Accepting the language of the lost : the development and validation of the Stigma Message Acceptance Scale for Substance Use (SMAS-SU)
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[EMBARGOED UNTIL 08/01/2026] The purpose of this dissertation was to develop and validate the Stigma Message Acceptance Scale for Substance Use (SMAS-SU), a novel instrument designed to measure attitudinal acceptance of others' use of stigma messages directed at people who use drugs. Grounded in Smith's Model of Stigma Communication (MSC), SMAS-SU captures acceptance of mark, label, peril, and etiology content--key components of stigma messaging. The study addressed the gap in existing social stigma measures, which largely rely on direct approaches that may be vulnerable to social desirability bias and fail to capture implicit attitudes. The validation process involved three studies. Study One established content validity through expert panel review, leading to refinement of scale items. Study Two used exploratory factor analysis (EFA) to identify the scale's factor structure, resulting in a four-factor solution aligned with MSC's content cues. Study Three employed confirmatory factor analysis (CFA) to assess structural validity, as well as tests of convergent, discriminant, and predictive validity. The results demonstrated that SMAS-SU is a reliable and valid tool for assessing acceptance of stigma messages in both public and professional contexts. The development of SMAS-SU offers important contributions to stigma research, theory, and practice. It provides scholars, clinicians, and health communication practitioners with a means of assessing stigma communication acceptance that can inform intervention efforts, training programs, and future scale development for other stigmatized conditions.
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Ph. D