breast Cancer: Mediation and Moderation Model of Social Support, Sense of Coherence, and Coping Strategies

“…Markedly, as another adverse effect of stigma, social support failed to maintain its well-established positive effect on emotional wellbeing, meaning that stigma could eliminate all the effects of social support on emotional wellbeing. Consistent with previous findings on the diminished protective role of social support in the stigma-depression link ( Chang et al, 2021 ), these findings are in sheer accordance with the social support deterioration deterrence model suggesting stressors can paralyze the social support system at the cost of mental health problems ( Kaniasty and Norris, 1993 ; Norris and Kaniasty, 1996 ). Two explanations in personal and group dynamic levels may be provided.…”

“…Thus far, the role of social support in reducing the destructive effect of stigma on HRQoL has been addressed in various chronic conditions ( Earnshaw et al, 2012 ; Nearchou et al, 2017 ), people with HIV ( Larios et al, 2009 ), and lung cancer ( Lei et al, 2021 ). It is also suggested by the social support deterioration deterrence model that stigma as an impactful stressor can break the people’s support system resulting in diminished mental health ( Kaniasty and Norris, 1993 ; Norris and Kaniasty, 1996 ; Chang et al, 2021 ). Likewise, SOC was observed as a protective factor for HRQoL in the stigmatizing context of patients with chronic diseases ( Broersma et al, 2018 ), and its mediating effect was shown in the stigma-HRQoL link ( Świtaj et al, 2017 ), suggesting an insidious effect of stigma on patients’ GRRs.…”

Self-Stigma, Mental Health and Healthy Habits in Parent of Children with Severe Mental Disorder

“…Therefore, similar studies in SMD patients have shown that self-stigma is a precursor of emotional distress. 5,39,40 In this regard, the study by Hasan & Musleh 39 showed how self-stigma in people with SMD causes an increase in depression and anxiety. Similarly, a study by Grambal et al, 41 with patients with schizophrenia and borderline personality disorder showed that self-stigma acted as a predictor of depression and anxiety.…”

“…[1][2][3] Stigma towards mental disorders has a devastating effect on those who suffer from it in the first person, (more harmful, even, than the symptomatology itself), being a powerful barrier to access to treatment, recovery, social performance, which seriously compromises their personal autonomy. [4][5][6] Its multiple consequences have been studied, causing, among other effects, problems for incorporation into the world of work, less help-seeking, demoralisation, ostracism and isolation, hopelessness, low self-esteem. 7 Unfortunately, prejudice, discrimination and stigmatising effects can also extend to family members and close associates, in what is known as "courtesy stigma", "associated stigma" or "stigma by association".…”

Communicating mental health stigma amongst youths in Singapore: The role of narratives in inducing attitudinal change

“…Firstly, the study considers only one mental health condition -ADHD. This limits the generalisation of the study's results to individuals living with ADHD; should a more clinically obscure condition be examined (e.g., schizophrenia, personality disorders) or a mental health condition deemed to be prominently stigmatised contemporarily such as major depressive disorder (Chang et al, 2022), attitudinal outcomes yielded may differ. As such, future studies may establish reproducibility of the present findings with other mental health conditions or marginalised groups in society.…”