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Perceived alcohol stigma: factor structure and construct validation.

ABSTRACT: INTRODUCTION:There has been an increasing interest in studying the stigma of alcohol use disorders (AUDs) yet scant research has evaluated the conceptualization and measurement of alcohol stigma. This study examined the measurement properties (i.e., factor structure) and validity of the alcohol-adapted Perceived Devaluation-Discrimination scale (PDD), which assesses the construct of perceived alcohol stigma (PAS). METHODS:Our sample included 34,386 respondents from the Wave 2 assessment in the National Epidemiologic Survey on Alcohol and Related Conditions, a population-representative survey of noninstitutionalized U.S. adults. Analytic procedures included confirmatory factor analysis and structural equation modeling. RESULTS:One-factor (perceived devaluation-discrimination) and 2-factor (perceived devaluation, perceived discrimination) confirmatory factor analytic models fit the data well (Comparative Fit Index = 0.958, Tucker-Lewis Index = 0.942, Root Mean Square Error of Approximation = 0.056; Comparative Fit Index = 0.962, Tucker-Lewis Index = 0.946, Root Mean Square Error of Approximation = 0.054; respectively) when adjusting for item wording effects with a latent method factor. Despite having a better fit to the data, ?(2) (1) = 542, p < 0.0001, the 2 factors were highly correlated (r = 0.90), which led us to favor a 1-factor model. Structural equation models found that the inverse relationship between PAS and perceived interpersonal social support was strongest for persons with a stigmatized labeling status. The same was not true in analyses predicting social network involvement. CONCLUSIONS:A 1-factor solution of PAS had superior parsimony. The alcohol-adapted PDD appears to be a psychometrically sound measure and exhibits relationships that are consistent with modified labeling theory.

SUBMITTER: Glass JE

PROVIDER: S-EPMC3893041 | biostudies-literature | 2013 Jan

REPOSITORIES: biostudies-literature

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Perceived alcohol stigma: factor structure and construct validation.

Glass Joseph E JE Kristjansson Sean D SD Bucholz Kathleen K KK

Alcoholism, clinical and experimental research 20120703

<h4>Introduction</h4>There has been an increasing interest in studying the stigma of alcohol use disorders (AUDs) yet scant research has evaluated the conceptualization and measurement of alcohol stigma. This study examined the measurement properties (i.e., factor structure) and validity of the alcohol-adapted Perceived Devaluation-Discrimination scale (PDD), which assesses the construct of perceived alcohol stigma (PAS).<h4>Methods</h4>Our sample included 34,386 respondents from the Wave 2 asse ...[more]

PMID: 22758603

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Project description:Background and aimExperience of stigma towards methadone maintenance treatment (MMT) may be a barrier to the use of this treatment by people with opioid use disorder. We evaluated the factor structure, internal reliability, construct and criterion validity of a theory-based stigma measure, the Methadone Maintenance Treatment Stigma Mechanisms Scale (MMT-SMS) and compared this with the Substance Use Stigma Mechanism Scale (SU-SMS).DesignSurveys at the beginning and end of a prospective study together with records of drug use and treatment attendance during that study.SettingCommunity methadone clinic in the Northeastern USA.ParticipantsNinety-three participants who were receiving MMT; the average daily methadone dose was 84.8 mg/day (standard deviation = 28.39 mg/day).MeasurementsThe MMT-SMS uses a self-report questionnaire to assess three dimensions reflecting experiences of anticipated (nine items), enacted (nine items) and internalized stigma (seven items) specifically related to receiving MMT. Anticipated and enacted scales include three stigma source subscales (family, employers, health care workers; three items each). Responses are recorded on a five-point Likert-type scale, then averaged to produce the MMT-SMS scale/subscale scores. The SU-SMS is a self-report questionnaire to assess experiences of anticipated, enacted and internalized stigma regarding substance use history. Both scales were administered at the final parent study visit. Other measures included were assessed in the parent study and used to assess life-time and recent MMT (e.g. current MMT dose) and drug use experiences (e.g. past 30-day heroin injection).FindingsThe MMT-SMS demonstrated good internal reliability (α = 0.806-0.952 for components). Confirmatory factor analysis supported the seven-factor scale structure, distinguishing between experiences of anticipated, enacted and internalized stigma, and anticipated and enacted stigma source subscales (family, employers, health care workers) [root mean square error of approximation (RMSEA) = 0.076, 90% confidence interval (CI) = 0.061-0.090, P-close = 0.003; confirmatory fit index (CFI) = 0.974; Tucker-Lewis index (TLI) = 0.971]. Construct validity helped to distinguish the MMT-SMS from established substance use stigma constructs. Criterion validity observed associations with substance use experiences while on MMT, likely to predict future MMT success. Internalized MMT stigma was uniquely associated with daily MMT dose. Regarding criterion validity: anticipated MMT and enacted substance use stigma were associated with past 30-day heroin injection, MMT stigma uniquely associated with opioid use behaviors while receiving MMT, and substance use stigma broadly associated with injection-related behaviors.ConclusionsThe Methadone Maintenance Treatment Stigma Mechanisms Scale appears to be a reliable measure of methadone maintenance treatment stigma with robust validity in a sample of people with opioid use disorders receiving methadone maintenance treatment.

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Perceived alcohol stigma: factor structure and construct validation.

Publications

Perceived alcohol stigma: factor structure and construct validation.

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