Employing Bayesian analysis to establish a cut-off point and assess stigma prevalence in substance use disorder: a comprehensive study of the Chinese version of the Substance Use Stigma Mechanism Scale

• Published in: Social Psychiatry and Psychiatric Epidemiology 2024-10, Vol.59 (10), p.1883-1892
• Main Authors: Wang, Dongfang, Zhou, Yanan, Chen, Shubao, Wu, Qiuxia, He, Li, Wang, Qianjin, Hao, Yuzhu, Liu, Yueheng, Peng, Pu, Li, Manyun, Liu, Tieqiao, Ma, Yuejiao
• Format: Article
• Language: English
• Subjects: Adult; Bayes Theorem; Bayesian analysis; China - epidemiology; Discriminant analysis; Drug use; Epidemiology; Factor analysis; Factor Analysis, Statistical; Female; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Multidimensional methods; Prevalence; Psychiatric Status Rating Scales; Psychiatry; Psychometrics; Reproducibility of Results; Social Stigma; Social Support; Stigma; Substance use disorder; Substance-Related Disorders - epidemiology; Substance-Related Disorders - psychology; Surveys and Questionnaires; Young Adult
• ISSN: 0933-7954; 1433-9285; 1433-9285
• DOI: 10.1007/s00127-024-02621-5

Purpose In China, individuals with substance use disorders (SUD) face severe stigma, but reliable stigma assessment tool is lacking. Therefore, this study aimed to validate the Chinese version of the Substance Use Stigma Mechanism Scale (SU-SMS-C) and set its cut-off point. Methods We recruited 1005 individuals with SUDs from Chinese rehabilitation centers. These participants completed a battery of questionnaires that included the SU-SMS-C, The Multidimensional Scale of Perceived Social Support (MSPSS), Center for Epidemiologic Studies Depression Scale (CES-D), General Self-Efficacy Scale (GSES), and Perceived Devaluation and Discrimination (PDD). Confirmatory factor analysis was used to assess the construct validity of the scale. Additionally, the Naive Bayes classifier was used to establish the cut-off point for the SU-SMS-C. We additionally explored the correlation between patient demographic characteristics and stigma. Results A confirmatory factor analysis was utilized, revealing a second-order five-factor model. Based on the Naive Bayes classifier, the area under the receiver operating characteristic (AUCROC) of 0.746, the cut-off point for the SU-SMS-C was established at 44.5. The prevalence of stigma observed in the study population was 49.05%. Significant disparities were observed in the distribution of stigma across genders, with males experiencing more pronounced stigma than females. Moreover, patients consuming different primary substances reported diverse levels of stigma. Notably, those primarily using heroin endured a higher degree of stigma than users of other substances. Conclusion The study is the first to identify a cut-off point for the SU-SMS-C by Naive Bayes classifier, bridging a major gap in stigma measurement research. SU-SMS-C may help treat and manage SUDs by reducing stigma.