Resilience and Quality of Life in Families of Individuals With Polysubstance Use Disorder: Mediating Effects of Internalized Stigma and Caregiving Burden

Family members of individuals with polysubstance substance use disorder (PSUD) face many stressors that negatively affect their quality of life (QoL). This study examined the mediating roles of internalized stigma and perceived caregiving burden in the relationship between psychological resilience and QoL among parents of individuals with PSUD. A cross-sectional study was conducted with a sample of 277 individuals consisting of mothers or fathers of individuals diagnosed with PSUD. Participants completed several instruments, including the Connor-Davidson Resilience Scale, Parents' Internalized Stigma of Mental Illness Scale (adapted), Perceived Family Burden Scale, and WHOQOL-BREF. Data analyses included descriptive statistics, correlation analyses, and serial mediation analysis performed using SPSS 27.0 and PROCESS macro (Model 6). Psychological resilience was positively associated with higher QoL and showed an indirect association with QoL through a sequential mediation involving internalized stigma and perceived care burden. The model explained 67% of the variance in QoL (R² = 0.672). Internalized stigma was associated with perceived care burden, which in turn was negatively associated with QoL. Our study emphasizes the importance of addressing psychological resilience, stigma, and caregiving burden together to improve the QoL of families affected by PSUD. Multifaceted interventions targeting these interrelated factors are recommended to improve the QoL of caregivers.