The role of executive functioning deficits in the association between substance-use-related stigma and substance use problems among trauma-exposed individuals

Abstract

Background: Previous research has linked the internalization of shame and negative stereotypes associated with substance use to increased severity of substance use problems (i.e., negative consequences associated with alcohol and drug use, including occupational or relational difficulties and illegal behavior). However, little work has examined how other aspects of substance-use-related stigma (e.g., encounters with and anticipation of discrimination) might be related to the severity of substance use problems. Further, the psychological mechanisms through which stigma drives substance use problems remain poorly understood. Addressing these key limitations, the current study examined the role of executive functioning (EF) deficits in the relation between substance-use-related stigma and severity of substance use problems. Methods: In fall 2019, adults exposed to trauma who use substances were recruited via Amazon’s Mechanical Turk (N = 320, 46.9% women) and completed self-report measures of substance-use-related stigma, EF deficits, and substance use problems. Results: Substance-use-related stigma was positively associated with EF deficits, which in turn related to substance use problems. Substance-use-related stigma was also indirectly associated with substance use problems through EF deficits, suggesting that EF deficits accounted for the significant association between substance-use-related stigma and substance use problems. Conclusions: These findings provide initial support for the role of EF deficits as a mechanism through which stigma drives substance use problems among individuals exposed to trauma. Results underscore the potential utility of addressing stigma coping and EF deficits in interventions aimed at preventing and treating substance use disorders.

Keywords:

• Stigma
• substance use
• executive functioning
• trauma

Author Contributions

Author Wang conceptualized the project, guided the selection of study variables and analyses, and contributed to writing the initial draft. Author Schick provided the formal statistical analyses and contributed to writing the initial draft. Author Weiss provided the data used in the present project and contributed to writing the initial draft. All authors reviewed and approved the final manuscript before submission.

Acknowledgement

The authors would like to thank the lead research assistant for this study, Devon Quinn.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This research was supported by grants from the National Institutes of Health awarded to Katie Wang [K01DA045738] and Nicole H. Weiss [K23DA039327, P20GM125507], as well as a grant awarded to Devon L. Quinn from the University of Rhode Island Undergraduate Research and Innovation Committee. The funding sources had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication.