Skip to main content
SpringerLink
Log in

Factors associated with perceived stigma for alcohol use and treatment among at-risk drinkers

  • Regular Articles
  • Published:
The Journal of Behavioral Health Services & Research Aims and scope Submit manuscript

Abstract

This study examined the perceived public stigma for alcohol use and treatment among a sample of 733 at-risk drinkers living in the South. Substantial levels of perceived stigma were reported for the community's judgment about at-risk drinking (86.1%), community's judgment about seeking primary care treatment for alcohol disorders (48.9%), community's judgment about seeking specialty treatment (56.3%), and primary care providers' judgment about their patients who were at-risk drinkers (35.7%). Similarly, respondents perceived a substantial lack of privacy associated with primary care treatment (42.0%) and specialty treatment (45.2%). African Americans were more likely to perceive a lack of treatment privacy but they were less likely to perceive community judgment about seeking specialty treatment. Those with greater social network contact intensity were more likely to perceive community judgment about at-risk drinking and more likely to perceive a lack of treatment privacy. Rural at-risk drinkers were more likely to perceive a lack of privacy in primary care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Link BG, Phelan JC. Conceptualizing stigma.Annual Review of Sociology. 1997;27:363–385.

    Google Scholar 

  2. Judd CM, Park B. Definition and assessment of accuracy in social stereotypes.Psychological Review. 1993;100(1):109–128.

    Google Scholar 

  3. Corrigan PW, Steiner L, McCracken SG, et al. Strategies for disseminating evidence-based practices to staff who treat people with serious mental illness.Psychiatric Services. 2001;52(12):1598–1606.

    Google Scholar 

  4. Corrigan PW, Watson AC. The paradox of self-stigma and mental illness.Clinical Psychology. 2002;9(1):35–53.

    Google Scholar 

  5. Bhugra D. Attitudes towards mental illness: a review of the literature.Acta Psychiatrica Scandinavica. 1989;80(1):1–12.

    Google Scholar 

  6. Crisp AH, Gelder MG, Rix S, et al. Stigmatisation of people with mental illnesses.British Journal of Psychiatry. 2000;177:4–7.

    Google Scholar 

  7. Pescosolido BA, Monahan J, Link BG, et al. The public's view of the competence, dangerousness, and need for legal coercion of persons with mental health problems.American Journal of Public Health. 1999;89(9):1339–1345.

    Google Scholar 

  8. Link BG, Phelan JC, Bresnahan M, et al. Public conceptions of mental illness: labels, causes, dangerousness, and social distance.American Journal of Public Health. 1999;89(9):1328–1333.

    Google Scholar 

  9. Brockington IF, Hall P, Levings J, et al. The community's tolerance of the mentally ill.British Journal of Psychiatry. 1993;162:93–99.

    Google Scholar 

  10. Dudley JR. Confronting stigma within the services system.Social Work. 2000;45(5):449–455.

    Google Scholar 

  11. Schlosberg A. Psychiatric stigma and mental health professionals (stigmatizers and destigmatizers).Medicine & Law. 1993;12(3–5):409–416.

    Google Scholar 

  12. Druss BG, Rosenheck RA, Desai MM, et al. Quality of preventive medical care for patients with mental disorders.Medical Care. 2002;40(2):129–136.

    Google Scholar 

  13. Desai MM, Rosenheck RA, Druss BG, et al. Mental disorders and quality of care among postacute myocardial infarction outpatients.Journal of Nervous & Mental Disease. 2002;190(1):51–53.

    Google Scholar 

  14. Cradock-O'Leary J, Young AS, Yano EM, et al. Use of general medical services by VA patients with psychiatric disorders.Psychiatric Services. 2002;53(7):874–878.

    Google Scholar 

  15. Crocker J, Major B, Steele C. Social stigma. In: Gilbert D, Fisk ST, Lindsey J, eds.The Handbook of Social Psychology. Boston, Mass: McGraw-Hill; 1998;504–553.

    Google Scholar 

  16. Link B. Mental patient status, work, and income: an examination of the effects of a psychiatric label.American Sociological Review. 1982;47(2):202–215.

    Google Scholar 

  17. Link BG. Understanding labeling effects in the area of mental disorders: an assessment of the effects of expectations of rejection.American Social Review. 1987;52:96–112.

