Suchergebnisse

Understanding the stigma of substance use disorders -- My experience with the stigma of substance use -- Substance use stigma and policy -- Experiences of stigma and criminal in/justice among people who use people who use substances -- Substance use disorders, stigma and ethics -- Intersectional stigma in substance use disorders -- International perspectives on stigma towards people with substance use with disorders -- Using community-based participatory research to address the based participatory research to address the stigma of substance use disorder -- Three competing agendas of addressing stigma of substance use disorder -- The benefits of disclosure -- The role of peers in SUD stigma change : a personal perspective -- The role of media reporting for substance use stigma -- Reducing substance use stigma in healthcare -- Final considerations and future directions for erasing the stigma of substance use disorders.

Zusammenfassung. Hintergrund: Stigmatisierung schadet den Betroffenen und verstärkt Suchtprobleme. Sie ist ein Hindernis auf dem Weg zur Hilfe, führt zu schlechterer Behandlung und vergrößert die sozialen und gesundheitlichen Folgen einer Suchtkrankheit. Das gilt sowohl für die individuellen Folgen als auch für die gesellschaftlichen einschließlich der öffentlichen Gesundheitskosten. Zudem ist Stigmatisierung ein ethisches Problem, weil sie eine bestimmte Gruppe benachteiligt und die Menschenwürde der Betroffenen angreift. Ein stigmafreier Umgang mit Suchtkrankheiten ist möglich. Entstigmatisierung bedeutet, bessere Lösungen für Suchtprobleme zu finden und verfügbar zu machen. Nicht Abwertung, Ausgrenzung und Disziplinierung, sondern Wertschätzung und Befähigung (Empowerment) müssen im Zentrum von Prävention, Behandlung sowie dem alltäglichen Umgang mit Suchtkrankheiten stehen.

<b><i>Background:</i></b> Alcohol dependence is among the most severely stigmatized mental disorders. We examine whether negative stereotypes and illness beliefs related to alcohol dependence have changed between 1990 and 2011. <b><i>Methods:</i></b> We used data from two population surveys with identical methodology that were conducted among German citizens aged ≥18 years, living in the 'old' German states. They were conducted in 1990 and 2011, respectively. In random subsamples (1990: n = 1,022, and 2011: n = 1,167), identical questions elicited agreement with statements regarding alcohol dependence, particularly with regard to the illness definition of alcohol dependence and blame. <b><i>Results:</i></b> Overall, agreement with negative stereotypes did not change in the course of 2 decades. About 55% of the respondents agreed that alcohol dependence is an illness like any other, >40% stated that it was a weakness of character and 30% endorsed that those affected are themselves to blame for their problems. <b><i>Conclusions:</i></b> It is apparent that promoting an illness concept of alcohol dependence has not been an easy solution to the problem of stigma. We discuss how the normative functions of alcohol dependence stigma might have prevented a reduction of negative stereotypes.

Zusammenfassung. Zielsetzung: Menschen mit Alkoholabhängigkeit werden im Vergleich zu Personen mit anderen psychischen Krankheiten besonders stark stigmatisiert. Selbststigmatisierung aufgrund der eigenen Alkoholabhängigkeit hat vielfältige soziale Folgen. Unter Anwendung von Corrigans progressivem Modell zur Selbststigmatisierung soll der Zusammenhang zwischen geringer sozialer Integration und Selbststigmatisierung bei Alkoholabhängigen näher untersucht werden. Methodik: Es wurden N = 86 Patienten mit Alkoholabhängigkeit interviewt. Dabei wurden ein objektives Maß zur sozialen Integration, eine Skala zur Selbststigmatisierung bei Menschen mit Alkoholabhängigkeit, eine Skala zur Erfassung der Schwere der Alkoholabhängigkeit und das Ausmaß an psychischer Belastung erfasst. Ergebnisse: Es zeigte sich ein signifikanter negativer Zusammenhang zwischen der Anwendung negativer Stereotype auf sich selbst und geringerer sozialer Integration, sowie zwischen dem Selbstwertverlust aufgrund der eigenen Alkoholabhängigkeit und der sozialer Integration. In allen Regressionsanalysen wurde für die konfundierenden Variablen psychische Belastung, Schwere der Alkoholerkrankung, Alter und Geschlecht kontrolliert. Schlussfolgerung: Selbststigmatisierung aufgrund der eigenen Alkoholabhängigkeit ist ein wichtiges Korrelat fehlender sozialer Integration oder sozialem Rückzug bei Menschen mit Alkoholabhängigkeit und sollte daher bei der psychotherapeutischen Behandlung berücksichtigt werden.

