The relationship between COVID-19-related stigma and alcohol use, mental health, fear of COVID-19 and fatigue at 2-year follow-up

Authors

• BL Stangl
• JW Luk
• RV Shah
• CL Vaughan
• AJ Waters
• ML Schwandt
• D Goldman
• N Diazgranados
• VA Ramchandani

Abstract

Purpose: The negative effect of stigma on mental health has been well documented. However, the stigma associated with COVID-19 has been understudied. We adapted a stigma questionnaire to examine the effect of COVID-19 related stigma on alcohol use, mental health, fear of COVID-19 and fatigue at 2-year follow-up in individuals across a wide range of alcohol use patterns.
Methods/Data: Participants (N=250, M=125) previously enrolled in the NIAAA Natural History Protocol were recruited for a 2-year follow-up longitudinal survey study. Alcohol use and consequences were measured using the Alcohol Use Disorder Identification Test (AUDIT). Twelve stigma questions were adapted from a scale of 17 items measuring HIV/AIDS related stigma (Visser et al., 2008). Mental health measures of anxiety and depression included the Generalized Anxiety Disorder (GAD) questionnaire and the Patient Health Questionnaire (PHQ-9), respectively. Fear of COVID was measured using the Fear of COVID-19 Scale (FCV-19S). Fatigue was measured using the Fatigue Assessment Scale (FAS) with three measures of fatigue: physical fatigue, mental fatigue, and pandemic fatigue.
Results: The Stigma scale had strong internal consistency (Cronbach’s α = 0.80). Correlational analyses revealed that greater COVID-19 related stigma was associated with greater anxiety and depression symptoms, less alcohol use, greater fear of COVID-19, and greater physical and mental fatigue (all p’s<0.05).
Conclusions: These findings highlight the need to address COVID-19 related stigma and its association with poorer mental health. Future directions include examining the role of race, discrimination, and impact from the COVID-19 pandemic on stigma to better understand sources of vulnerability.

Scientific Focus Area: Clinical Research

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