We believe this raises an important question: how should labeling status be inferred in research on alcohol and drug stigma? While proxy measures for labeling status such as previous treatment participation and/or time since an individual’s initial diagnosis have been used (Link et al., 1989; Mueller et al., 2006), they may have limitations. A dissonance between one’s own behavior and societal conceptions of what is normal may result in “self-labeling,” which may occur independently of treatment and provoke a fear of stigma (Moses, 2009; Thoits, 1985). Even those who undergo treatment may not personalize their assigned psychiatric diagnosis (Moses, 2009) and/or may become empowered to reject the social connotations associated with psychiatric labels (Camp et al., 2002; Howard, 2008). It has also been argued that certain types of treatment or specific treatment programs may encourage diagnostic labels more than others (Rosenfield, 1997), which may be applicable to alcohol treatment services. To replace proxy measures, we suggest development of direct assessments of labeling via the query of individuals’ perception of being labeled, the extent to which their addiction has been disclosed