<b><i>Introduction:</i></b> Stigma towards alcohol-related conditions is more pronounced than stigma against any other mental illness and has remained high throughout past decades. Although alcohol consumption is a known and persistent contributor to the burden of disease and interpersonal threat and may thus shape public attitudes towards consumption, no study to date has provided an overview of the prevalence of alcohol stigma and its association with (a) alcohol consumption and (b) harm attributable to alcohol across Europe. As a social reaction to thresholds of accepted use of alcohol, stigma could impact consumption, resulting in a reduced quantity or at least less harmful drinking patterns. This contribution provides an initial overview by addressing the following research questions. (i) What are the country-level prevalence rates of alcohol stigma compared across European countries? (ii) Is alcohol stigma associated with (a) alcohol consumption and (b) alcohol-attributable harm? (iii) Is there an association between alcohol stigma and alcohol consumption by type of beverage? <b><i>Methods:</i></b> We combined data on country-level desire for social distance towards "heavy drinkers" (European Values Survey, operationalization of "alcohol stigma") with indicators of alcohol consumption, including adult per capita consumption (APC), heavy episodic drinking, consumption by type of beverage (wine, beer, spirits), and harm attributable to alcohol, namely age-standardized disability-adjusted life years lost to alcohol consumption (AADALYs) for 28 countries. Linear regression models were applied<i>.</i> <b><i>Results:</i></b> (i) Social distance varied noticeably across countries (M = 62.9%, SD = 16.3%) in a range of 28.3% and 87.3%. (ii) APC was significantly positive related to social distance (β = 0.55, <i>p</i> = 0.004). (iii) Wine consumption was significantly negative related to social distance; the opposite was true for spirits consumption. No association was found for beer consumption<i>.</i> The best model fit was achieved with APC (β = 0.48, <i>p</i> = 0.002) and wine per capita consumption (β = −0.55, <i>p</i> &#x3c; 0.001) explaining 57.0% (adjusted <i>R</i>²) of the variance in social distance. <b><i>Conclusion:</i></b> Our study shows a strong relationship between country-level alcohol stigma and alcohol consumption. If stigma was to deter people from harmful alcohol consumption, it would be expected that higher levels of alcohol stigma are associated with lower levels of overall alcohol consumption or consumption of spirits in particular. Instead, stigma seems to be a reaction to harmful drinking patterns without changing these patterns for the better.

Abstract. Background: Despite being affected by a severe disease with increased morbidity and mortality, alcohol-dependent individuals often experience stigmatizing situations in the health care system. This study aimed to investigate medical students' attitudes towards alcoholism and their readiness for cutbacks in health care expenditures for alcohol-dependent individuals. Methods: In total, 2253 students of all federal states in Germany took part in this study. Attitudes towards alcoholism, sociodemographic variables, and motives for studying medicine were assessed with an online questionnaire. Students' readiness for cutbacks in health care expenditures of alcohol-dependent individuals was measured in relation to the other diseases, including psychiatric conditions (e. g. depression, schizophrenia), potentially stigmatized non-psychiatric disorders (e. g. AIDS), and potentially lifestyle-related acute (e.g. myocardial infarction) or chronic (e. g. diabetes) conditions. Data were analyzed with hierarchical logistic regression models. Results: Compared to other medical and mental diseases, alcoholism was by far the most frequently chosen condition with a potential for financial savings. In multivariate analyses, the preference for cutbacks was associated with the increased wish for social distance, high internal attribution of responsibility, low perceived severity and personal vulnerability, the absence of alcoholism in participants' social environment, and certain motives for studying medicine. Discussion: Since the majority of alcohol-dependent individuals avoid seeking addiction-specific help, physicians in primary care are often the only contact person in the health care system who can initiate health-related behavioral changes. However, persisting prejudges may affect the physician-patient-relationship and therapy adherence. Interventions aimed at reducing stigmatizing attitudes should be implemented at an early stage of medical education.

Zusammenfassung. Zielsetzung: Ziel der vorliegenden Studie war, die Veränderung des Alkoholkonsums während der SARS-CoV-2 Pandemie in Deutschland zu untersuchen und mit derer anderer europäischer Länder zu vergleichen. Methodik: Analyse von soziodemographischen und sozioökonomischen Daten sowie Angaben zur Veränderung des Alkoholkonsums seit der Pandemie in einer europaweiten Onlinebefragung (n=40.064) aus 21 Ländern. Zur Anpassung an die Bevölkerungsverteilung in den Ländern erfolgte eine Gewichtung anhand von Geschlecht, Alter und Bildungsabschluss. Ergebnisse: Seit Beginn der Pandemie wurde im Mittel weniger Alkohol getrunken. Der Rückgang des Konsums ist vor allem auf eine Reduktion der Gelegenheiten zum Rauschtrinken zurückzuführen. Der Alkoholkonsum ist in Deutschland weniger stark als in anderen Europäischen Ländern zurückgegangen. Gründe dafür sind Zunahmen im Alkoholkonsum bei Frauen sowie bei Personen, die negative Auswirkungen in Beruf und Finanzen erlebt haben und bei Personen mit riskanten Konsummustern. Schlussfolgerungen: Um den negativen Folgen des in Teilgruppen verstärkten Alkoholkonsums während der Pandemie entgegenzuwirken, sollte die Verfügbarkeit von Alkohol durch eine sinnvolle Besteuerung reduziert sowie eine Ausweitung routinemäßiger Alkoholscreenings in der allgemeinärztlichen Versorgung umgesetzt werden.

Background: Whether mental disorders should be considered as categorical or dimensional has found increasing attention among mental health professionals. Only little is known about what the public thinks about this issue. Aims: First, to assess how prevalent the belief in a continuum of symptoms from mental health to mental illness is among the general public. Second, to examine how continuum beliefs are associated with attitudes towards people with mental disorder. Methods: In 2012, an on-line survey was conducted in France ( N = 1,600). After the presentation of a case-vignette depicting a person with either schizophrenia or depression, belief in a continuum of symptoms, emotional reactions and desire for social distance related to the person in the vignette were assessed. Results: While 58.2% of respondents agreed in a symptom continuum for depression, this percentage was only 28.5% for schizophrenia. In both disorders, continuum beliefs were associated with more pro-social reactions and less desire for social distance. Only in schizophrenia, there was an inverse relationship with the expression of anger. Conclusions: There is increasing evidence of an association between continuum beliefs and positive attitudes towards people with mental illness. Information on the continuous nature of psychopathological phenomena may usefully be included in anti-stigma messages.