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Negative Impacts of Self-Stigma on the Quality of Life of Patients in Methadone Maintenance Treatment: The Mediated Roles of Psychological Distress and Social Functioning

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Ching Ming Cheng, Chih Cheng Chang, Jung Der Wang, Kun Chia Chang, Shuo Yen Ting, Chung Ying Lin

Original languageEnglish
Article number1299
JournalInternational Journal of Environmental Research and Public Health
Issue number7
Accepted/In press6 Apr 2019
Published11 Apr 2019

King's Authors


A sample of heroin users (n = 250) in methadone maintenance treatment (MMT) was used in this cross-sectional study to clarify the mechanisms of the effects of stigma on quality of life (QoL) through psychological distress and social functioning. All the participants had their self-stigma, psychological distress, social functioning, and QoL measured. Psychological distress and social functioning were proposed to be mediators between self-stigma and QoL. Several linear models using structural equation modeling were conducted to examine the mediated effects. The negative effects of self-stigma on QoL were significantly mediated by psychological distress, as self-stigma directly and significantly influenced psychological distress, but not social functioning. This study demonstrated a linear model describing the effects of self-stigma on QoL for opioid-dependent individuals; psychological distress was also an important mediator between self-stigma and their QoL. Clinicians were able to notice the importance of reducing self-stigma for opioid-dependent individuals according to the following results: higher levels of self-stigma were associated with high psychological distress, decreased social functioning, and impaired QoL. Our mediation findings suggest that treating psychological distress is better than treating social functioning if we want to eliminate the effects of self-stigma on QoL for heroin users.

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