Treatments for addictive behaviours

What are common public perceptions of people with substance use disorder (SUD)?

Dangerous, unpredictable, helpless, and non-human.

Compared to mental disorders, how are individuals with alcohol use disorder perceived?

As more dangerous and more responsible for their condition.

What is public stigma?

Negative beliefs/attitudes held by the public toward a group, leading to discrimination.

What is self-stigma?

Internalisation of public stigma by individuals, leading to marginalisation and reduced treatment engagement.

What is the Brain Disease Model of Addiction?

The idea that addiction is driven by neuroadaptations from chronic drug use, making abstinence and treatment difficult.

How do biogenetic explanations affect stigma?

They reduce blame but increase perceptions of danger, unpredictability, social distance, and prognostic pessimism.

What is the Mixed-Blessing Model?

A framework stating biogenetic explanations have both positive (less blame) and negative (more dangerousness) effects on stigma.

What was manipulated in Kelly et al.’s vignettes?

Labels (e.g., “brain disease,” “illness,” “problem”) and gender of person described.

What did Kelly et al. find about the “chronically relapsing brain disease” label?

It decreased blame attribution but did not reduce other forms of stigma.

In Kelly et al study. Which label increased prognostic optimism?

The label “problem”.

Rundle et al., 2021

• Public stigma was highest for alcohol use disorder.

• Psychological and nature models of addiction associated with lower public stigma

• Moral model of addiction associated with higher stigma

What was a key methodological difference between Kelly and Rundle?

Kelly manipulated labels; Rundle measured participants’ existing beliefs.

How did treatment stability differ between Kelly and Rundle

• Kelly: High likelihood of treatment success

• Rundle: Uncertain, variable outcomes

Pennington et al. (2023)

• Registered Report (methodology peer-reviewed before data collection).

• Participants believed they were connected online to another participant (the vignette target).

• Condition type (drug use vs. health concern)

• Label (brain disease vs. problem)

• Treatment stability (high vs. low)

How did the ‘drug use’ condition compare to 'health concern'- Pennington et al. (2023)

It produced:

• ↑ Social distance

• ↑ Perceived danger

• ↓ Blame

• ↑ Public stigma

• ↑ Punishment in financial discrimination task

Effects of “chronically relapsing brain disease” vs. “problem” label- Pennington et al. (2023)

• ↓ Social distance

• ↑ Blame (genetic/biological blame)

• ↓ Public stigma

• No clear effect on danger or optimism

Effects of low vs. high treatment stability- Pennington et al. (2023)

Low stability increased:

• Social distance

• Perceived danger

• Public stigma

What does Pennington et al. (2023) study suggests about addiction stigma

Stigma is strongly context-dependent and influenced by labels, condition type, and treatment expectations.

What is “functional attribution” in addiction?

The idea that judgments of responsibility and blame depend on context rather than fixed traits.

What are the overall conclusions of Pennington et al.?

• All three manipulations (condition type, label, stability) influenced stigma.

• Drug use continues to be highly stigmatised.

• The brain disease model’s effect on stigma remains mixed.

• Labels influence different dimensions of stigma rather than producing a uniform effect.