    Google Scholar 

  18. Rabkin J. Public attitudes toward mental illness: a review of lieterature.Schizophrenia Bulletin. 1974;1(10):9–33.

    Google Scholar 

  19. Scheff TJ.Being Mentally Ill: a Sociological Theory. Chicago: Aldine de Gruyter; 1966.

    Google Scholar 

  20. Link BG, Cullen FT, Struening EL, et al. A modified labeling theory approach to mental disorders: an empirical assessment.American Sociological Review. 1989;54:400–423.

    Google Scholar 

  21. Link BG. Stigma: many mechanisms require multifaceted responses.Epidemiologia e Psichiatria Sociale. 2001;10(1):8–11.

    Google Scholar 

  22. Hingson R, Mangione T, Meyers A, et al. Seeking help for drinking problems: a study in the Boston metropolitan area.Journal of Studies on Alcohol. 1982;43(3):273–288.

    Google Scholar 

  23. Rost K, Smith GR, Taylor JL. Rural-urban differences in stigma and the use of care for depressive disorders.Journal of Rural Health. 1993;9(1):57–62.

    Google Scholar 

  24. Kessler RC, McGonagle KA, Zhao S, et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the national comorbidity survey.Archives of General Psychiatry. 1994;51(1):8–19.

    Google Scholar 

  25. Dawson DA, Grant BF, Chou SP, et al. Subgroup variation in U.S. drinking patterns: results of the 1992 National Longitudinal Alcohol Epidemiologic Study.Journal of Substance Abuse. 1995;7(3):331–344.

    Google Scholar 

  26. Grant BF. Prevalence and correlates of alcohol use and DSM-IV alcohol dependence in the United States: results of the national longitudinal alcohol epidemiologic survey.Journal of Studies on Alcohol. 1997;58:464–473.

    Google Scholar 

  27. Booth BM, Ross RL, Rost K. Rural and urban problem drinkers in six southern states.Substance Use and Misuse. 1999;34(4/5):471–493.

    Google Scholar 

  28. Grant BF. Toward an alcohol treatment model: a comparison of treated and untreated respondents with DSM-IV alcohol use disorders in the general population.Alcoholism: Clinical and Experimental Research. 1996;20(2):372–378.

    Google Scholar 

  29. Booth BM, Kirchner J, Fortney J, et al. Rural at-risk drinkers: correlates and one-year use of alcoholism treatment services.Journal of Studies on Alcohol. 2000;61(2):267–277.

    Google Scholar 

  30. Hoyt DR, Conger RD, Valde JG, et al. Psychological distress and help seeking in rural America.American Journal of Community Psychology. 1997;25(4):449–470.

    Google Scholar 

  31. Rost K, Fortney J, Zhang M, et al. Treatment of depression in rural Arkansas: policy implications for improving care.Journal of Rural Health. 1999;15(3):308–315.

    Google Scholar 

  32. Beckman LJ, Amaro H. Personal and social difficulties faced by women and men entering alcoholism treatment.Journal of Studies on Alcohol. 1986;47(2):135–145.

    Google Scholar 

  33. Wilsnack SC, Klassen AD, Schur BE, et al. Predicting onset and chronicity of women's problem drinking: a five-year longitudinal analysis.American Journal of Public Health. 1991;81(3):305–318.

    Google Scholar 

  34. Bradley KA, Boyd-Wickizer J, Powell SH, et al. Alcohol screening questionnaires in women: a critical review.Journal of the American Medical Association. 1998;280(2):166–171.

    Google Scholar 

  35. Lemle R, Mishkind ME. Alcohol and masculinity.Journal of Substance Abuse Treatment. 1989;6:213–222.

    Google Scholar 

  36. Miller WR, Cervantes EA. Gender and patterns of alcohol problems: pretreatment responses of women and men to the comprehensive drinker profile.Journal of Clinical Psychology. 1997;53(3):263–277.

    Google Scholar 

  37. Weisner C, Schmidt L. Gender disparities in treatment for alcohol problems.Journal of the American Medical Association. 1992;268(14):1872–1876.

    Google Scholar 

  38. Beckman LJ. Treatment needs of women with alcohol problems.Alcohol Health & Research World. 1994;18(3):206–211.

    Google Scholar 

  39. Beckman LJ, Kocel KM. The treatment-delivery system and alcohol abuse in women: social policy implications.Journal of Social Issues. 1982;38(2):139–151.

    Google Scholar 

  40. Jones W Jr, Clifford P. The privatization of treatment services for alcohol abusers: effect on the black community.Journal of the National Medical Association. 1990;82:337–342.

    Google Scholar 

  41. Alvidrez J. Ethnic variations in mental health attitudes and service use among low-income African American, Latina, and European American young women.Community Mental Health Journal. 1999;35(6):515–530.

