Assessing the validity of implicit and explicit measures of stigma toward clients with substance use disorders among mental health practitioners

Stigmatizing attitudes about individuals with a Substance Use Disorder (SUD) are known to contribute to the individual's psychological problems and response to treatment. Providers of SUD treatment services have been shown to endorse stigmatizing attitudes, explicitly and implicitly, and these attitudes can interfere with treatment. Most research on SUD stigma has used explicit measures, although a small body of implicit attitude research has demonstrated promise in using implicit measures. However, very little implicit measure data is available from populations of SUD treatment providers, and the ability of implicit measures to predict clinically relevant behaviors is a critical and relatively underexamined issue. The purpose of the current study was to examine implicit SUD stigma among treatment providers and to evaluate the impact of implicit stigma on measures of social distance and willingness to write letters of support for a client with a SUD. The results showed that an explicit measure of SUD stigma outperformed the implicit measure in predicting social distance, and that the implicit measure outperformed the explicit measure in predicting willingness to write letters of support. These data support the contention that implicit attitudes may have a practical and negative impact on treatment of individuals with a SUD. Future studies may focus on further developing implicit assessment of SUD stigma in the service of improving SUD treatment and therapist training.