These two scales measure knowledge that spans the continuum of substance use disorder (SUD) prevention, treatment, and recovery. The SUD Prevention Knowledge Scale includes 16 items measuring age-related risk factors, other risk factors, and protective factors for SUD. The SUD Knowledge Scale includes 16 items measuring SUD-related characteristics, treatment and recovery, and medications.
There have been recent increases in mental health problems in the United States, especially among youth and young adults. Evidence suggests that stigma is a barrier to mental health treatment. Our lab is working on understanding how mental illness stigma develops, changes over time, and ultimately relates to mental health treatment.
In this paper, we introduce a conceptual framework that identifies pathways linking structural-level stigma with outcomes across the mental illness (MI) and substance use disorder (SUD) treatment cascade.
Stigma is constantly changing. It waxes and wanes throughout history, is experienced and perpetuated by humans who develop over their life course, and is tied to social statuses (like illnesses and identities) that are gained, change, or lost over people’s lives. Although stigma is inherently fluid, our research and interventions typically treat stigma as if it were fixed or stagnant. We have argued that better integrating time into stigma research can accelerate our understanding of how and when stigma harms health as well as our ability to intervene to address stigma and improve health. We focus on three timescales, including the historical context, human development, and stigma course.
Read more in this paper and in our special section on stigma and time published in Stigma and Health in 2024.
Earnshaw, V. A., Watson, R. J., Eaton, L. A., Brousseau, N. M., Laurenceau, J. P., & Fox, A. B. (2022). Integrating time into stigma and health research. Nature Reviews Psychology, 1(4), 236-247.
The MMT-SMS measures enacted stigma (experiences of discrimination from others in the past or present), anticipated stigma (expectations of experiencing discrimination from others in the future), and internalized stigma (endorsement and application of negative beliefs and feelings about people receiving methadone and applying them to the self) among people receiving methadone maintenance treatment (MMT). Enacted and anticipated stigma from family members, employers, and healthcare workers are measured. The scale may be adapted for persons experienced with other forms of medication-assisted therapy for opioid use disorders.
Health-related stigma frameworks typically focus on one health condition in isolation. This tendency encourages a siloed approach to research on health-related stigma, impeding comparisons across stigmatized conditions and research on innovations to reduce health-related stigma and improve health outcomes.
There has been a proliferation of research on mental illness stigma; however, lack of consistency and clarity in the conceptualization and measurement of mental illness stigma has limited the accumulation of scientific knowledge about mental illness stigma and its consequences.
Much of our work aims to understand and address stigma and health inequities across the HIV prevention and treatment cascade.
The Chronic Illness Anticipated Stigma Scale (CIASS) measures anticipated stigma (expectations of experiencing discrimination from others in the future) among people living with chronic illnesses. The CIASS differentiates between three sources of stigma within three subscales: friends and family, work colleagues, and healthcare workers.
The Sexual Stigma Scale measures experiences of perceived stigma (awareness of negative attitudes toward one’s group) and enacted stigma (experiences of discrimination from others in the past or present) among lesbian, bisexual, and queer women.
