Misconceptions, prejudice and social distance towards people with alcohol use disorders in China

Misconceptions, prejudice and social distance towards people with alcohol use disorders in China | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Misconceptions, prejudice and social distance towards people with alcohol use disorders in China Qingyan Yang, Nicolas Rüsch, Kebing Yang, Yajuan Niu, Yanxia Xiao, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4971967/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 19 Feb, 2025 Read the published version in BMC Psychiatry → Version 1 posted 10 You are reading this latest preprint version Abstract Purpose: Research from Western societies indicates pervasive public stigma against people with alcohol use disorders (AUDs). However, there is a lack of knowledge about the interactions between different components of stigma and their contribution to discriminatory behaviour towards individuals with AUDs within the Chinese cultural context. The aim of the present study was therefore to investigate the relationships of (mis-)conceptions, stereotypes, emotional reactions, perceived public stigma and their contribution to the desire for social distance among the Chinese adults. Methods: (Mis-)conceptions, stereotypes, emotional responses, willingness to help and avoid, perceived stigma, and the desire for social distance from individuals with AUDs were assessed via a cross-sectional online survey with a sample of 1,100 adults from the Chinese population. Results: Three-fourth of the participants recognised AUDs as mental illnesses, though 70% of the sample did not support health insurance coverage for the treatment of AUDs. A stronger desire for social distance was associated with increased perceived public stigma, greater recognition of alcohol use disorders as mental illnesses, heightened perceptions of personal responsibility, increased fear, and more willingness to avoid and withhold help, controlling for age, gender, education, employment, and alcohol consumption. Conclusions: To improve social integration for individuals with AUDs in China, culturally tailored anti-stigma programmes are needed to reduce negative attitudes and discriminatory behaviours among the Chinese population. alcohol use disorders public stigma stereotype discrimination China stigma change 1. Introduction Alcohol use disorders (AUDs) are one of the most prevalent mental disorders globally and are associated with high mortality and burden of diseases [1]. In China, the lifetime and 12-month prevalence of any alcohol use disorder was 4.4% and 1.8%, respectively, which was more than that of any drug use disorders [2]. However, many individuals with symptoms consistent with AUDs remain undiagnosed and untreated worldwide [3], including in China, where only 2.4% of individuals with alcohol dependence receive treatment [4]. Recent studies [5-7] indicate that alcohol-related stigma might be one of the most prominent barriers to treatment-seeking for alcohol use disorders. Myths about AUDs are prevalent and can lead to misconception and stigma, further impeding the willingness of people with AUDs to seek the necessary help and support [8]. Common myths may involve the perception that alcohol use disorders result from personality weakness or character flaws, rather than recognising these disorders as mental illnesses influenced by a complex interplay of biological, psychological, and environmental factors [9]. Some people may believe alcohol-related treatment should not be covered by medical insurance [10]. These oversimplified perspectives can contribute to judgmental attitudes and discourage individuals from seeking help, exacerbating discrimination towards individuals with these conditions and hinder their recovery process. Public stigma is markedly encountered by people with AUDs and often leads to additional challenges in their lives [11]. Stigma towards AUDs encompasses widely endorsed negative stereotypes, leading to prejudice and discrimination [12]. Common stereotypes about people with AUDs are that they lack self-control, are dangerous and are emotionally unstable [11, 13]. According to the attribution theory of mental illness stigma [14, 15], people who attribute a person’s problems to controllable factors are more likely to be hostile and critical towards this individual. Compared to individuals with psychosis, people with AUDs are judged as much more responsible for their conditions and less worthy of support or care [13]. Prejudice occurs if people endorse these stereotypes and react emotionally. For example, “It is right that people with alcohol use disorders are unreliable and dangerous. I am scared of them” [12]. Discrimination involves unjustified unequal treatment or actions taken towards the stigmatised individuals or groups [16], such as limitations to rental opportunities, employment prospects and interpersonal relationships [17]. Studies among the general population [18, 19] suggested a connection between higher levels of stereotypes and a greater preference for social distance from individuals with AUDs. Perceived stigma refers to the subjective perception of the stereotypes, prejudice and discrimination held by the majority population [20], which pertains to how stigmatised individuals are viewed and treated by society. It is deeply rooted in public stigma and reflects the anticipated stigmatising attitudes among the general public, where individuals fear being judged, blamed, or socially excluded if they were experiencing alcohol use disorders [21, 22]. Findings from a German national survey [23] suggested a potential association between perceived stigma and the tendency for social distancing from individuals with AUDs. Consequently, perceived stigma may discourage individuals from pursuing the necessary help for their alcohol use problems [24], contribute to social withdrawal to avoid judgement from others [25], and lead individuals to internalise stereotypes, thereby diminishing self-worth [26, 27]. Other types of stigma, such as structural stigma and self-stigma, are also significant factors that can impact individuals with AUDs [13], though these are beyond the scope of this study. Although drinking alcohol is a widely accepted cultural tradition and crucial for fostering social bonding in China, traditional collectivist culture emphasises morality and self-controlled drinking, stressing maintenance of social order and the avoidance of embarrassment with drunken behaviours [28]. Furthermore, the concept of “saving face” is deeply rooted in Chinese culture [29]. Social harmony and the reputation of the family and community are highly valued. Individuals with AUDs may be viewed as bringing shame not only upon themselves but also upon their families [30]. Feeling ashamed, and fearing being labelled and discriminated against were identified as key factors contributing to reluctance to seek help and social withdrawal among individuals with substance use disorders [30]. These cultural norms, subject to stigma and social marginalization [31], are amplified by the collectivistic nature of Chinese society, where individuals tend to perceive public prejudices as justified [32]. Stigma towards AUDs may therefore be particularly widespread in China. Few studies conducted among the Chinese population provided initial insights into public stigma and its potential impacts on individuals with AUDs. A community-based study [30] showed that the vast majority of respondents perceived individuals with alcohol addiction as having undesirable characteristics, which could potentially hinder their willingness to seek help. A cross-sectional study [33] found an association between alcohol use problems and experience of unfair treatment in public services. Xiong et al. [34] found that the general public expected occupational restrictions of people with a history of alcohol use problems, particularly in roles requiring high responsibility, such as that of a bus driver. These population-based surveys investigated specific aspects of alcohol-related stigma, however, they did not consider stigma as a multidimensional concept that encompasses various components, including stereotypes, prejudice, and discrimination [12, 13]. Discriminatory behaviour, in particular, is a critical manifestation of stigma, that impacts individuals’ access to treatment, social integration, and overall well-being [17]. The interactions between different components of stigma and their contribution to discriminatory behaviour in the Chinese cultural context remain unclear. Research in this field is needed to inform targeted interventions and address alcohol-related stigma. The present study therefore aimed to test the hypothesis that a higher level of desire for social distance from individuals with AUDs is independently associated with more (mis-)conceptions, perceived public stigma, stereotypes, and negative emotional reactions among Chinese adults. As female gender, older age, lower education, and unemployment were found to be associated with higher public stigma about mental illness among the Chinese population [35], we controlled age, gender, education, and employment to avoid confounding effects. Additionally, given the association of alcohol consumption and mental health utilisation with alcohol-related stigma [36], we also included these as confounding variables. Findings from the study could help guide the development of targeted interventions to reduce stigma and improve social integration for individuals with AUDs among the Chinese population. 2. Methods 2.1 Design and participants This cross-sectional online survey involves a convenience sample of Chinese adults. A sample of 1,100 participants, aged 18 and older, engaged in the online survey utilizing the Wenjuanxing platform, which is a professional online survey tool in China and is often compared to Amazon Mechanical Turk in terms of functionality and use. Recruitment of participants was achieved via advertisements on social media platforms, dissemination through community newsletters, and the use of both convenience and snowball sampling methodologies. For the snowball sampling, participants initially recruited through convenience methods were encouraged to refer the study link to other individuals who might potentially meet the study criteria, and all participants were subsequently asked to invite others to participate in the study. Data were collected from March 1st to 15th, 2022. 2.2 Measurements We provided a description of “alcohol use disorders” in the informed consent to ensure participants had a clear understanding of the term. The term “alcohol use disorders” was consistently used throughout the entire survey. Adapted from Schomerus et al.’s study [19] on public views towards individuals with AUDs, we used the following empirical questions regarding (mis-)conceptions about AUDs: Whether they think alcohol use disorders are mental illnesses (0=no, 1 = yes); Do they believe that alcohol use disorders are due to a lack of willpower (0 = no, 1 = yes); What do they think is the possible cause of an alcohol use disorder (1 = biogenetic, 2 = psychosocial, 3 = biopsychosocial, 4 = others); Whether they think the treatment for alcohol use disorders should be covered by health insurance (0=no, 1 = yes). The Attribution Questionnaire (AQ, [14]) was used and adapted to measure stereotypes and emotional responses towards individuals with alcohol use problems. The AQ has been employed in the Chinese population to assess stigmatising attitudes towards individuals with schizophrenia [37] and children with autism [38]. Both adoptions demonstrated robust psychometric properties. In this study, the vignette in the original AQ was modified to depict David, a 32-year-old single male. He is a company employee and currently lives with his parents. Due to his alcohol use disorders, he had been hospitalised for treatment multiple times. After reading the vignette, participants were given eight questions on dangerousness, responsibility, treatment optimism, pity, anger, fear, willingness to help, and avoidance. Items were coded on a 9-point Likert scale from 1 = “none at all” to 9 = “very much” (Cronbach’s alpha = 0.73). Perceived stigma was measured using a Chinese version of the Perceived Stigma towards People who use Substances [39], which is a cross-cultural validation of the 8-item Perceived Stigma of Addiction Scale [40]. Items were scored from 1 to 4 with higher scores representing stronger agreement with the statements. To specifically measure stigma associated with alcohol use disorders, the term “substance use concerns” was replaced by “alcohol use disorders” in this study (Cronbach’s alpha = 0.79). The desire for social distance, as a proxy for discriminatory behaviour, was measured by the Link et al.’s Social Distance Scale [20]. This scale has been employed in Chinese samples and has shown good psychometric properties [41]. It comprises 7 items (e. g. “how willing are you to have someone like David as a neighbour?) on a 4-point Likert scale ranging from 0 (definitely willing) to 3 (definitely unwilling), with higher scores representing a greater desire to distance oneself from persons with AUDs (Cronbach’s alpha = 0.90). Alcohol consumption was assessed using the brief version of the Alcohol Use Disorders Identification Test - Consumption (AUDIT-C, [42]), which included the following three questions: a. How often do you have a drink containing alcohol? b. How many drinks did you have on a typical day when you were drinking in the past year? c. How often did you have 6 or more drinks on one occasion in the past year? The AUDIT-C was scored on a scale ranging from 0 to 12, with higher scores indicating higher levels of alcohol consumption. Risky drinking was defined using an optimal cut-off of ≥5 for males and ≥4 for females in the Chinese population [43]. 2.3 Procedure The study protocol was fully reviewed and approved by the Research & Ethics Committee of Peking University Clinical Medical School, Beijing Huilongguan Hospital, China. Prospective research participants were informed of the study aims and asked to sign an online consent form to participate in the study. Anonymity and confidentiality were ensured throughout the study. The online survey lasted 5 to 10 minutes. It was designed to require participants to complete all questions before submission. Those who did not fully complete the survey were not included in the study. Participants did not receive compensation for their involvement in the survey. To enhance the validity of this survey, time completion checks, IP Address verification, and reverse-coding questions were implemented. Participants who completed the survey too quickly (i.e. less than 2 minutes), provided inconsistent answers on reverse-coded questions, or submitted multiple responses from the same IP address were excluded from the final analysis to ensure data quality. 