Early writings on modified labeling theory described that perceived stigma only has negative consequences for individuals who carry the associated stigmatized label, such as those who have been mental health patients (Link et al., 1989). However, our analyses suggested that PAS might have consequences for untreated persons. Specifically, we found that even among individuals who were deemed to be unlabeled, a positive association existed between PAS and psychiatric outcomes that was mediated through lower levels of social support. Research supports that the general public uses information about others’ former treatment status as cues for labeling, judgment, and social distancing (Ben-Porath, 2002; Crisp et al., 2000; Link and Cullen, 1983), and research conducted with individuals who have non-substance-related psychiatric disorders (e.g., depression, serious mental illness) supports the use of prior treatment status as a proxy for labeling (Kroska and Harkness, 2006; Link, 1987; Link et al., 1989). However, it is plausible that social labeling by means other than treatment status exists to a greater extent for the addictive disorders, given the externalizing nature of the symptoms (Hasin and Kilcoyne, 2012), low
