Understanding public stigma toward substance dependence Patrick Janulis 1 , Joseph R. Ferrari 2 , Patrick Fowler 3 1 Department of Psychology, Michigan State University 2 Department of Psychology, DePaul University 3 Department of Psychology, Washington University Correspondence concerning this article should be addressed to Patrick Janulis, Department of Psychology, Michigan State University, Psychology Building, East Lansing, MI 48824-1116, USA. E-mail: janulisp@msu.edu doi: 10.1111/jasp.12070 Abstract This study examined the mechanisms of stigma toward individuals diagnosed with substance-related disorders. The applicability of a mental health model of stigma extended to substance dependence was tested. Undergraduates completed a modi- fied version of stigma questionnaires previously used to measure mental health stigma models. Questionnaires captured familiarity, perceived dangerousness, fear, and desired social distance toward individuals dependent to alcohol, marijuana, and heroin. Path analysis assessed the direct and indirect effects within this theoretical model for each substance. For marijuana and heroin, path models suggested that familiarity indirectly predicted desired social distance through perceived dangerous- ness and fear. For alcohol, familiarity did not indirectly or directly predict desired social distance. Implications for applying mental health models to substance disor- der stigma are discussed. Mental health stigma has been recognized as a major barrier to seeking psychological treatment and psychiatric recovery (Corrigan, 2004; Link, Struening, Neese-Todd, Asmussen, & Phelan, 2001). Although evidence documented the damaging effects of mental health stigma on psychological well-being (Corrigan, 2004, 2005; Link & Phelan, 2006), few studies examined how mental health stigma manifests for specific psychological disorders. Furthermore, stigma toward sub- stance disorders was rarely studied, perhaps because the assumed preventative benefits yielded from this stigma (Rasinksi, Woll, & Cooke, 2005). However, substance abuse stigma has numerous negative consequences such as disem- powering addicted individuals (Madden & Cavalieri, 2007), limiting access to much needed health services (Ahern, Stuber, & Galea, 2007; Drumm et al., 2003; Skinner, Feather, Freeman, & Roche, 2007), and increasing the cost for addicted individuals to engage in optimally healthy behavior (Rhodes, Singer, Bourgois, Friedman, & Strathdee, 2005). In an effort to guide stigma research and interventions toward effective and lasting change, the process of stigmatization must be thoroughly understood (Corrigan, 2000). The present study evaluated a theoretical stigma models of desired social distance (Angermeyer, Matschinger, & Corrigan, 2004; Corrigan, 2000) for dependence to alcohol, marijuana, or heroin. Stigma is defined as a social mark signifying deviancy (Jones et al., 1984) accompanied by a deeply discrediting attribute (Goffman, 1986). Stigma is a moral statement about the relationship between an individual’s characteristic(s) and the social world (Yang et al., 2007) and acts as a threat to an individual’s humanity (Dovidio, Major, & Crocker, 2003). Stigma is dependent on the relationship between the specific discrediting attribute and the specific social context; in other words, a stigmatized characteristic may not be discrediting in all situations (e.g., when with other members of a stigmatized group), it is therefore a product of the social situation rather than any specific individual (Major & O’Brien, 2005). There are two manifestations of social stigma. Public stigma includes the negative beliefs individuals in society have about individuals from stigmatized groups. (Corrigan & Watson, 2002). Self-stigma is internalized devaluation that individuals from stigmatized groups turn against themselves (Corrigan & Watson, 2002). As a specific category of mental illness, substance disorders have a unique stigma. Substance disorders are viewed as a combination of crime and disease; consequently, stigma toward substance abuse is seen as both a form of deterrent social control and a damaging force toward individuals already dependent on drugs (Room, 2005). Alcohol and drug disorders are viewed as some of the most dangerous psychological disorders (Link, Phelan, Bresnahan, Stueve, & Pescosolido, 1999). In the 1996 General Social Survey, 87.3% of respondents viewed individuals with drug dependence as likely to do something violent compared with 70.9% for Journal of Applied Social Psychology 2013, 43, pp. 1065–1072 © 2013 Wiley Periodicals, Inc. Journal of Applied Social Psychology 2013, 43, pp. 1065–1072