2.4 Analyses First, we used descriptive statistics to analyse individual items, determining the extent to which answers to each item are related. Second, Spearman correlations and chi-square tests were used to analyse the correlations between misconceptions, stereotypes, emotional reactions, perceived stigma, and the desire for social distance. As the variable of the potential causes of AUDs contains multiple categories, we treated it as a nominal variable, employing either chi-square test or ANOVA for further correlation analyses. Third, we used multiple linear regression analysis to examine the independent associations of predictor variables with the desire for social distance as the dependent variable, controlling for age, gender, education, employment, alcohol consumption and lifetime mental health service utilisation. As the variable representing the potential causes of alcohol use disorders contains multiple categories, we used dummy independent variables for each non-reference category in the regression model. Multicollinearity was assessed using variance inflation factor (VIF) for each independent variable, with a VIF value 2.5 or above indicating multicollinearity [44]. The data were analysed using Statistical Program for Social Science (SPSS) - version 29. A two-tailed significance of p < 0.05 was used in the analyses. Specifically, for correlation analyses, a more stringent threshold of p < 0.01 was employed to bolster the reliability of the correlation results. A correlation coefficient of 0.10, 0.30, and 0.50 or higher indicates a small, moderate, or large effect size, respectively [45]. 3. Results Totally, 1,124 participants submitted the survey. Twenty-four participants were excluded because they either completed the survey in less than 2 minutes or provided inconsistent answers on reverse-coded questions. The sample comprised 1,100 participants across 34 province-level administrative regions in China. The vast majority of the participants were from the Han Ethnic group. Nearly 60% of the participants were women. The socio-demographic characteristics of participants are presented in Table 1. In this study, 29.6% of males and 4.9% of females were identified as risky drinkers, which reflects an average level within the general population [46]. Insert Table 1 about here. Nearly three-quarters of participants recognised AUDs as mental illnesses, though approximately one-third held the belief that individuals with AUDs lacked willpower. Over 60% of participants endorsed a biopsychosocial model of alcohol use disorders. It is noteworthy that nearly 70% of the sample did not support health insurance coverage for alcohol-related treatment (Table 2). Insert Table 2 about here. In bivariate relationships, the desire for social distance was markedly associated with a higher level of perceived stigma, moderately associated with more perceived dangerousness, avoidance and higher levels of fear and anger, while there is a weak correlation between the desire for social distance and less willingness to help. Increased perceived dangerousness was highly associated with more perceived responsibility and a higher level of fear. The recognition that AUDs are mental illnesses was slightly associated with a biopsychosocial attribution and greater perceived treatment optimism; however, it was mildly correlated with a greater endorsement of weakened willpower, higher levels of pity and fear, as well as increased perceived stigma and a desire for social distance. Individuals attributing the cause to biogenetics perceived the lowest level of anger, while those with biopsychosocial perspectives were more likely to support health insurance coverage for alcohol-related treatment. More withholding help was associated with higher levels of pity, anger and fear, avoidance, and perceived stigma, while more willingness to help was significantly associated with more perceived dangerousness and treatment optimism. Increased perceived stigma was associated with higher levels of anger and fear, respectively, but neither was associated with pity (Table 3). Insert Table 3 about here. We then examined the independent correlations of the desire for social distance using linear regression analysis. After controlling for age, gender, education, employment, lifetime mental health utilisation and alcohol consumption, a greater desire for social distance was independently associated with more recognition of AUDs as mental illnesses, increased perceived responsibility, a higher level of fear, less willingness to help, a greater tendency of avoidance, as well as increased perceived stigma (Table 4). Furthermore, younger people and those who had more alcohol consumption showed less desire for social distance. These factors together explained 40% of the variance in the desire for social distance from individuals with AUDs. All VIF values were less than 2.5, indicating low multicollinearity. Insert Table 4 about here. 4. Discussion The present study provides initial evidence that a higher level of desire for social distance towards individuals with AUDs is independently associated with increased perceived stigma, stereotypes and negative emotional reactions among Chinese adults. Specifically, consistent with previous findings, stronger perceptions of public stigma, beliefs in personal responsibility for AUDs, higher fear levels, less willingness to help, and a greater tendency to avoid contribute to the desire for social distance. Contrary to previous findings [13], this study found that a higher level of recognition AUDs as mental illnesses was associated with increased desire for social distance from people with AUDs. In this study, the majority of participants labelled AUDs as mental illnesses and recognised the connection between AUDs and a biopsychosocial model. However, the recognitions coexist with perceptions of lack of willpower, dangerousness, perceived stigma, and a desire for social distance. It implies that alcohol-related stigma may be intertwined with the overall stigma surrounding mental illnesses. The results could help interpret previous findings that despite an increasing knowledge about alcohol use disorders, high levels of public stigma have persisted and, in some cases, worsened [23, 47]. While the recognition of alcohol use disorders as mental illnesses is essential for promoting a comprehensive approach to treatment and support [13, 48], equally critical is the need to address pervasive stigmatised attitudes associated with mental illness. In China, health insurance plans generally encompass treatment for alcohol use disorders. However, the extent of reimbursement of medical expense varies significantly based on specific insurance plans [49]. Remarkably, a significant majority of the respondents in this study opposed health insurance coverage for alcohol-related treatment, which was associated with perceptions of personal responsibility, unwillingness to help, avoidance and a desire for social distance. This stance could lead to discrimination within the healthcare system and hinder the provision of adequate care [50]. In alignment with previous research [13, 23], heightened perceptions of dangerousness and responsibility were correlated with increased tendencies to avoid, elevated negative emotions such as pity, anger and fear, and a greater desire for social distance. Conversely, higher perceptions of dangerousness and treatment optimism were associated with a greater willingness to help. Safety concerns may drive individuals in collectivistic society, such as China, to engage in helping behaviours that mitigate perceived risks and benefit the collective community [51, 52]. Additionally, an optimistic attitude towards treatment could play a role, as individuals may believe that their assistance can contribute positively to the recovery journey of those with AUDs [53, 54]. However, the public perception of treatment optimism, a proxy of controllability [55], might also create an expectation that individuals should be able to manage their alcohol use problems with available treatments. The failure to meet expectations may result in increased blame and social rejection, especially in Chinese society that emphasise on self-control [6]. Recognising the dual nature of treatment optimism as a double-edged sword in addressing alcohol-related stigma, efforts should extend beyond merely promoting optimism about treatment outcomes to fostering a no-blame perception to reduce stigma and support recovery [56]. Given the significantly low treatment rate for AUDs in China [4], there is a high demand to promote treatment availability and accessibility of AUDs treatment. Consistent with the reactions observed towards individuals with substance use disorders [6], the negative emotional responses, including pity, fear and anger, were associated with heightened perceived dangerousness, responsibilities and treatment optimism. Pity was associated with more willingness to help, which aligns with previous research indicating that pity might elicit compassion and thus promote supportive behaviour [12]. While pity is often considered as a moral virtue and reflects a compassionate response to someone’s suffering [57], it did not show a significant correlation with perceived stigma or a desire for social distance. Our findings suggest that perceptions of societal attitudes towards individuals with AUDs could lead to discriminatory behaviour towards the stigmatised group. Stigma emerges as individuals with AUDs are categorised as members of an out-group [16]. This categorisation, especially pronounced in collective societies like China, makes it more likely that people conform to dominant cultural beliefs [58, 59], resulting in discrimination. These results suggest that stigma reduction campaigns in China should aim to address negative attitudes and discriminatory behaviour of the general public [60]. Some limitations to this study need to be considered. First, compared to the general Chinese population, this study had more female, younger participants with higher education levels. Specifically, younger people in this study showed less desire for social distance towards individuals with AUDs, potentially leading to less stigmatising attitudes compared to the general population. Furthermore, the findings may not generalise well to those who are less active online or chose not to participate in this study. Second, there is no causality or potential direction of the associations can be drawn from this cross-sectional study. Third, self-report desire for social distance, rather than observed discriminatory behaviour, was used as a proxy for measuring discrimination. Fourth, a few variables, including (mis-)conception and attributions, were assessed with a single item, providing limited information. This may reduce the sensitivity and statistical power of the analyses. Lastly, social desirability may lead to potential underreporting of stereotypes and the desire for social distance, while leading to an over-reporting of the willingness to help. Despite these limitations, findings from this study have research and clinical implications for stigma reduction and the improvement of social integration for individuals with AUDs. Highlighting the multifaceted causes of AUDs may help dispel misconceptions and stereotypes, fostering a more supportive and understanding environment for individuals with AUDs. Comprehensive public mental health programmes should address both mental illnesses in general and alcohol use disorders specifically. Without tackling the broader issue of mental illness stigma, educating the public that alcohol use disorders are mental illnesses may inadvertently worsen alcohol-related stigma. Culturally sensitive anti-stigma campaigns need to focus on addressing negative attitudes and discriminatory behaviours by promoting non-blamed causal attributions [61, 62]. Programmes like the Honest, Open, Proud peer-led group programme [63], which support individuals with lived experience to share their recovery stories, can enhance public respect and contribute to stigma change [8]. Future research should develop targeted stigma reduction programmes for various stakeholders, including healthcare professionals, media outlets, policymakers, policemen, employers, and community networks. In conclusion, this study presents novel findings that highlight heightened perceived public stigma, personal responsibility, fear, more withholding help, and avoidance as significant factors associated with the desire for social distance from individuals with AUDs. The findings underscore the urgent need for targeted stigma reduction programmes that emphasise non-blame attributions and facilitate contact strategies to enhance helping behaviours and social acceptance. Efforts through policy advocacy and population-based anti-stigma campaigns may be critical in fostering a supportive environment for individuals with AUDs. Declarations Acknowledgements We are grateful to all participants. Author contributions Dr Ziyan Xu is responsible for the integrity of the data and the accuracy of data analysis and had full access to all data in the study. Concept and design: Ziyan Xu and Qingyan Yang. Acquisition, analysis, or interpretation of data: All authors. Drafting of the manuscript: Ziyan Xu, Qingyan Yang. Critically revise manuscripts of important intellectual content: Nicolas Rüsch, Patrick W. Corrigan, Kebing Yang, Yajuan Niu, Yunlong Tan. Statistical analysis: Yanxia Xiao, Yanfang Zhou, Ziyan Xu. Obtained funding: Qingyan Yang. Administrative, technical, or material support: Ziyan Xu and Qingyan Yang. Funding This paper was supported by Beijing Municipal Administration of Hospitals Incubating Program, PX202307, 2023, and Capital’s Funds for Health Improvement and Research, SF2024-2-2133. Data Availability The datasets are available from the corresponding author on reasonable request. Ethics approval and consent to participate The study protocol was fully reviewed and approved by the Research & Ethics Committee of Peking University Clinical Medical School, Beijing Huilongguan Hospital, China. All methods were carried out in accordance with the Declaration of Helsinki. Prospective research participants were informed of the study aims and asked to sign an online consent form to participate in the study. Consent for publication Not applicable. Competing interests None. Clinical trial number Not applicable. References Carvalho AF, Heilig M, Perez A, Probst C, Rehm J (2019) Alcohol use disorders. Lancet 394 (10200):781-792 Huang Y, Wang Y, Wang H, Liu Z, Yu X, Yan J, Yu Y, Kou C, Xu X, Lu J (2019) Prevalence of mental disorders in China: a cross-sectional epidemiological study. Lancet Psychiatry 6 (3):211-224 Socias ME, Scheuermeyer FX, Cui Z, Mok WY, Crabtree A, Fairbairn N, Nolan S, Slaunwhite A, Ti L (2023) Using a cascade of care framework to identify gaps in access to medications for alcohol use disorder in British Columbia, Canada. Addiction 118 (11): 2128-2138 Xiang YT, Ma X, Lu JY, Cai ZJ, Li SR, Xiang YQ, Guo HL, Hou YZ, Li ZB, Li ZJ (2009) Alcohol-related disorders in beijing, china: Prevalence, socio-demographic correlates, and unmet need for treatment. Alcohol Clin Exp Res 33 (6): 1111-1118 Hammarlund R, Crapanzano K, Luce L, Mulligan L, Ward K (2018) Review of the effects of self-stigma and perceived social stigma on the treatment-seeking decisions of individuals with drug-and alcohol-use disorders. Subst Abuse Rehabil 