Expressive flexibility as a buffer in the association between substance use stigma and drug use problems among substance-using individuals with depression.

Prior research has linked stigma associated with substance use (e.g., encounters with and anticipation of discrimination, internalization of negative stereotypes) to increased drug use problems, yet little work has examined protective factors that mitigate this association. The current study examined expressive flexibility (i.e., the ability to flexibly enhance and suppress one's emotional expression in accordance with situational demands), an important component of emotion regulation and psychological flexibility, as a buffer in the relation between substance use stigma and drug use problems among individuals with depression, a population disproportionately impacted by substance use disorder. A community sample of U.S. adults diagnosed with major depressive disorder (<i>N</i> = 112) completed self-report measures of substance use stigma, expressive flexibility, and drug use problems. Moderation analyses showed that substance use stigma was significantly associated with drug use problems, but the association was attenuated for participants with high levels of expressive flexibility. These findings underscored the potential utility of fostering expressive flexibility as a stigma coping resource in substance use prevention and treatment interventions.

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Publication Details

Journal
Stigma and Health
Published
2026-01-08
DOI
https://doi.org/10.1037/sah0000680
Primary Topic
Mental Health Treatment and Access
Type
article
Field-Weighted Citation Impact
0.00
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article

Expressive flexibility as a buffer in the association between substance use stigma and drug use problems among substance-using individuals with depression.

R Girard, Katie Wang, Nicole H. Weiss, Robert B. Manning
Stigma and Health
Mental Health Treatment and Access
article

Expressive flexibility as a buffer in the association between substance use stigma and drug use problems among substance-using individuals with depression.

R Girard, Katie Wang, Nicole H. Weiss, Robert B. Manning
article en

Abstract

Prior research has linked stigma associated with substance use (e.g., encounters with and anticipation of discrimination, internalization of negative stereotypes) to increased drug use problems, yet little work has examined protective factors that mitigate this association. The current study examined expressive flexibility (i.e., the ability to flexibly enhance and suppress one's emotional expression in accordance with situational demands), an important component of emotion regulation and psychological flexibility, as a buffer in the relation between substance use stigma and drug use problems among individuals with depression, a population disproportionately impacted by substance use disorder. A community sample of U.S. adults diagnosed with major depressive disorder (<i>N</i> = 112) completed self-report measures of substance use stigma, expressive flexibility, and drug use problems. Moderation analyses showed that substance use stigma was significantly associated with drug use problems, but the association was attenuated for participants with high levels of expressive flexibility. These findings underscored the potential utility of fostering expressive flexibility as a stigma coping resource in substance use prevention and treatment interventions.

Stigma and Health
University of Rhode Island (US), Yale University (US), Miami University (US)
Reduced inequalities
Openalex Percentile: Top 94%
Mental Health Treatment and Access
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Expressive flexibility as a buffer in the association between substance use stigma and drug use problems among substance-using individuals with depression. — R Girard, Katie Wang, et al. · Stigma and Health (2026) | TGRS Research Map | TGRS