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Title: Psychological distress mediated the effects of self-stigma on quality of life in opioid-dependent individuals : a cross-sectional study
Authors: Chang, KC
Lin, CY 
Chang, CC
Ting, SY
Cheng, CM
Wang, JD
Issue Date: 2019
Publisher: Public Library of Science
Source: PLoS one, 2019, v. 14, no. 2, e0211033 How to cite?
Journal: PLoS one 
Abstract: Background: Both stigma and psychological distress affect quality of life (QOL). This study is an attempt to determine the effects of these two factors on QOL and to explore possible mediation effects between psychological distress and self-stigma in opioid-dependent individuals.
Methods: This cross-sectional study comprised 268 consecutive, treatment-seeking opioid-dependent individuals who were interviewed using the brief version of the World Health Organization Quality of Life instrument (WHOQOL-BREF), the Self-Stigma Scale-Short (SSS-S), the Chinese Health Questionnaire-12 (CHQ-12), and the Opiate Treatment Index (OTI). A series of regression models were constructed to determine if the SSS-S and CHQ-12 predict the WHOQOL-BREF scores. Moreover, a comparison of the potential mediation effects of psychological distress (as assessed by the CHQ-12) was made between the SSS-S and the WHOQOL-BREF using the Baron and Kenny procedure (including three separate regressions), along with the Sobel test.
Results: The CHQ-12 score was predictive of the scores for the four domains and almost all facets of the WHOQOL-BREF except the item, “Dependence on medical aids.” Nonetheless, the SSS-S score predicted three of the four facets of the social QOL after adjustment of the CHQ-12 score. Psychological distress completely mediated the relation between self-stigma and the physical, psychological, and environmental domains, and partially mediated the relationship between self-stigma and social QOL (two-tailed Sobel test: p = 0.02 for each domain).
Conclusions: Psychological distress has a significant impact on the QOL of treated opioid users. It appears to be a core element in reducing the negative effects of self-stigma on aspects of QOL.
EISSN: 1932-6203
DOI: 10.1371/journal.pone.0211033
Rights: © 2019 Chang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
The following publication Chang K-C, Lin C-Y, Chang C-C, Ting S-Y, Cheng C-M, Wang J-D (2019) Psychological distress mediated the effects of self-stigma on quality of life in opioid-dependent individuals: A cross-sectional study. PLoS ONE 14(2): e0211033 is available at
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