9:115 Yang LH, Wong LY, Grivel MM, Hasin DS (2017) Stigma and substance use disorders: an international phenomenon. Curr Opin Psychiatry 30 (5):378-388. doi:10.1097/yco.0000000000000351 Finn SW, Mejldal A, Nielsen AS (2023) Public stigma and treatment preferences for alcohol use disorders. BMC Health Serv Res 23 (1):76. doi:10.1186/s12913-023-09037-y Morris J, Schomerus G (2023) Why stigma matters in addressing alcohol harm. Drug Alcohol Rev 42 (5): 1264-1268. doi: 10.1111/dar.13660 Morris J, Boness CL, Witkiewitz K (2024) Should we promote alcohol problems as a continuum? Implications for policy and practice. Drugs Educ Prev Policy 31: 271-281. doi.org/10.1080/09687637.2023.2187681 Schomerus G, Baumann E, Sander C, Speerforck S, Angermeyer MC (2021) Some good news for psychiatry: resource allocation preferences of the public during the COVID‐19 pandemic. World Psychiatry 20 (2):301-302 Schomerus G, Lucht M, Holzinger A, Matschinger H, Carta MG, Angermeyer MC (2011) The stigma of alcohol dependence compared with other mental disorders: a review of population studies. Alcohol Alcohol 46 (2):105-112 Corrigan PW, Schomerus G, Shuman V, Kraus D, Perlick D, Harnish A, Kulesza M, Kane-Willis K, Qin S, Smelson D (2017) Developing a research agenda for understanding the stigma of addictions Part I: Lessons from the Mental Health Stigma Literature. Am J Addict 26 (1):59-66. doi:10.1111/ajad.12458 Kilian C, Manthey J, Carr S, Hanschmidt F, Rehm J, Speerforck S, Schomerus G (2021) Stigmatization of people with alcohol use disorders: An updated systematic review of population studies. Alcohol Clin Exp Res 45 (5):899-911 Corrigan PW, Rowan D, Green A, Lundin R, River P, Uphoff-Wasowski K, White K, Kubiak MA (2002) Challenging two mental illness stigmas: Personal responsibility and dangerousness. Schizophr Bull 28 (2):293-309 Weiner B, Perry RP, Magnusson J (1988) An attributional analysis of reactions to stigmas. J Pers Soc Psychol 55 (5):738 Link BG, Phelan JC (2001) Conceptualizing stigma. Annu Rev Sociol 27 (1):363-385 Nieweglowski K, Dubke R, Mulfinger N, Sheehan L, Corrigan PW (2019) Understanding the factor structure of the public stigma of substance use disorder. Addict Res Theory 27 (2):156-161. doi:10.1080/16066359.2018.1474205 Wallhed Finn S, Mejldal A, Nielsen AS (2023) The associations between public stigma and support for others' help-seeking for alcohol use disorder: a cross sectional study in the general Danish population. Addict Sci Clin Pract 18 (1):46. doi:10.1186/s13722-023-00400-2 Schomerus G, Matschinger H, Angermeyer MC (2014) Causal beliefs of the public and social acceptance of persons with mental illness: a comparative analysis of schizophrenia, depression and alcohol dependence. Psychol Med 44 (2):303-314. doi:10.1017/s003329171300072x Link BG (1987) Understanding labeling effects in the area of mental disorders: An assessment of the effects of expectations of rejection. Am Sociol Rev 52:96-112 May C, Nielsen AS, Bilberg R (2019) Barriers to treatment for alcohol dependence. J Drug Alcohol Res 8:236083 Probst C, Manthey J, Martinez A, Rehm J (2015) Alcohol use disorder severity and reported reasons not to seek treatment: a cross-sectional study in European primary care practices. Subst Abuse Treat Prev Policy 10:32. doi: 10.1186/s13011-015-0028-z Schomerus G, Matschinger H, Lucht MJ, Angermeyer MC (2014) Changes in the perception of alcohol-related stigma in Germany over the last two decades. Drug Alcohol Depend 143:225-231. doi:10.1016/j.drugalcdep.2014.07.033 Venegas A, Donato S, Meredith LR, Ray LA (2021) Understanding low treatment seeking rates for alcohol use disorder: A narrative review of the literature and opportunities for improvement. Am J Drug Alcohol Abuse 47 (6):664-679. doi:10.1080/00952990.2021.1969658 Birtel MD, Wood L, Kempa NJ (2017) Stigma and social support in substance abuse: Implications for mental health and well-being. Psychiatry Res 252:1-8. doi:https://doi.org/10.1016/j.psychres.2017.01.097 Corrigan PW, Bink AB, Schmidt A, Jones N, Rüsch N (2016) What is the impact of self-stigma? Loss of self-respect and the “why try” effect. J Ment Health 25 (1):10-15 Milan L, Varescon I (2022) Self-stigma in alcohol use disorder: Involvement of guilt and shame in the progressive model. Stig Health https://doi.org/10.1037/sah0000424 Jiang L (2011) Comparison of the difference between Chinese and Western drinking culture. Asian Soc Sci 7 (5):251 Yang LH (2007) Application of mental illness stigma theory to Chinese societies: synthesis and new direction. Singap Med 48 (11):977 Cheung M, Leung P, Chen W, Gearing RE, Brewer KB, Chen X, Li X, He X (2022) Public stigma on substance users in China. J Subst Use 27 (4):398-403 Room R (2005) Stigma, social inequality and alcohol and drug use. Drug Alcohol Rev 24 (2):143-155 Lam CS, Tsang HW, Corrigan PW, Lee Y-T, Angell B, Shi K, Jin S, Larson JE (2010) Chinese lay theory and mental illness stigma: Implications for research and practices. J Rehabil 76 (1):35 Gu J, Ming X (2020) Perceived Social Discrimination, Socioeconomic Status, and Alcohol Consumption among Chinese Adults: A Nationally Representative Study. Int J Environ Res Public Health 17 (17). doi:10.3390/ijerph17176043 Xiong W, Phillips MR, Wang Z, Zhang Y, Cheng HG, Link BG (2021) Stigma and discrimination associated with mental illness and other stigmatizing conditions in China using two cultural-sensitive measures of stigma: interpersonal distance and occupational restrictiveness. Psycho Med 51 (16):2804-2813. doi:10.1017/s0033291720001439 Lo LLH, Suen YN, Chan SKW, Sum MY, Charlton C, Hui CLM, Lee EHM, Chang WC, Chen EYH (2021) Sociodemographic correlates of public stigma about mental illness: a population study on Hong Kong’s Chinese population. BMC Psychiatry 21 (1):274 Kummetat JL, Leonhard A, Manthey J, Speerforck S, Schomerus G (2022) Understanding the Association between Alcohol Stigma and Alcohol Consumption within Europe: A Cross-Sectional Exploratory Study. Eur Addict Res 28 (6):446-454. doi:10.1159/000526200 Zheng LX, Keegan JP, Rosenthal D, Talley W, Hunter CA (2016) Examining the attributions of discrimination toward people with mental illness among Chinese college students. Aust J Rehabil Couns 22 (1):40-50. doi:10.1017/jrc.2016.3 Ling CY, Mak WW, Cheng JN (2010) Attribution model of stigma towards children with autism in Hong Kong. J Appl Res Intellec Disabil 23 (3):237-249 Chang CC, Chang KC, Hou WL, Yen CF, Lin CY, Potenza MN (2020) Measurement invariance and psychometric properties of Perceived Stigma toward People who use Substances (PSPS) among three types of substance use disorders: Heroin, amphetamine, and alcohol. Drug Alcohol Depend 216:108319 Luoma JB, O'Hair Ak Fau - Kohlenberg BS, Kohlenberg Bs Fau - Hayes SC, Hayes Sc Fau - Fletcher L, Fletcher L (2010) The development and psychometric properties of a new measure of perceived stigma toward substance users. Subst Use Misuse 45 (1-2): 47-57 Han DY, Chen SH (2014) Reducing the stigma of depression through neurobiology-based psychoeducation: a randomized controlled trial. Psychiatry Clin Neurosci 68 (9):666-673. doi:10.1111/pcn.12174 Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA, Project ACQI (1998) The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Arch Intern Med 158 (16):1789-1795 Yip BH, Chung RY, Chung VC, Kim J, Chan IW, Wong MC, Wong SY, Griffiths SM (2015) Is Alcohol Use Disorder Identification Test (AUDIT) or its shorter versions more useful to identify risky drinkers in a Chinese population? A diagnostic study. PloS One 10 (3):e0117721. doi:10.1371/journal.pone.0117721 Johnston R, Jones K, Manley D (2018) Confounding and collinearity in regression analysis: a cautionary tale and an alternative procedure, illustrated by studies of British voting behaviour. Qual & Quant 52:1957-1976 Cohen J (1988) Statistical power analysis for the behavioral science (2nd ed.). Hillsadale, NJ: Lawrence Erlbaum Associates. Hu A, Jiang H, Dowling R, Guo L, Zhao X, Hao W, Xiang X (2022) The transition of alcohol control in China 1990-2019: Impacts and recommendations. Int J Drug Policy 105:103698 Pescosolido BA, Halpern-Manners A, Luo L, Perry B (2021) Trends in Public Stigma of Mental Illness in the US, 1996-2018. JAMA Netw Open 4 (12):e2140202. doi:10.1001/jamanetworkopen.2021.40202 Morris J, Boness CL, Burton R (2023) (Mis)understanding alcohol use disorder: Making the case for a public health first approach. Drug Alcohol Depend 253:111019. doi:https://doi.org/10.1016/j.drugalcdep.2023.111019 He W (2023) Does the immediate reimbursement of medical insurance reduce the socioeconomic inequality in health among the floating population? Evidence from China. Int J Equity Health 22 (1):96. doi:10.1186/s12939-023-01913-7 Roche A, Kostadinov V, Fischer J, Nicholas R, O'Rourke, K, Pidd, K, Trifonoff A (2015) Addressing inequities in alcohol consumption and related harms. Health Promot Int, 30, 20-35 Pfattheicher S, Nielsen YA, Thielmann I (2022) Prosocial behavior and altruism: A review of concepts and definitions. Curr Opin Psychol 44:124-129. doi:https://doi.org/10.1016/j.copsyc.2021.08.021 Sheng J, Luo S, Jiang B, Hu Y, Lin S, Wang L, Ren Y, Zhao C, Liu Z, Chen J (2022) How prosocial behaviors are maintained in China: The relationship between communist authority and prosociality. Front Psychol 13:938468 Hamilton KM (2021) Willingness to help: how the portrayal and perception of a wrongfully convicted individual affects people’s willingness to help exonerees. Thesis, University of Ontario Institute of Technology (Canada), Rossetto A, Jorm AF, Reavley NJ (2016) Predictors of adults' helping intentions and behaviours towards a person with a mental illness: A six-month follow-up study. Psychiatry Res 240:170-176. doi:https://doi.org/10.1016/j.psychres.2016.04.037 Corrigan PW, Markowitz FE, Watson A, Rowan D, Kubiak MA (2003) An attribution model of public discrimination towards persons with mental illness. J Health Soc Behav 44:162-179 Foster S, O’Mealey M (2022) Socioeconomic status and mental illness stigma: the impact of mental illness controllability attributions and personal responsibility judgments. J Ment Health 31 (1):58-65. doi:10.1080/09638237.2021.1875416 Seok B (2015) Moral psychology of shame in early Confucian philosophy. Front Philos China 10 (1):21-57 Yu BCL, Mak WWS (2022) Unpacking Cultural Influences on Stigma of People with Mental Illness between Group-Oriented and Individual-Oriented Cultures. In: Vogel DL, Wade NG (eds) The Cambridge Handbook of Stigma and Mental Health. Cambridge Handbooks in Psychology. Cambridge University Press, Cambridge, pp 263-281. doi:DOI: 10.1017/9781108920995.016 Rhee E, Uleman JS, Lee HK (1996) Variations in collectivism and individualism by ingroup and culture: Confirmatory factor analysis. J Pers Soc Psychol 71 (5):1037 Zhang Z, Sun K, Jatchavala C, Koh J, Chia Y, Bose J, Li Z, Tan W, Wang S, Chu W, Wang J, Tran B, Ho R (2019) Overview of Stigma against Psychiatric Illnesses and Advancements of Anti-Stigma Activities in Six Asian Societies. Int J Environ Res Public Health 17 (1):280. doi:10.3390/ijerph17010280 Schomerus G, Corrigan PW (2022) Understanding the stigma of substance use disorders. In: Schomerus G, Corrigan PW (Eds.) The stigma of substance use disorders. Cambridge University Press, Cambridge, pp. 1-14. Clark TW (2022) Causal responsibility for addiction. Addict Behav 130:107292. doi:10.1016/j.addbeh.2022.107292 Rüsch N, Kösters M (2021) Honest, Open, Proud to support disclosure decisions and to decrease stigma's impact among people with mental illness: conceptual review and meta-analysis of program efficacy. Soc Psychiatry Psychiatr Epidemiol 56 (9):1513-1526. doi:10.1007/s00127-021-02076-y Tables Table 1. Socio-demographic characteristics of participants (N=1,100) Variable N (percentage)/M (SD) Age 39.3 (10.1) Gender, female 657 (59.7%) Ethnic groups Han Manchu Korean Hui Mongolian Others 1053 (95.7%) 25 (2.2%) 5 (0.5%) 4 (0.4%) 4 (0.4%) 9 (0.8%) Education (years) 8-9 10-12 13-16 >16 48 (4.4%) 66 (6.0%) 690 (62.7%) 296 (26.9%) Married 826 (75.1%) Unemployed 25 (2.3%) Alcohol consumption (0-12) 2.3 (2.6) Any mental health service use, lifetime 140 (12.7%) Table 2. Descriptive Statistics (N=1,100) Variable N (Percentage)/ M ± SD (Range) AUDs a are mental illnesses (yes) 820 (74.5%) AUDs are due to a lack of willpower (yes) 345 (31.4%) Potential causes of AUDs Bio-psycho-social Psychosocial Biological Others 700 (63.6%) 235 (21.4%) 16 (1.5%) 149 (13.5%) Supporting health insurance coverage (yes) 338 (30.7%) Attributions b Dangerousness 7.28 ± 1.87 (1-9) Responsibility 7.63 ± 1.66 (1-9) Treatability 7.04 ± 1.98 (1-9) Willingness to help 5.46 ± 2.36 (1-9) Avoidance 5.35 ± 2.43 (1-9) Pity 5.87 ± 2.75 (1-9) Anger 5.84 ± 2.52 (1-9) Fear 6.32 ± 2.28 (1-9) Perceived stigma b 23.96 ± 4.39 (9-36) Desire for social distance b 24.68 ± 3.69 (7-28) a AUD = Alcohol use disorders; b A higher score indicates a higher level of the measured variables Table 3. Correlations between misconceptions, stereotypes, emotional reactions, perceived stigma and the desire for social distance (* p<0.01; ** p<0.001) 1 2 3 4 5 6 7 8 9 10 11 12 13 1 AUDs a are mental illnesses 2 Lack of willpower 0.20 ** 3 Potential causes of AUDs a, b 0.12 **c -0.05 4 Supporting health insurance coverage 0.04 -0.03 0.10 *c 5 Dangerousness 0.07 0.05 0.02 -0.02 6 Responsibility 0.05 0.08 * -0.02 -0.10 * 0.53 ** 7 Treatability 0.18 ** 0.05 -0.02 0.001 0.45 ** 0.40 ** 8 Willingness to Help 0.05 0.01 0.07 0.08 * 0.17 ** 0.07 0.32 ** 9 Avoidance 0.04 0.12 ** -0.04 -0.12 ** 0.26 ** 0.27 ** 0.11 ** -0.22 ** 10 Pity 0.09 * 0.02 0.04 0.04 0.32 ** 0.19 ** 0.26 ** 0.29 ** 0.03 11 Anger 0.03 0.14 ** 0.09 *d -0.06 0.42 ** 0.40 ** 0.31 ** 0.29 ** 0.27 ** 0.29 ** 12 Fear 0.07 * 0.12 ** 0.04 -0.02 0.64 ** 0.48 ** 0.32 ** 0.11 ** 0.37 ** 0.27 ** 0.54 ** 13 Perceived stigma 0.14 ** 0.12 ** -0.05 -0.002 0.06 0.10 * 0.07 -0.11 ** 0.20 ** -0.02 0.10 * 0.10 * 14 Desire for social distance 0.12 ** 0.14 ** -0.02 -0.08 * 0.32 ** 0.32 ** 0.19 ** -0.13 ** 0.41 ** 0.05 0.29 ** 0.38 ** 0.49 ** a AUDs = Alcohol use disorders. b It is treated as a nominal variable with multiple categories (biogenetic, psychosocial, biopsychosoical and other causal beliefs). c It is positively associated with biopsychosocial perspectives. d A biogenetical perspective was associated with the lowest level of anger, followed by psychosocial and then biopsychosocial perspectives. Table 4. Linear regression analysis on the desire for social distance, controlling for age, gender, education, employment, alcohol consumption and lifetime mental health service us (Adjusted R 2 =0.41) Independent variables B * SE c* * * d * * Error Beta # p 95% CI d AUD a is a mental illness (0=no, 1=yes) 0.60 0.26 0.07 0.02 0.09 – 1.11 AUDs are due to a lack of willpower (0=no, 1=yes) 0.30 0.23 0.04 0.18 -0.14 – 0.74 Potential causes of AUDs b -0.35 0.29 -0.04 0.23 -0.92 – 0.22 Supporting health insurance coverage (0=yes, 1=no) 0.11 0.22 0.01 0.60 0.54 – -0.31 Dangerousness 0.12 0.07 0.06 0.09 -0.02 – 0.27 Responsibility 0.20 0.07 0.09 0.006 0.06 – 0.35 Treatability 0.05 0.06 0.03 0.44 -0.07 – 0.17 Pity -0.05 0.04 -0.04 0.22 -0.13 – 0.03 Anger 0.03 0.05 0.02 0.59 -0.07 – 0.13 Fear 0.20 0.06 0.13 0.002 0.08 – 0.32 Willingness to Help -0.15 0.05 -0.09 0.004 -0.25 – -0.05 Avoidance 0.27 0.05 0.18 <0.001 0.18 – 0.36 Perceived stigma 0.34 0.03 0.37 <0.001 0.29 – 0.39 Age 0.03 0.01 0.09 0.001 0.01 – 0.05 Gender (0=male, 1=female) -0.17 0.24 -0.02 0.49 -0.64 – 0.30 Education (years) -0.08 0.09 0.03 0.38 0.11 – -0.28 Employment (0=no, 1=yes) -0.87 0.78 0.03 0.27 0.66 – -2.39 Any mental health service uses, lifetime (0=no, 1=yes) -0.18 0.29 -0.02 0.55 -0.75 – 0.40 Alcohol consumption -0.22 0.05 -0.15 <0.001 -0.31 – -0.13 a AUD = Alcohol use disorder. b reference category = biopsychosocial model. c SE = Standard Error. d CI = Confidence Interval. * Unstandardised coefficient. # Standardised coefficient. