Childhood Trauma and Self-Stigma of Alcohol Dependence: Applying the Progressive Model of Self-Stigma

摘要

Alcohol dependence is a highly stigmatized mental illness, and self-stigmatization has severe consequences for treatment outcomes and help seeking. To better understand the process of self-stigmatization for persons with alcohol dependence, this paper explores the impact of negative childhood experiences on self-stigmatization in alcohol dependence. Eighty-six patients with alcohol dependence of different severity were interviewed. Measurements included the Self-Stigma of Alcohol Dependence scale, Childhood Trauma Questionnaire (CTQ), Severity Scale of Alcohol Dependence, and Brief Symptom Inventory. Childhood trauma was associated with stronger self-stigma. Within the progressive model of self-stigma, childhood trauma was associated with stronger agreement with negative stereotypes, stronger applying negative stereotypes to oneself, and more harm because of the loss of self-esteem. Associations with agree and apply remained significant when controlling for current type of treatment seeking, severity of alcohol dependence, and depression in multiple regression analyses. Mediation analyses indicated that the association of the CTQ score with apply was fully mediated by stronger personal agreement with negative stereotypes, and the association of the CTQ score with harm was fully mediated by the severity of depression. Childhood trauma aggravates self-stigma in alcohol dependence. Stronger agreement with negative stereotypes seems a crucial step in this process.