    Google Scholar 

  42. de Crane RS, Spielberger CD. Attitudes of Hispanic, Black, and Caucasian University students toward mental illness.Hispanic Journal of Behavioral Sciences. 1981;3(3):241–255.

    Google Scholar 

  43. Grant BF. Barriers to alcoholism treatment: reasons for not seeking treatment in a general population sample.Journal of Studies on Alcohol. 1997;58:365–371.

    Google Scholar 

  44. Cooper-Patrick L, Gallo JJ, Powe NR, et al. Mental health service utilization by African Americans and Whites.Medical Care. 1999;37(10):1034–1045.

    Google Scholar 

  45. Fortney J, Booth BM. Access to substance abuse services in rural areas. In: Galanter M, ed.Recent Developments in Alcoholism, Services Research in an Era of Managed Care. Vol XV. New York: Kluwer Academic/Plenum; 2001:177–209.

    Google Scholar 

  46. Groves RM, Kahn RL.Surveys by Telephone: a National Comparison with Personal Interviews. New York: Academic Press; 1979.

    Google Scholar 

  47. Poulou M. The role of vignettes in the research of emotional and behavioral difficulties.Emotional and Behavioral Difficulties. 2001;6(1):50–62.

    Google Scholar 

  48. Hughes R. Considering vignette technique and its application to a study of drug injecting and HIV risk and safer behavior.Sociology of Science and Illness. 1998;20(3):381–400.

    Google Scholar 

  49. Rahman N. Caregivers sensitivity to conflict: the use of vignette methodology.Journal of Elder Abuse and Neglect. 1996;8:35–47.

    Google Scholar 

  50. Greenfield TK. Ways of measuring drinking patterns and the difference they make: experience with graduated frequencies.Journal of Substance Abuse. 2000;12:33–49.

    Google Scholar 

  51. Project MATCH Research Group. Matching alcoholism treatments to client heterogeneity: project MATCH posttreatment drinking outcomes.Journal of Studies on Alcohol. 1997;58:7–29.

    Google Scholar 

  52. Rost K, Fortney J, Fischer E, et al. Use, quality and outcomes of care for mental health: the rural perspective.Medical Care Research and Review. 2002;59(3):231–265.

    Google Scholar 

  53. Heaney CA, Israel BA. Social networks and social support. In: Glanz K, Rimer BK, Lewis FM, eds.Health Behavior and Health Education. San Francisco, Calif: Wiley; 2002:185–209.

    Google Scholar 

  54. Lewis MA, DeVellis BM, Sleath B. Social influence and interpersonal communication in health behavior. In: Glanz K, Rimer BK, Lewis FM, eds.Health Behavior and Health Education: Theory Research and Practice. San Francisco, Calif: Wiley; 2002:240–264.

    Google Scholar 

  55. Lewis MA, Rook KS. Social control in personal relationships: impact on health behaviors and psychological distress.Health Psychology. 1999;18(1):63–71.

    Google Scholar 

  56. Pescosolido BA, Wright ER, Alegría M, et al. Social networks and patterns of use among the poor with mental health problems in Puerto Rico.Medical Care. 1998;36(7):1057–1072.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. VA HSR&D Center for Mental Health and Outcomes Research, USA

    John Fortney PhD (research health scientist), Geoffrey Curran PhD (research health scientist) & Brenda M. Booth PhD (biostatistician)

  2. Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Arkansas for Medical Sciences, 5800 W 10th St, Suite 605, 72204, Little Rock, AR

    John Fortney PhD (research health scientist), Snigdha Mukherjee PhD (assistant professor), Geoffrey Curran PhD (research health scientist), Stacy Fortney MA (technical writer), Xiaotong Han MS (programmer) & Brenda M. Booth PhD (biostatistician)

  3. The South Central Mental Illness Research Education and Clinical Center, Little Rock, Ark

    Snigdha Mukherjee PhD (assistant professor)

Authors
  1. John Fortney PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Snigdha Mukherjee PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Geoffrey Curran PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Stacy Fortney MA
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Xiaotong Han MS
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Brenda M. Booth PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to John Fortney PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fortney, J., Mukherjee, S., Curran, G. et al. Factors associated with perceived stigma for alcohol use and treatment among at-risk drinkers. The Journal of Behavioral Health Services & Research 31, 418–429 (2004). https://doi.org/10.1007/BF02287693

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02287693

Keywords

Search

Navigation