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 19 Feb, 2025 Read the published version in BMC Psychiatry → Version 1 posted Editorial decision: Revision requested 13 Nov, 2024 Reviews received at journal 12 Oct, 2024 Reviewers agreed at journal 03 Oct, 2024 Reviews received at journal 30 Sep, 2024 Reviewers agreed at journal 25 Sep, 2024 Reviewers invited by journal 25 Sep, 2024 Editor invited by journal 02 Sep, 2024 Editor assigned by journal 01 Sep, 2024 Submission checks completed at journal 01 Sep, 2024 First submitted to journal 25 Aug, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4971967","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":360756401,"identity":"9a30474a-6523-45c3-bce3-03e0a1f5a089","order_by":0,"name":"Qingyan Yang","email":"","orcid":"","institution":"Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Qingyan","middleName":"","lastName":"Yang","suffix":""},{"id":360756402,"identity":"f14ed237-a15a-47f7-90ab-51e4bbff4b4d","order_by":1,"name":"Nicolas Rüsch","email":"","orcid":"","institution":"University of Ulm and BKH Günzburg","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Nicolas","middleName":"","lastName":"Rüsch","suffix":""},{"id":360756403,"identity":"eb0485a6-aed7-4f68-870a-a092f2089195","order_by":2,"name":"Kebing Yang","email":"","orcid":"","institution":"Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Kebing","middleName":"","lastName":"Yang","suffix":""},{"id":360756404,"identity":"ba19af92-1515-4397-ba95-168900047370","order_by":3,"name":"Yajuan Niu","email":"","orcid":"","institution":"Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Yajuan","middleName":"","lastName":"Niu","suffix":""},{"id":360756405,"identity":"9e19667d-bf75-484f-ab56-75d8cb804b9a","order_by":4,"name":"Yanxia Xiao","email":"","orcid":"","institution":"Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Yanxia","middleName":"","lastName":"Xiao","suffix":""},{"id":360756406,"identity":"b65985cc-eb60-4461-8c9a-53fb98061130","order_by":5,"name":"Yanfang Zhou","email":"","orcid":"","institution":"Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Yanfang","middleName":"","lastName":"Zhou","suffix":""},{"id":360756407,"identity":"29a110bf-4e7e-403b-bc22-b47ec20b4785","order_by":6,"name":"Yunlong Tan","email":"","orcid":"","institution":"Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Yunlong","middleName":"","lastName":"Tan","suffix":""},{"id":360756408,"identity":"8a09601a-1d35-4644-8f65-9e779b88a65f","order_by":7,"name":"Yi Zhang","email":"","orcid":"","institution":"Tianjing Binhai New District Anding Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Yi","middleName":"","lastName":"Zhang","suffix":""},{"id":360756409,"identity":"da1d6171-e9db-4f12-a257-184440771c9a","order_by":8,"name":"Patrick W. Corrigan","email":"","orcid":"","institution":"Illinois Institute of Technology","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Patrick","middleName":"W.","lastName":"Corrigan","suffix":""},{"id":360756410,"identity":"6e1d1f2d-e091-40be-a06a-a72097ccd4c6","order_by":9,"name":"Ziyan Xu","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA6klEQVRIie3RQQsBQRTA8bdNDYeHm0YvfIXRlsiXIddVe5KTlFoX5brfQzmTg6+w5cLFWSkpwtulOM1elfnXbLM1v6bXANhsv5hIvireLQE0QP79m0YavGQ7ITKVvBrwQp1sU0l1grWTz2d05J3J96ETFJdOdDQQZ4wuhUxKYW9BoWZCbdEMTaMI1JS7KygoJqgfMZGEBiIFulfkW6TyDkzgRW4GggLrFJOC8uSHmMZXQvZbTLA0PbgtJm5AnXFzaiDV2Xq+RRhW9Ka73+INyjPqrqKL6RrIJs/xPa8zMgKAzC7lgM1ms/19TxT6M/lkCM7aAAAAAElFTkSuQmCC","orcid":"","institution":"University of Ulm","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Ziyan","middleName":"","lastName":"Xu","suffix":""}],"badges":[],"createdAt":"2024-08-25 09:01:58","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4971967/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4971967/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12888-025-06595-9","type":"published","date":"2025-02-19T15:56:51+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":77052450,"identity":"a9e3fce5-ccb4-4fc9-a490-adeb9669579b","added_by":"auto","created_at":"2025-02-24 16:02:06","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":719688,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4971967/v1/2105cfb4-a953-4daa-a4e2-530d468fe7ad.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Misconceptions, prejudice and social distance towards people with alcohol use disorders in China","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eAlcohol use disorders (AUDs) are one of the most prevalent mental disorders globally and are associated with high mortality and burden of diseases [1]. In China, the lifetime and 12-month prevalence of any alcohol use disorder was 4.4% and 1.8%, respectively, which was more than that of any drug use disorders [2]. However, many individuals with symptoms consistent with AUDs remain undiagnosed and untreated worldwide [3], including in China, where only 2.4% of individuals with alcohol dependence receive treatment [4]. Recent studies [5-7] indicate that alcohol-related stigma might be one of the most prominent barriers to treatment-seeking for alcohol use disorders.\u003c/p\u003e\n\u003cp\u003eMyths about AUDs are prevalent and can lead to misconception and stigma, further impeding the willingness of people with AUDs to seek the necessary help and support [8]. Common myths may involve the perception that alcohol use disorders result from personality weakness or character flaws, rather than recognising these disorders as mental illnesses influenced by a complex interplay of biological, psychological, and environmental factors [9]. Some people may believe alcohol-related treatment should not be covered by medical insurance [10]. These oversimplified perspectives can contribute to judgmental attitudes and discourage individuals from seeking help, exacerbating discrimination towards individuals with these conditions and hinder their recovery process.\u003c/p\u003e\n\u003cp\u003ePublic stigma is markedly encountered by people with AUDs and often leads to additional challenges in their lives [11]. Stigma towards AUDs encompasses widely endorsed negative stereotypes, leading to prejudice and discrimination [12]. Common stereotypes about people with AUDs are that they lack self-control, are dangerous and are emotionally unstable [11, 13]. According to the attribution theory of mental illness stigma [14, 15], people who attribute a person’s problems to controllable factors are more likely to be hostile and critical towards this individual. Compared to individuals with psychosis, people with AUDs are judged as much more responsible for their conditions and less worthy of support or care [13]. Prejudice occurs if people endorse these stereotypes and react emotionally. For example, “It is right that people with alcohol use disorders are unreliable and dangerous. I am scared of them” [12]. Discrimination involves unjustified unequal treatment or actions taken towards the stigmatised individuals or groups [16], such as limitations to rental opportunities, employment prospects and interpersonal relationships [17]. Studies among the general population [18, 19] suggested a connection between higher levels of stereotypes and a greater preference for social distance from individuals with AUDs. \u003c/p\u003e\n\u003cp\u003ePerceived stigma refers to the subjective perception of the stereotypes, prejudice and discrimination held by the majority population [20], which pertains to how stigmatised individuals are viewed and treated by society. It is deeply rooted in public stigma and reflects the anticipated stigmatising attitudes among the general public, where individuals fear being judged, blamed, or socially excluded if they were experiencing alcohol use disorders [21, 22]. Findings from a German national survey [23] suggested a potential association between perceived stigma and the tendency for social distancing from individuals with AUDs. Consequently, perceived stigma may discourage individuals from pursuing the necessary help for their alcohol use problems [24], contribute to social withdrawal to avoid judgement from others [25], and lead individuals to internalise stereotypes, thereby diminishing self-worth [26, 27]. Other types of stigma, such as structural stigma and self-stigma, are also significant factors that can impact individuals with AUDs [13], though these are beyond the scope of this study. \u003c/p\u003e\n\u003cp\u003eAlthough drinking alcohol is a widely accepted cultural tradition and crucial for fostering social bonding in China, traditional collectivist culture emphasises morality and self-controlled drinking, stressing maintenance of social order and the avoidance of embarrassment with drunken behaviours [28]. Furthermore, the concept of “saving face” is deeply rooted in Chinese culture [29]. Social harmony and the reputation of the family and community are highly valued. Individuals with AUDs may be viewed as bringing shame not only upon themselves but also upon their families [30]. Feeling ashamed, and fearing being labelled and discriminated against were identified as key factors contributing to reluctance to seek help and social withdrawal among individuals with substance use disorders [30]. These cultural norms, subject to stigma and social marginalization [31], are amplified by the collectivistic nature of Chinese society, where individuals tend to perceive public prejudices as justified [32]. Stigma towards AUDs may therefore be particularly widespread in China. \u003c/p\u003e\n\u003cp\u003eFew studies conducted among the Chinese population provided initial insights into public stigma and its potential impacts on individuals with AUDs. A community-based study [30] showed that the vast majority of respondents perceived individuals with alcohol addiction as having undesirable characteristics, which could potentially hinder their willingness to seek help. A cross-sectional study [33] found an association between alcohol use problems and experience of unfair treatment in public services. Xiong et al. [34] found that the general public expected occupational restrictions of people with a history of alcohol use problems, particularly in roles requiring high responsibility, such as that of a bus driver. These population-based surveys investigated specific aspects of alcohol-related stigma, however, they did not consider stigma as a multidimensional concept that encompasses various components, including stereotypes, prejudice, and discrimination [12, 13]. Discriminatory behaviour, in particular, is a critical manifestation of stigma, that impacts individuals’ access to treatment, social integration, and overall well-being [17]. The interactions between different components of stigma and their contribution to discriminatory behaviour in the Chinese cultural context remain unclear. Research in this field is needed to inform targeted interventions and address alcohol-related stigma.\u003c/p\u003e\n\u003cp\u003eThe present study therefore aimed to test the hypothesis that a higher level of desire for social distance from individuals with AUDs is independently associated with more (mis-)conceptions, perceived public stigma, stereotypes, and negative emotional reactions among Chinese adults. As female gender, older age, lower education, and unemployment were found to be associated with higher public stigma about mental illness among the Chinese population [35], we controlled age, gender, education, and employment to avoid confounding effects. Additionally, given the association of alcohol consumption and mental health utilisation with alcohol-related stigma [36], we also included these as confounding variables. Findings from the study could help guide the development of targeted interventions to reduce stigma and improve social integration for individuals with AUDs among the Chinese population.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cp\u003e2.1 Design and participants\u003c/p\u003e\n\u003cp\u003eThis cross-sectional online survey involves a convenience sample of Chinese adults. A sample of 1,100 participants, aged 18 and older, engaged in the online survey utilizing the Wenjuanxing platform, which is a professional online survey tool in China and is often compared to Amazon Mechanical Turk in terms of functionality and use. Recruitment of participants was achieved via advertisements on social media platforms, dissemination through community newsletters, and the use of both convenience and snowball sampling methodologies. For the snowball sampling, participants initially recruited through convenience methods were encouraged to refer the study link to other individuals who might potentially meet the study criteria, and all participants were subsequently asked to invite others to participate in the study. Data were collected from March 1st to 15th, 2022. \u003c/p\u003e\n\u003cp\u003e2.2 Measurements\u003c/p\u003e\n\u003cp\u003eWe provided a description of “alcohol use disorders” in the informed consent to ensure participants had a clear understanding of the term. The term “alcohol use disorders” was consistently used throughout the entire survey.