While these studies offer insight into intermediate outcomes, we are aware of no alcohol research formally investigating mediators of hypothesized stigma outcomes. While higher PAS has been linked to lower levels of social support (Glass et al., 2013), only alcohol research outside of the stigma literature has linked social network measures such as social support and related constructs to negative outcomes. For example, a smaller social network and lack of social relationships or social support is known to be a risk factor for increased alcohol consumption (Pressman et al., 2005) and depressive symptoms (Booth et al., 1992). Conversely, alcohol-abstinent social networks and treatment-supportive relationships predict alcohol dependence recovery (Hunter-Reel et al., 2010). To summarize, while stigma, social relationships, and outcomes have been linked in separate lines of alcohol research, formal tests of mediation are warranted to better understand the mechanisms of alcohol stigma that may worsen psychiatric outcomes.
