Abstract
BackgroundWhile it is well-recognized that the stigma associated with alcohol use problems can prevent or delay help-seeking, there is limited research examining stigmatising attitudes towards alcohol misuse, or their consequences, during adolescence. The current study examined the results of a school-based intervention on adolescents’ stigmatising attitudes towards alcohol misuse among their peers, and how changes in attitudes influenced intentions to encourage help-seeking, as well as participants’ personal use and misuse of alcohol.MethodsParticipants (n = 463) were a subset of a larger sample participating in a randomized controlled trial of the MAKINGtheLINK intervention. Of the included participants, 287 (62%) were allocated to the intervention group and 176 (38%) to the control group. Assessments were conducted at baseline and 6-weeks, 6-months, and 12-months post-baseline. At each assessment, participants were presented with a vignette describing a peer experiencing alcohol misuse and completed the General Help Seeking Questionnaire as well as a 10-item scale measuring stigmatising attitudes. Alcohol use was also assessed.ResultsThe intervention was associated with a greater reduction in ‘weak-not-sick’ attitudes over time, which in turn predicted stronger intentions to encourage help-seeking from family members and formal help sources at the 12-month follow-up. Perceptions of dangerousness did not change significantly as a result of the intervention, however overall perceptions of dangerousness demonstrated a trend towards encouraging help-seeking from formal sources. Changes in stigma were not associated with past-year alcohol use or problems.ConclusionsSchool-based interventions such as MAKINGtheLINK can decrease some stigmatising attitudes towards alcohol misuse during adolescence, and increase adolescents’ intentions to encourage help-seeking from both formal and informal help sources. However, results varied depending on both the dimension of stigma examined and the type of help source, highlighting a complex relationship between stigma, intentions, and sources of help that requires further investigation. Importantly, reducing stigma did not appear to result in negative effects due to greater acceptance of drinking (e.g., heavier alcohol use), supporting continued efforts to reduce alcohol-related stigma during adolescence.Trial registration: Registered with the Australia and New Zealand Clinical Trials Register (ANZCTR) on the 27th of February 2013 (ACTRN12613000235707)
Highlights
While it is well-recognized that the stigma associated with alcohol use problems can prevent or delay help-seeking, there is limited research examining stigmatising attitudes towards alcohol misuse, or their consequences, during adolescence
In analysis of baseline data from the same sample, we found that ‘weaknot-sick’ attitudes were associated with weaker intentions to encourage help-seeking for alcohol misuse from peers, family members, formal help sources, and the internet, while ‘dangerousness’ attitudes were associated with weaker intentions to encourage help-seeking from peers and the internet, but stronger intentions to encourage help-seeking from formal sources [15]
Change in stigmatizing attitudes over time There was no overall change in ‘weak-not-sick’ attitudes over the 12-month study period (F(3, 1368) = 1.678, p =
Summary
While it is well-recognized that the stigma associated with alcohol use problems can prevent or delay help-seeking, there is limited research examining stigmatising attitudes towards alcohol misuse, or their consequences, during adolescence. Research from the mental health literature has highlighted the adverse outcomes of stigmatising attitudes and beliefs, which can include discrimination, social isolation, delayed problem recognition, and avoidance of professional treatment [3, 4]. Together, this literature highlights a need to reduce the stigma associated with alcohol misuse. As young people often rely on peers rather than seeking professional help [9], it is vital that they are not ostracized or provided with unhelpful advice due to the stigma associated with alcohol misuse
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