\u003c/p\u003e\n\u003cp\u003eAdapted from Schomerus et al.’s study [19] on public views towards individuals with AUDs, we used the following empirical questions regarding (mis-)conceptions about AUDs: Whether they think alcohol use disorders are mental illnesses (0=no, 1 = yes); Do they believe that alcohol use disorders are due to a lack of willpower (0 = no, 1 = yes); What do they think is the possible cause of an alcohol use disorder (1 = biogenetic, 2 = psychosocial, 3 = biopsychosocial, 4 = others); Whether they think the treatment for alcohol use disorders should be covered by health insurance (0=no, 1 = yes). \u003c/p\u003e\n\u003cp\u003eThe Attribution Questionnaire (AQ, [14]) was used and adapted to measure stereotypes and emotional responses towards individuals with alcohol use problems. The AQ has been employed in the Chinese population to assess stigmatising attitudes towards individuals with schizophrenia [37] and children with autism [38]. Both adoptions demonstrated robust psychometric properties. In this study, the vignette in the original AQ was modified to depict David, a 32-year-old single male. He is a company employee and currently lives with his parents. Due to his alcohol use disorders, he had been hospitalised for treatment multiple times. After reading the vignette, participants were given eight questions on dangerousness, responsibility, treatment optimism, pity, anger, fear, willingness to help, and avoidance. Items were coded on a 9-point Likert scale from 1 = “none at all” to 9 = “very much” (Cronbach’s alpha = 0.73). \u003c/p\u003e\n\u003cp\u003ePerceived stigma was measured using a Chinese version of the Perceived Stigma towards People who use Substances [39], which is a cross-cultural validation of the 8-item Perceived Stigma of Addiction Scale [40]. Items were scored from 1 to 4 with higher scores representing stronger agreement with the statements. To specifically measure stigma associated with alcohol use disorders, the term “substance use concerns” was replaced by “alcohol use disorders” in this study (Cronbach’s alpha = 0.79). \u003c/p\u003e\n\u003cp\u003eThe desire for social distance, as a proxy for discriminatory behaviour, was measured by the Link et al.’s Social Distance Scale [20]. This scale has been employed in Chinese samples and has shown good psychometric properties [41]. It comprises 7 items (e. g. “how willing are you to have someone like David as a neighbour?) on a 4-point Likert scale ranging from 0 (definitely willing) to 3 (definitely unwilling), with higher scores representing a greater desire to distance oneself from persons with AUDs (Cronbach’s alpha = 0.90). \u003c/p\u003e\n\u003cp\u003eAlcohol consumption was assessed using the brief version of the Alcohol Use Disorders Identification Test - Consumption (AUDIT-C, [42]), which included the following three questions: a. How often do you have a drink containing alcohol? b. How many drinks did you have on a typical day when you were drinking in the past year? c. How often did you have 6 or more drinks on one occasion in the past year? The AUDIT-C was scored on a scale ranging from 0 to 12, with higher scores indicating higher levels of alcohol consumption. Risky drinking was defined using an optimal cut-off of ≥5 for males and ≥4 for females in the Chinese population [43]. \u003c/p\u003e\n\u003cp\u003e2.3 Procedure \u003c/p\u003e\n\u003cp\u003eThe study protocol was fully reviewed and approved by the Research \u0026amp; Ethics Committee of Peking University Clinical Medical School, Beijing Huilongguan Hospital, China. Prospective research participants were informed of the study aims and asked to sign an online consent form to participate in the study. Anonymity and confidentiality were ensured throughout the study. The online survey lasted 5 to 10 minutes. It was designed to require participants to complete all questions before submission. Those who did not fully complete the survey were not included in the study. Participants did not receive compensation for their involvement in the survey. To enhance the validity of this survey, time completion checks, IP Address verification, and reverse-coding questions were implemented. Participants who completed the survey too quickly (i.e. less than 2 minutes), provided inconsistent answers on reverse-coded questions, or submitted multiple responses from the same IP address were excluded from the final analysis to ensure data quality. \u003c/p\u003e\n\u003cp\u003e2.4 Analyses\u003c/p\u003e\n\u003cp\u003eFirst, we used descriptive statistics to analyse individual items, determining the extent to which answers to each item are related. Second, Spearman correlations and chi-square tests were used to analyse the correlations between misconceptions, stereotypes, emotional reactions, perceived stigma, and the desire for social distance. As the variable of the potential causes of AUDs contains multiple categories, we treated it as a nominal variable, employing either chi-square test or ANOVA for further correlation analyses. Third, we used multiple linear regression analysis to examine the independent associations of predictor variables with the desire for social distance as the dependent variable, controlling for age, gender, education, employment, alcohol consumption and lifetime mental health service utilisation. As the variable representing the potential causes of alcohol use disorders contains multiple categories, we used dummy independent variables for each non-reference category in the regression model. Multicollinearity was assessed using variance inflation factor (VIF) for each independent variable, with a VIF value 2.5 or above indicating multicollinearity [44]. The data were analysed using Statistical Program for Social Science (SPSS) - version 29. A two-tailed significance of p \u0026lt; 0.05 was used in the analyses. Specifically, for correlation analyses, a more stringent threshold of p \u0026lt; 0.01 was employed to bolster the reliability of the correlation results. A correlation coefficient of 0.10, 0.30, and 0.50 or higher indicates a small, moderate, or large effect size, respectively [45]. \u003c/p\u003e"},{"header":"3. Results","content":"\u003cp\u003eTotally, 1,124 participants submitted the survey. Twenty-four participants were excluded because they either completed the survey in less than 2 minutes or provided inconsistent answers on reverse-coded questions. The sample comprised 1,100 participants across 34 province-level administrative regions in China. The vast majority of the participants were from the Han Ethnic group. Nearly 60% of the participants were women. The socio-demographic characteristics of participants are presented in Table 1. In this study, 29.6% of males and 4.9% of females were identified as risky drinkers, which reflects an average level within the general population [46]. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eInsert Table 1 about here.\u003c/p\u003e\n\u003cp\u003eNearly three-quarters of participants recognised AUDs as mental illnesses, though approximately one-third held the belief that individuals with AUDs lacked willpower. Over 60% of participants endorsed a biopsychosocial model of alcohol use disorders. It is noteworthy that nearly 70% of the sample did not support health insurance coverage for alcohol-related treatment (Table 2).\u003c/p\u003e\n\u003cp\u003eInsert Table 2 about here.\u003c/p\u003e\n\u003cp\u003eIn bivariate relationships, the desire for social distance was markedly associated with a higher level of perceived stigma, moderately associated with more perceived dangerousness, avoidance and higher levels of fear and anger, while there is a weak correlation between the desire for social distance and less willingness to help. Increased perceived dangerousness was highly associated with more perceived responsibility and a higher level of fear. The recognition that AUDs are mental illnesses was slightly associated with a biopsychosocial attribution and greater perceived treatment optimism; however, it was mildly correlated with a greater endorsement of weakened willpower, higher levels of pity and fear, as well as increased perceived stigma and a desire for social distance. Individuals attributing the cause to biogenetics perceived the lowest level of anger, while those with biopsychosocial perspectives were more likely to support health insurance coverage for alcohol-related treatment. More withholding help was associated with higher levels of pity, anger and fear, avoidance, and perceived stigma, while more willingness to help was significantly associated with more perceived dangerousness and treatment optimism. Increased perceived stigma was associated with higher levels of anger and fear, respectively, but neither was associated with pity (Table 3).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eInsert Table 3 about here.\u003c/p\u003e\n\u003cp\u003eWe then examined the independent correlations of the desire for social distance using linear regression analysis. After controlling for age, gender, education, employment, lifetime mental health utilisation and alcohol consumption, a greater desire for social distance was independently associated with more recognition of AUDs as mental illnesses, increased perceived responsibility, a higher level of fear, less willingness to help, a greater tendency of avoidance, as well as increased perceived stigma (Table 4). Furthermore, younger people and those who had more alcohol consumption showed less desire for social distance. These factors together explained 40% of the variance in the desire for social distance from individuals with AUDs. All VIF values were less than 2.5, indicating low multicollinearity.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eInsert Table 4 about here.\u003c/p\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThe present study provides initial evidence that a higher level of desire for social distance towards individuals with AUDs is independently associated with increased perceived stigma, stereotypes and negative emotional reactions among Chinese adults. Specifically, consistent with previous findings, stronger perceptions of public stigma, beliefs in personal responsibility for AUDs, higher fear levels, less willingness to help, and a greater tendency to avoid contribute to the desire for social distance. \u003c/p\u003e\n\u003cp\u003eContrary to previous findings [13], this study found that a higher level of recognition AUDs as mental illnesses was associated with increased desire for social distance from people with AUDs. In this study, the majority of participants labelled AUDs as mental illnesses and recognised the connection between AUDs and a biopsychosocial model. However, the recognitions coexist with perceptions of lack of willpower, dangerousness, perceived stigma, and a desire for social distance. It implies that alcohol-related stigma may be intertwined with the overall stigma surrounding mental illnesses. The results could help interpret previous findings that despite an increasing knowledge about alcohol use disorders, high levels of public stigma have persisted and, in some cases, worsened [23, 47]. While the recognition of alcohol use disorders as mental illnesses is essential for promoting a comprehensive approach to treatment and support [13, 48], equally critical is the need to address pervasive stigmatised attitudes associated with mental illness. \u003c/p\u003e\n\u003cp\u003eIn China, health insurance plans generally encompass treatment for alcohol use disorders. However, the extent of reimbursement of medical expense varies significantly based on specific insurance plans [49]. Remarkably, a significant majority of the respondents in this study opposed health insurance coverage for alcohol-related treatment, which was associated with perceptions of personal responsibility, unwillingness to help, avoidance and a desire for social distance. This stance could lead to discrimination within the healthcare system and hinder the provision of adequate care [50]. \u003c/p\u003e\n\u003cp\u003eIn alignment with previous research [13, 23], heightened perceptions of dangerousness and responsibility were correlated with increased tendencies to avoid, elevated negative emotions such as pity, anger and fear, and a greater desire for social distance. Conversely, higher perceptions of dangerousness and treatment optimism were associated with a greater willingness to help. Safety concerns may drive individuals in collectivistic society, such as China, to engage in helping behaviours that mitigate perceived risks and benefit the collective community [51, 52]. Additionally, an optimistic attitude towards treatment could play a role, as individuals may believe that their assistance can contribute positively to the recovery journey of those with AUDs [53, 54]. \u003c/p\u003e\n\u003cp\u003eHowever, the public perception of treatment optimism, a proxy of controllability [55], might also create an expectation that individuals should be able to manage their alcohol use problems with available treatments. The failure to meet expectations may result in increased blame and social rejection, especially in Chinese society that emphasise on self-control [6]. Recognising the dual nature of treatment optimism as a double-edged sword in addressing alcohol-related stigma, efforts should extend beyond merely promoting optimism about treatment outcomes to fostering a no-blame perception to reduce stigma and support recovery [56]. Given the significantly low treatment rate for AUDs in China [4], there is a high demand to promote treatment availability and accessibility of AUDs treatment.\u003c/p\u003e\n\u003cp\u003eConsistent with the reactions observed towards individuals with substance use disorders [6], the negative emotional responses, including pity, fear and anger, were associated with heightened perceived dangerousness, responsibilities and treatment optimism. Pity was associated with more willingness to help, which aligns with previous research indicating that pity might elicit compassion and thus promote supportive behaviour [12]. While pity is often considered as a moral virtue and reflects a compassionate response to someone’s suffering [57], it did not show a significant correlation with perceived stigma or a desire for social distance.\u003c/p\u003e\n\u003cp\u003eOur findings suggest that perceptions of societal attitudes towards individuals with AUDs could lead to discriminatory behaviour towards the stigmatised group. Stigma emerges as individuals with AUDs are categorised as members of an out-group [16]. This categorisation, especially pronounced in collective societies like China, makes it more likely that people conform to dominant cultural beliefs [58, 59], resulting in discrimination. These results suggest that stigma reduction campaigns in China should aim to address negative attitudes and discriminatory behaviour of the general public [60]. \u003c/p\u003e\n\u003cp\u003eSome limitations to this study need to be considered. First, compared to the general Chinese population, this study had more female, younger participants with higher education levels. Specifically, younger people in this study showed less desire for social distance towards individuals with AUDs, potentially leading to less stigmatising attitudes compared to the general population. Furthermore, the findings may not generalise well to those who are less active online or chose not to participate in this study. Second, there is no causality or potential direction of the associations can be drawn from this cross-sectional study. Third, self-report desire for social distance, rather than observed discriminatory behaviour, was used as a proxy for measuring discrimination. Fourth, a few variables, including (mis-)conception and attributions, were assessed with a single item, providing limited information. This may reduce the sensitivity and statistical power of the analyses. Lastly, social desirability may lead to potential underreporting of stereotypes and the desire for social distance, while leading to an over-reporting of the willingness to help. \u003c/p\u003e\n\u003cp\u003eDespite these limitations, findings from this study have research and clinical implications for stigma reduction and the improvement of social integration for individuals with AUDs. Highlighting the multifaceted causes of AUDs may help dispel misconceptions and stereotypes, fostering a more supportive and understanding environment for individuals with AUDs. Comprehensive public mental health programmes should address both mental illnesses in general and alcohol use disorders specifically. Without tackling the broader issue of mental illness stigma, educating the public that alcohol use disorders are mental illnesses may inadvertently worsen alcohol-related stigma. Culturally sensitive anti-stigma campaigns need to focus on addressing negative attitudes and discriminatory behaviours by promoting non-blamed causal attributions [61, 62]. Programmes like the Honest, Open, Proud peer-led group programme [63], which support individuals with lived experience to share their recovery stories, can enhance public respect and contribute to stigma change [8]. Future research should develop targeted stigma reduction programmes for various stakeholders, including healthcare professionals, media outlets, policymakers, policemen, employers, and community networks. \u003c/p\u003e\n\u003cp\u003eIn conclusion, this study presents novel findings that highlight heightened perceived public stigma, personal responsibility, fear, more withholding help, and avoidance as significant factors associated with the desire for social distance from individuals with AUDs. The findings underscore the urgent need for targeted stigma reduction programmes that emphasise non-blame attributions and facilitate contact strategies to enhance helping behaviours and social acceptance. Efforts through policy advocacy and population-based anti-stigma campaigns may be critical in fostering a supportive environment for individuals with AUDs. \u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe are grateful to all participants.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDr Ziyan Xu is responsible for the integrity of the data and the accuracy of data analysis and had full access to all data in the study. Concept and design: Ziyan Xu\u0026nbsp;and\u0026nbsp;Qingyan Yang. Acquisition, analysis, or interpretation of data: All authors. Drafting of the manuscript:\u0026nbsp;Ziyan Xu,\u0026nbsp;Qingyan Yang. Critically revise manuscripts of important intellectual content: Nicolas R\u0026uuml;sch, Patrick W. Corrigan, Kebing Yang,\u0026nbsp;Yajuan Niu,\u0026nbsp;Yunlong Tan. Statistical analysis: Yanxia Xiao, Yanfang Zhou,\u0026nbsp;Ziyan Xu. Obtained funding: Qingyan Yang. Administrative, technical, or material support: Ziyan Xu\u0026nbsp;and\u0026nbsp;Qingyan Yang.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis\u0026nbsp;paper was supported by Beijing Municipal Administration of Hospitals Incubating Program, PX202307,\u0026nbsp;2023, and Capital\u0026rsquo;s Funds for Health Improvement and Research, SF2024-2-2133.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study protocol was fully reviewed and approved by the Research \u0026amp; Ethics Committee of Peking University Clinical Medical School, Beijing Huilongguan Hospital, China. All methods were carried out in accordance with the Declaration of Helsinki. Prospective research participants were informed of the study aims and asked to sign an online consent form to participate in the study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot\u0026nbsp;applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eCarvalho AF, Heilig M, Perez A, Probst C, Rehm J (2019) Alcohol use disorders. Lancet 394 (10200):781-792\u003c/li\u003e\n\u003cli\u003eHuang Y, Wang Y, Wang H, Liu Z, Yu X, Yan J, Yu Y, Kou C, Xu X, Lu J (2019) Prevalence of mental disorders in China: a cross-sectional epidemiological study. Lancet Psychiatry 6 (3):211-224\u003c/li\u003e\n\u003cli\u003eSocias ME, Scheuermeyer FX, Cui Z, Mok WY, Crabtree A, Fairbairn N, Nolan S, Slaunwhite A, Ti L (2023) Using a cascade of care framework to identify gaps in access to medications for alcohol use disorder in British Columbia, Canada. Addiction 118 (11): 2128-2138\u003c/li\u003e\n\u003cli\u003eXiang YT, Ma X, Lu JY, Cai ZJ, Li SR, Xiang YQ, Guo HL, Hou YZ, Li ZB, Li ZJ (2009) Alcohol-related disorders in beijing, china: Prevalence, socio-demographic correlates, and unmet need for treatment. Alcohol Clin Exp Res 33 (6): 1111-1118\u003c/li\u003e\n\u003cli\u003eHammarlund R, Crapanzano K, Luce L, Mulligan L, Ward K (2018) Review of the effects of self-stigma and perceived social stigma on the treatment-seeking decisions of individuals with drug-and alcohol-use disorders. Subst Abuse Rehabil 9:115\u003c/li\u003e\n\u003cli\u003eYang LH, Wong LY, Grivel MM, Hasin DS (2017) Stigma and substance use disorders: an international phenomenon. Curr Opin Psychiatry 30 (5):378-388. doi:10.1097/yco.0000000000000351\u003c/li\u003e\n\u003cli\u003eFinn SW, Mejldal A, Nielsen AS (2023) Public stigma and treatment preferences for alcohol use disorders. BMC Health Serv Res 23 (1):76. doi:10.1186/s12913-023-09037-y\u003c/li\u003e\n\u003cli\u003eMorris J, Schomerus G (2023) Why stigma matters in addressing alcohol harm. Drug Alcohol Rev 42 (5): 1264-1268. doi: 10.1111/dar.13660\u003c/li\u003e\n\u003cli\u003eMorris J, Boness CL, Witkiewitz K (2024) Should we promote alcohol problems as a continuum? Implications for policy and practice. Drugs Educ Prev Policy 31: 271-281. doi.org/10.1080/09687637.2023.2187681 \u003c/li\u003e\n\u003cli\u003eSchomerus G, Baumann E, Sander C, Speerforck S, Angermeyer MC (2021) Some good news for psychiatry: resource allocation preferences of the public during the COVID‐19 pandemic. World Psychiatry 20 (2):301-302\u003c/li\u003e\n\u003cli\u003eSchomerus G, Lucht M, Holzinger A, Matschinger H, Carta MG, Angermeyer MC (2011) The stigma of alcohol dependence compared with other mental disorders: a review of population studies. Alcohol Alcohol 46 (2):105-112\u003c/li\u003e\n\u003cli\u003eCorrigan PW, Schomerus G, Shuman V, Kraus D, Perlick D, Harnish A, Kulesza M, Kane-Willis K, Qin S, Smelson D (2017) Developing a research agenda for understanding the stigma of addictions Part I: Lessons from the Mental Health Stigma Literature. Am J Addict 26 (1):59-66. doi:10.1111/ajad.12458\u003c/li\u003e\n\u003cli\u003eKilian C, Manthey J, Carr S, Hanschmidt F, Rehm J, Speerforck S, Schomerus G (2021) Stigmatization of people with alcohol use disorders: An updated systematic review of population studies. Alcohol Clin Exp Res 45 (5):899-911\u003c/li\u003e\n\u003cli\u003eCorrigan PW, Rowan D, Green A, Lundin R, River P, Uphoff-Wasowski K, White K, Kubiak MA (2002) Challenging two mental illness stigmas: Personal responsibility and dangerousness. Schizophr Bull 28 (2):293-309\u003c/li\u003e\n\u003cli\u003eWeiner B, Perry RP, Magnusson J (1988) An attributional analysis of reactions to stigmas. J Pers Soc Psychol 55 (5):738\u003c/li\u003e\n\u003cli\u003eLink BG, Phelan JC (2001) Conceptualizing stigma. Annu Rev Sociol 27 (1):363-385\u003c/li\u003e\n\u003cli\u003eNieweglowski K, Dubke R, Mulfinger N, Sheehan L, Corrigan PW (2019) Understanding the factor structure of the public stigma of substance use disorder. Addict Res Theory 27 (2):156-161. doi:10.1080/16066359.2018.1474205\u003c/li\u003e\n\u003cli\u003eWallhed Finn S, Mejldal A, Nielsen AS (2023) The associations between public stigma and support for others\u0026apos; help-seeking for alcohol use disorder: a cross sectional study in the general Danish population. Addict Sci Clin Pract 18 (1):46. doi:10.1186/s13722-023-00400-2\u003c/li\u003e\n\u003cli\u003eSchomerus G, Matschinger H, Angermeyer MC (2014) Causal beliefs of the public and social acceptance of persons with mental illness: a comparative analysis of schizophrenia, depression and alcohol dependence. Psychol Med 44 (2):303-314. doi:10.1017/s003329171300072x\u003c/li\u003e\n\u003cli\u003eLink BG (1987) Understanding labeling effects in the area of mental disorders: An assessment of the effects of expectations of rejection. Am Sociol Rev 52:96-112\u003c/li\u003e\n\u003cli\u003eMay C, Nielsen AS, Bilberg R (2019) Barriers to treatment for alcohol dependence. J Drug Alcohol Res 8:236083\u003c/li\u003e\n\u003cli\u003eProbst C, Manthey J, Martinez A, Rehm J (2015) Alcohol use disorder severity and reported reasons not to seek treatment: a cross-sectional study in European primary care practices. Subst Abuse Treat Prev Policy 10:32. doi: 10.1186/s13011-015-0028-z\u003c/li\u003e\n\u003cli\u003eSchomerus G, Matschinger H, Lucht MJ, Angermeyer MC (2014) Changes in the perception of alcohol-related stigma in Germany over the last two decades. Drug Alcohol Depend 143:225-231. doi:10.1016/j.drugalcdep.2014.07.033\u003c/li\u003e\n\u003cli\u003eVenegas A, Donato S, Meredith LR, Ray LA (2021) Understanding low treatment seeking rates for alcohol use disorder: A narrative review of the literature and opportunities for improvement. Am J Drug Alcohol Abuse 47 (6):664-679. doi:10.1080/00952990.2021.1969658\u003c/li\u003e\n\u003cli\u003eBirtel MD, Wood L, Kempa NJ (2017) Stigma and social support in substance abuse: Implications for mental health and well-being. Psychiatry Res 252:1-8. doi:https://doi.org/10.1016/j.psychres.2017.01.097\u003c/li\u003e\n\u003cli\u003eCorrigan PW, Bink AB, Schmidt A, Jones N, R\u0026uuml;sch N (2016) What is the impact of self-stigma? Loss of self-respect and the \u0026ldquo;why try\u0026rdquo; effect. J Ment Health 25 (1):10-15\u003c/li\u003e\n\u003cli\u003eMilan L, Varescon I (2022) Self-stigma in alcohol use disorder: Involvement of guilt and shame in the progressive model. Stig Health https://doi.org/10.1037/sah0000424\u003c/li\u003e\n\u003cli\u003eJiang L (2011) Comparison of the difference between Chinese and Western drinking culture. Asian Soc Sci 7 (5):251\u003c/li\u003e\n\u003cli\u003eYang LH (2007) Application of mental illness stigma theory to Chinese societies: synthesis and new direction. Singap Med 48 (11):977\u003c/li\u003e\n\u003cli\u003eCheung M, Leung P, Chen W, Gearing RE, Brewer KB, Chen X, Li X, He X (2022) Public stigma on substance users in China. J Subst Use 27 (4):398-403\u003c/li\u003e\n\u003cli\u003eRoom R (2005) Stigma, social inequality and alcohol and drug use. Drug Alcohol Rev 24 (2):143-155\u003c/li\u003e\n\u003cli\u003eLam CS, Tsang HW, Corrigan PW, Lee Y-T, Angell B, Shi K, Jin S, Larson JE (2010) Chinese lay theory and mental illness stigma: Implications for research and practices. J Rehabil 76 (1):35\u003c/li\u003e\n\u003cli\u003eGu J, Ming X (2020) Perceived Social Discrimination, Socioeconomic Status, and Alcohol Consumption among Chinese Adults: A Nationally Representative Study. Int J Environ Res Public Health 17 (17). doi:10.3390/ijerph17176043\u003c/li\u003e\n\u003cli\u003eXiong W, Phillips MR, Wang Z, Zhang Y, Cheng HG, Link BG (2021) Stigma and discrimination associated with mental illness and other stigmatizing conditions in China using two cultural-sensitive measures of stigma: interpersonal distance and occupational restrictiveness. Psycho Med 51 (16):2804-2813. doi:10.1017/s0033291720001439\u003c/li\u003e\n\u003cli\u003eLo LLH, Suen YN, Chan SKW, Sum MY, Charlton C, Hui CLM, Lee EHM, Chang WC, Chen EYH (2021) Sociodemographic correlates of public stigma about mental illness: a population study on Hong Kong\u0026rsquo;s Chinese population. BMC Psychiatry 21 (1):274\u003c/li\u003e\n\u003cli\u003eKummetat JL, Leonhard A, Manthey J, Speerforck S, Schomerus G (2022) Understanding the Association between Alcohol Stigma and Alcohol Consumption within Europe: A Cross-Sectional Exploratory Study. Eur Addict Res 28 (6):446-454. doi:10.1159/000526200\u003c/li\u003e\n\u003cli\u003eZheng LX, Keegan JP, Rosenthal D, Talley W, Hunter CA (2016) Examining the attributions of discrimination toward people with mental illness among Chinese college students. Aust J Rehabil Couns 22 (1):40-50. doi:10.1017/jrc.2016.3\u003c/li\u003e\n\u003cli\u003eLing CY, Mak WW, Cheng JN (2010) Attribution model of stigma towards children with autism in Hong Kong. J Appl Res Intellec Disabil 23 (3):237-249\u003c/li\u003e\n\u003cli\u003eChang CC, Chang KC, Hou WL, Yen CF, Lin CY, Potenza MN (2020) Measurement invariance and psychometric properties of Perceived Stigma toward People who use Substances (PSPS) among three types of substance use disorders: Heroin, amphetamine, and alcohol. Drug Alcohol Depend 216:108319\u003c/li\u003e\n\u003cli\u003eLuoma JB, O\u0026apos;Hair Ak Fau - Kohlenberg BS, Kohlenberg Bs Fau - Hayes SC, Hayes Sc Fau - Fletcher L, Fletcher L (2010) The development and psychometric properties of a new measure of perceived stigma toward substance users. Subst Use Misuse 45 (1-2): 47-57\u003c/li\u003e\n\u003cli\u003eHan DY, Chen SH (2014) Reducing the stigma of depression through neurobiology-based psychoeducation: a randomized controlled trial. Psychiatry Clin Neurosci 68 (9):666-673. doi:10.1111/pcn.12174\u003c/li\u003e\n\u003cli\u003eBush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA, Project ACQI (1998) The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Arch Intern Med 158 (16):1789-1795\u003c/li\u003e\n\u003cli\u003eYip BH, Chung RY, Chung VC, Kim J, Chan IW, Wong MC, Wong SY, Griffiths SM (2015) Is Alcohol Use Disorder Identification Test (AUDIT) or its shorter versions more useful to identify risky drinkers in a Chinese population? A diagnostic study. PloS One 10 (3):e0117721. doi:10.1371/journal.pone.0117721\u003c/li\u003e\n\u003cli\u003eJohnston R, Jones K, Manley D (2018) Confounding and collinearity in regression analysis: a cautionary tale and an alternative procedure, illustrated by studies of British voting behaviour. Qual \u0026amp; Quant 52:1957-1976\u003c/li\u003e\n\u003cli\u003eCohen J (1988) Statistical power analysis for the behavioral science (2nd ed.). Hillsadale, NJ: Lawrence Erlbaum Associates. \u003c/li\u003e\n\u003cli\u003eHu A, Jiang H, Dowling R, Guo L, Zhao X, Hao W, Xiang X (2022) The transition of alcohol control in China 1990-2019: Impacts and recommendations. Int J Drug Policy 105:103698\u003c/li\u003e\n\u003cli\u003ePescosolido BA, Halpern-Manners A, Luo L, Perry B (2021) Trends in Public Stigma of Mental Illness in the US, 1996-2018. JAMA Netw Open 4 (12):e2140202. doi:10.1001/jamanetworkopen.2021.40202\u003c/li\u003e\n\u003cli\u003eMorris J, Boness CL, Burton R (2023) (Mis)understanding alcohol use disorder: Making the case for a public health first approach. Drug Alcohol Depend 253:111019. doi:https://doi.org/10.1016/j.drugalcdep.2023.111019\u003c/li\u003e\n\u003cli\u003eHe W (2023) Does the immediate reimbursement of medical insurance reduce the socioeconomic inequality in health among the floating population? Evidence from China. Int J Equity Health 22 (1):96. doi:10.1186/s12939-023-01913-7\u003c/li\u003e\n\u003cli\u003eRoche A, Kostadinov V, Fischer J, Nicholas R, O\u0026apos;Rourke, K, Pidd, K, Trifonoff A (2015) Addressing inequities in alcohol consumption and related harms. Health Promot Int, 30, 20-35\u003c/li\u003e\n\u003cli\u003ePfattheicher S, Nielsen YA, Thielmann I (2022) Prosocial behavior and altruism: A review of concepts and definitions. Curr Opin Psychol 44:124-129. doi:https://doi.org/10.1016/j.copsyc.2021.08.021\u003c/li\u003e\n\u003cli\u003eSheng J, Luo S, Jiang B, Hu Y, Lin S, Wang L, Ren Y, Zhao C, Liu Z, Chen J (2022) How prosocial behaviors are maintained in China: The relationship between communist authority and prosociality. Front Psychol 13:938468\u003c/li\u003e\n\u003cli\u003eHamilton KM (2021) Willingness to help: how the portrayal and perception of a wrongfully convicted individual affects people\u0026rsquo;s willingness to help exonerees. Thesis, University of Ontario Institute of Technology (Canada), \u003c/li\u003e\n\u003cli\u003eRossetto A, Jorm AF, Reavley NJ (2016) Predictors of adults\u0026apos; helping intentions and behaviours towards a person with a mental illness: A six-month follow-up study. Psychiatry Res 240:170-176. doi:https://doi.org/10.1016/j.psychres.2016.04.037\u003c/li\u003e\n\u003cli\u003eCorrigan PW, Markowitz FE, Watson A, Rowan D, Kubiak MA (2003) An attribution model of public discrimination towards persons with mental illness. J Health Soc Behav 44:162-179\u003c/li\u003e\n\u003cli\u003eFoster S, O\u0026rsquo;Mealey M (2022) Socioeconomic status and mental illness stigma: the impact of mental illness controllability attributions and personal responsibility judgments. J Ment Health 31 (1):58-65. doi:10.1080/09638237.2021.1875416\u003c/li\u003e\n\u003cli\u003eSeok B (2015) Moral psychology of shame in early Confucian philosophy. Front Philos China 10 (1):21-57\u003c/li\u003e\n\u003cli\u003eYu BCL, Mak WWS (2022) Unpacking Cultural Influences on Stigma of People with Mental Illness between Group-Oriented and Individual-Oriented Cultures. In: Vogel DL, Wade NG (eds) The Cambridge Handbook of Stigma and Mental Health. Cambridge Handbooks in Psychology. Cambridge University Press, Cambridge, pp 263-281. doi:DOI: 10.1017/9781108920995.016\u003c/li\u003e\n\u003cli\u003eRhee E, Uleman JS, Lee HK (1996) Variations in collectivism and individualism by ingroup and culture: Confirmatory factor analysis. J Pers Soc Psychol 71 (5):1037\u003c/li\u003e\n\u003cli\u003eZhang Z, Sun K, Jatchavala C, Koh J, Chia Y, Bose J, Li Z, Tan W, Wang S, Chu W, Wang J, Tran B, Ho R (2019) Overview of Stigma against Psychiatric Illnesses and Advancements of Anti-Stigma Activities in Six Asian Societies. Int J Environ Res Public Health 17 (1):280. doi:10.3390/ijerph17010280\u003c/li\u003e\n\u003cli\u003eSchomerus G, Corrigan PW (2022) Understanding the stigma of substance use disorders. In: Schomerus G, Corrigan PW (Eds.) The stigma of substance use disorders. Cambridge University Press, Cambridge, pp. 1-14. \u003c/li\u003e\n\u003cli\u003eClark TW (2022) Causal responsibility for addiction. Addict Behav 130:107292. doi:10.1016/j.addbeh.2022.107292\u003c/li\u003e\n\u003cli\u003eR\u0026uuml;sch N, K\u0026ouml;sters M (2021) Honest, Open, Proud to support disclosure decisions and to decrease stigma\u0026apos;s impact among people with mental illness: conceptual review and meta-analysis of program efficacy. Soc Psychiatry Psychiatr Epidemiol 56 (9):1513-1526. doi:10.1007/s00127-021-02076-y\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable 1. Socio-demographic characteristics of participants (N=1,100)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 61.5584%;\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38.4416%;\"\u003e\n \u003cp\u003eN (percentage)/M (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 61.5584%;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38.4416%;\"\u003e\n \u003cp\u003e39.3 (10.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 61.5584%;\"\u003e\n \u003cp\u003eGender, female\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38.4416%;\"\u003e\n \u003cp\u003e657 (59.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 61.5584%;\"\u003e\n \u003cp\u003eEthnic groups\u003c/p\u003e\n \u003cp\u003eHan\u003c/p\u003e\n \u003cp\u003eManchu\u003c/p\u003e\n \u003cp\u003eKorean\u003c/p\u003e\n \u003cp\u003eHui\u003c/p\u003e\n \u003cp\u003eMongolian\u003c/p\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38.4416%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1053 (95.7%)\u003c/p\u003e\n \u003cp\u003e25 (2.2%)\u003c/p\u003e\n \u003cp\u003e5 (0.5%)\u003c/p\u003e\n \u003cp\u003e4 (0.4%)\u003c/p\u003e\n \u003cp\u003e4 (0.4%)\u003c/p\u003e\n \u003cp\u003e9 (0.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 61.5584%;\"\u003e\n \u003cp\u003eEducation (years)\u003c/p\u003e\n \u003cp\u003e8-9\u003c/p\u003e\n \u003cp\u003e10-12\u003c/p\u003e\n \u003cp\u003e13-16\u003c/p\u003e\n \u003cp\u003e\u0026gt;16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38.4416%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e48 (4.4%)\u003c/p\u003e\n \u003cp\u003e66 (6.0%)\u003c/p\u003e\n \u003cp\u003e690 (62.7%)\u003c/p\u003e\n \u003cp\u003e296 (26.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 61.5584%;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38.4416%;\"\u003e\n \u003cp\u003e826 (75.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 61.5584%;\"\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38.4416%;\"\u003e\n \u003cp\u003e25 (2.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 61.5584%;\"\u003e\n \u003cp\u003eAlcohol consumption (0-12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38.4416%;\"\u003e\n \u003cp\u003e2.3 (2.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 61.5584%;\"\u003e\n \u003cp\u003eAny mental health service use, lifetime\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38.4416%;\"\u003e\n \u003cp\u003e140 (12.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 2. Descriptive Statistics (N=1,100)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62.4266%;\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37.5734%;\"\u003e\n \u003cp\u003eN (Percentage)/ M \u0026plusmn; SD (Range)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62.4266%;\"\u003e\n \u003cp\u003eAUDs \u003csup\u003ea\u003c/sup\u003e are mental illnesses (yes)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37.5734%;\"\u003e\n \u003cp\u003e820 (74.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62.4266%;\"\u003e\n \u003cp\u003eAUDs are due to a lack of willpower (yes)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37.5734%;\"\u003e\n \u003cp\u003e345 (31.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62.4266%;\"\u003e\n \u003cp\u003ePotential causes of AUDs\u003c/p\u003e\n \u003cp\u003eBio-psycho-social\u0026nbsp;\u003c/p\u003e\n \u003cp\u003ePsychosocial\u003c/p\u003e\n \u003cp\u003eBiological\u003c/p\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37.5734%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e700 (63.6%)\u003c/p\u003e\n \u003cp\u003e235 (21.4%)\u003c/p\u003e\n \u003cp\u003e16 (1.5%)\u003c/p\u003e\n \u003cp\u003e149 (13.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62.4266%;\"\u003e\n \u003cp\u003eSupporting health insurance coverage (yes)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37.5734%;\"\u003e\n \u003cp\u003e338 (30.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62.4266%;\"\u003e\n \u003cp\u003eAttributions \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003cp\u003eDangerousness\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37.5734%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e7.28 \u0026plusmn; 1.87 (1-9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62.4266%;\"\u003e\n \u003cp\u003eResponsibility\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37.5734%;\"\u003e\n \u003cp\u003e7.63 \u0026plusmn; 1.66 (1-9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62.4266%;\"\u003e\n \u003cp\u003eTreatability\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37.5734%;\"\u003e\n \u003cp\u003e7.04 \u0026plusmn; 1.98 (1-9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62.4266%;\"\u003e\n \u003cp\u003eWillingness to help\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37.5734%;\"\u003e\n \u003cp\u003e5.46 \u0026plusmn; 2.36 (1-9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62.4266%;\"\u003e\n \u003cp\u003eAvoidance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37.5734%;\"\u003e\n \u003cp\u003e5.35 \u0026plusmn; 2.43 (1-9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62.4266%;\"\u003e\n \u003cp\u003ePity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37.5734%;\"\u003e\n \u003cp\u003e5.87 \u0026plusmn; 2.75 (1-9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62.4266%;\"\u003e\n \u003cp\u003eAnger\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37.5734%;\"\u003e\n \u003cp\u003e5.84 \u0026plusmn; 2.52 (1-9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62.4266%;\"\u003e\n \u003cp\u003eFear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37.5734%;\"\u003e\n \u003cp\u003e6.32 \u0026plusmn; 2.28 (1-9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62.4266%;\"\u003e\n \u003cp\u003ePerceived stigma \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37.5734%;\"\u003e\n \u003cp\u003e23.96 \u0026plusmn; 4.39 (9-36)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62.4266%;\"\u003e\n \u003cp\u003eDesire for social distance \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37.5734%;\"\u003e\n \u003cp\u003e24.68 \u0026plusmn; 3.69 (7-28)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003csup\u003ea\u003c/sup\u003e AUD = Alcohol use disorders; \u003csup\u003eb\u003c/sup\u003e A higher score indicates a higher level of the measured variables\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Table 3. Correlations between misconceptions, stereotypes, emotional reactions, perceived stigma and the desire for social distance (* p\u0026lt;0.01; ** p\u0026lt;0.001)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"1004\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 3.98804%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.1336%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 3.98804%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.1336%;\"\u003e\n \u003cp\u003eAUDs\u003csup\u003ea\u003c/sup\u003e are mental illnesses\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 3.98804%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.1336%;\"\u003e\n \u003cp\u003eLack of willpower\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.20\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 3.98804%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.1336%;\"\u003e\n \u003cp\u003ePotential causes of AUDs\u003csup\u003ea, b\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.12\u003csup\u003e**c\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e-0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 3.98804%;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.1336%;\"\u003e\n \u003cp\u003eSupporting health insurance coverage\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e-0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.10\u003csup\u003e*c\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 3.98804%;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.1336%;\"\u003e\n \u003cp\u003eDangerousness\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e-0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 3.98804%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.1336%;\"\u003e\n \u003cp\u003eResponsibility\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.08\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e-0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e-0.10\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.53\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 3.98804%;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.1336%;\"\u003e\n \u003cp\u003eTreatability\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.18\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e-0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.45\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.40\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 3.98804%;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.1336%;\"\u003e\n \u003cp\u003eWillingness to Help\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.08\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.17\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.32\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 3.98804%;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.1336%;\"\u003e\n \u003cp\u003eAvoidance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.12\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e-0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e-0.12\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.26\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.27\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.11\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e-0.22\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 3.98804%;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.1336%;\"\u003e\n \u003cp\u003ePity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.09\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.32\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.19\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.26\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.29\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 3.98804%;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.1336%;\"\u003e\n \u003cp\u003eAnger\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.14\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.09\u003csup\u003e*d\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e-0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.42\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.40\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.31\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.29\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.27\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.29\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 3.98804%;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.1336%;\"\u003e\n \u003cp\u003eFear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.07\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.12\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e-0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.64\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.48\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.32\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.11\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.37\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.27\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.54\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 3.98804%;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.1336%;\"\u003e\n \u003cp\u003ePerceived stigma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.14\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.12\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e-0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e-0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.10\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e-0.11\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.20\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e-0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.10\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.10\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 3.98804%;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.1336%;\"\u003e\n \u003cp\u003eDesire for social distance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.12\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.14\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e-0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e-0.08\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.32\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.32\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.19\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e-0.13\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.41\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.29\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.38\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.68295%;\"\u003e\n \u003cp\u003e0.49\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003csup\u003ea\u003c/sup\u003eAUDs = Alcohol use disorders.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003csup\u003eb\u003c/sup\u003e It is treated as a nominal variable with multiple categories (biogenetic, psychosocial, biopsychosoical and other causal beliefs).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003csup\u003ec\u003c/sup\u003e It is positively associated with biopsychosocial perspectives.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003csup\u003ed\u003c/sup\u003e A biogenetical perspective was associated with the lowest level of anger, followed by psychosocial and then biopsychosocial perspectives.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 4. Linear regression analysis on the desire for social distance, controlling for age, gender, education, employment, alcohol consumption and lifetime mental health service us (Adjusted R\u003csup\u003e2\u003c/sup\u003e=0.41)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"631\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.6038%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIndependent variables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.66719%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eB\u003csup\u003e*\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.19176%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSE\u003c/strong\u003e\u003csup\u003ec* *\u003cstrong\u003e*\u003c/strong\u003ed\u003cstrong\u003e*\u003c/strong\u003e*\u003c/sup\u003e\u003cstrong\u003eError\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBeta\u003csup\u003e#\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.4707%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003csup\u003ed\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.6038%;\"\u003e\n \u003cp\u003eAUD\u003csup\u003ea\u003c/sup\u003e is a mental illness (0=no, 1=yes)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.66719%;\"\u003e\n \u003cp\u003e0.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.19176%;\"\u003e\n \u003cp\u003e0.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.4707%;\"\u003e\n \u003cp\u003e0.09 \u0026ndash; 1.11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.6038%;\"\u003e\n \u003cp\u003eAUDs are due to a lack of willpower (0=no, 1=yes)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.66719%;\"\u003e\n \u003cp\u003e0.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.19176%;\"\u003e\n \u003cp\u003e0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e0.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.4707%;\"\u003e\n \u003cp\u003e-0.14 \u0026ndash; 0.74\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.6038%;\"\u003e\n \u003cp\u003ePotential causes of AUDs\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.66719%;\"\u003e\n \u003cp\u003e-0.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.19176%;\"\u003e\n \u003cp\u003e0.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e-0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.4707%;\"\u003e\n \u003cp\u003e-0.92 \u0026ndash; 0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.6038%;\"\u003e\n \u003cp\u003eSupporting health insurance coverage (0=yes, 1=no)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.66719%;\"\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.19176%;\"\u003e\n \u003cp\u003e0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e0.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.4707%;\"\u003e\n \u003cp\u003e0.54 \u0026ndash; -0.31\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.6038%;\"\u003e\n \u003cp\u003eDangerousness\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.66719%;\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.19176%;\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.4707%;\"\u003e\n \u003cp\u003e-0.02 \u0026ndash; 0.27\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.6038%;\"\u003e\n \u003cp\u003eResponsibility\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.66719%;\"\u003e\n \u003cp\u003e0.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.19176%;\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.4707%;\"\u003e\n \u003cp\u003e0.06 \u0026ndash; 0.35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.6038%;\"\u003e\n \u003cp\u003eTreatability\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.66719%;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.19176%;\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e0.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.4707%;\"\u003e\n \u003cp\u003e-0.07 \u0026ndash; 0.17\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.6038%;\"\u003e\n \u003cp\u003ePity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.66719%;\"\u003e\n \u003cp\u003e-0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.19176%;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e-0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.4707%;\"\u003e\n \u003cp\u003e-0.13 \u0026ndash; 0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.6038%;\"\u003e\n \u003cp\u003eAnger\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.66719%;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.19176%;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e0.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.4707%;\"\u003e\n \u003cp\u003e-0.07 \u0026ndash; 0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.6038%;\"\u003e\n \u003cp\u003eFear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.66719%;\"\u003e\n \u003cp\u003e0.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.19176%;\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.4707%;\"\u003e\n \u003cp\u003e0.08 \u0026ndash; 0.32\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.6038%;\"\u003e\n \u003cp\u003eWillingness to Help\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.66719%;\"\u003e\n \u003cp\u003e-0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.19176%;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e-0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.4707%;\"\u003e\n \u003cp\u003e-0.25 \u0026ndash; -0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.6038%;\"\u003e\n \u003cp\u003eAvoidance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.66719%;\"\u003e\n \u003cp\u003e0.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.19176%;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e0.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.4707%;\"\u003e\n \u003cp\u003e0.18 \u0026ndash; 0.36\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.6038%;\"\u003e\n \u003cp\u003ePerceived stigma\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.66719%;\"\u003e\n \u003cp\u003e0.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.19176%;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e0.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.4707%;\"\u003e\n \u003cp\u003e0.29 \u0026ndash; 0.39\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.6038%;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.66719%;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.19176%;\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.4707%;\"\u003e\n \u003cp\u003e0.01 \u0026ndash; 0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.6038%;\"\u003e\n \u003cp\u003eGender (0=male, 1=female)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.66719%;\"\u003e\n \u003cp\u003e-0.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.19176%;\"\u003e\n \u003cp\u003e0.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e-0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e0.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.4707%;\"\u003e\n \u003cp\u003e-0.64 \u0026ndash; 0.30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.6038%;\"\u003e\n \u003cp\u003eEducation (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.66719%;\"\u003e\n \u003cp\u003e-0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.19176%;\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e0.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.4707%;\"\u003e\n \u003cp\u003e0.11 \u0026ndash; -0.28\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.6038%;\"\u003e\n \u003cp\u003eEmployment (0=no, 1=yes)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.66719%;\"\u003e\n \u003cp\u003e-0.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.19176%;\"\u003e\n \u003cp\u003e0.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e0.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.4707%;\"\u003e\n \u003cp\u003e0.66 \u0026ndash; -2.39\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.6038%;\"\u003e\n \u003cp\u003eAny mental health service uses, lifetime (0=no, 1=yes)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.66719%;\"\u003e\n \u003cp\u003e-0.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.19176%;\"\u003e\n \u003cp\u003e0.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e-0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e0.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.4707%;\"\u003e\n \u003cp\u003e-0.75 \u0026ndash; 0.40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.6038%;\"\u003e\n \u003cp\u003eAlcohol consumption\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.66719%;\"\u003e\n \u003cp\u003e-0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.19176%;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e-0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.03328%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.4707%;\"\u003e\n \u003cp\u003e-0.31 \u0026ndash; -0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003csup\u003ea\u003c/sup\u003eAUD = Alcohol use disorder. \u003csup\u003eb\u003c/sup\u003ereference category = biopsychosocial model. \u003csup\u003ec\u003c/sup\u003eSE = Standard Error.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003csup\u003ed\u003c/sup\u003eCI = Confidence Interval. \u003csup\u003e*\u003c/sup\u003e Unstandardised coefficient. \u003csup\u003e#\u003c/sup\u003e Standardised coefficient.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-psychiatry","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bpsy","sideBox":"Learn more about [BMC Psychiatry](http://bmcpsychiatry.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bpsy/default.aspx","title":"BMC Psychiatry","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"alcohol use disorders, public stigma, stereotype, discrimination, China, stigma change","lastPublishedDoi":"10.21203/rs.3.rs-4971967/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4971967/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003ePurpose:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eResearch from Western societies indicates pervasive public stigma against people with alcohol use disorders (AUDs). However, there is a lack of knowledge about the interactions between different components of stigma and their contribution to discriminatory behaviour towards individuals with AUDs within the Chinese cultural context. The aim of the present study was therefore to investigate the relationships of (mis-)conceptions, stereotypes, emotional reactions, perceived public stigma and their contribution to the desire for social distance among the Chinese adults.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e(Mis-)conceptions, stereotypes, emotional responses, willingness to help and avoid, perceived stigma, and the desire for social distance from individuals with AUDs were assessed via a cross-sectional online survey with a sample of 1,100 adults from the Chinese population.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThree-fourth of the participants recognised AUDs as mental illnesses, though 70% of the sample did not support health insurance coverage for the treatment of AUDs. A stronger desire for social distance was associated with increased perceived public stigma, greater recognition of alcohol use disorders as mental illnesses, heightened perceptions of personal responsibility, increased fear, and more willingness to avoid and withhold help, controlling for age, gender, education, employment, and alcohol consumption.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo improve social integration for individuals with AUDs in China, culturally tailored anti-stigma programmes are needed to reduce negative attitudes and discriminatory behaviours among the Chinese population.\u003c/p\u003e","manuscriptTitle":"Misconceptions, prejudice and social distance towards people with alcohol use disorders in China","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-10-01 11:54:19","doi":"10.21203/rs.3.rs-4971967/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-11-13T10:12:46+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-10-12T14:51:59+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"209272136279255916874851074864319593986","date":"2024-10-04T03:11:39+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-09-30T16:15:14+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"59854114369925707661197308845989551812","date":"2024-09-25T07:01:13+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-09-25T06:48:48+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2024-09-02T08:10:11+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-09-02T03:26:56+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-09-02T03:24:17+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Psychiatry","date":"2024-08-25T09:00:32+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-psychiatry","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bpsy","sideBox":"Learn more about [BMC Psychiatry](http://bmcpsychiatry.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bpsy/default.aspx","title":"BMC Psychiatry","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"3d246dfb-6a2b-4d5d-a358-e22a2f7ea9a5","owner":[],"postedDate":"October 1st, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-02-24T15:58:23+00:00","versionOfRecord":{"articleIdentity":"rs-4971967","link":"https://doi.org/10.1186/s12888-025-06595-9","journal":{"identity":"bmc-psychiatry","isVorOnly":false,"title":"BMC Psychiatry"},"publishedOn":"2025-02-19 15:56:51","publishedOnDateReadable":"February 19th, 2025"},"versionCreatedAt":"2024-10-01 11:54:19","video":"","vorDoi":"10.1186/s12888-025-06595-9","vorDoiUrl":"https://doi.org/10.1186/s12888-025-06595-9","workflowStages":[]},"version":"v1","identity":"rs-4971967","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4971967","identity":"rs-4971967","version":["v1"]},"buildId":"zQwnuV7TCBrMSSSToR1PI","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}