Perceived Social Support, Internalized Shame, and Subjective Well-Being in Patients with Substance Use Disorder in Pakistan: A Mediation Analysis

Abstract

This study examined the mediating role of internalized shame in the association between perceived social support and well-being among patients with SUDs receiving treatment in rehabilitation centers situated in Rawalpindi/ Islamabad, Pakistan. Perceived social support is known as a critical psychosocial factor influencing recovery and Subjective well-being among persons with substance use disorders. However, the role of internalized shame in this relationship remains less explored, particularly within treatment populations in Pakistan. A cross-sectional research design was used in the study with a sample of 250 patients who are undergoing treatment for SUDs. Participants completed the Multidimensional Scale of Perceived Social Support (MSPSS), Internalized Shame Scale, Depression Anxiety Stress Scale and the ICP Subjective Well-Being Scale. Mediation analyses were conducted to assess the indirect effects of internalized shame. Perceived social support was positively associated with well-being. Internalized shame partially mediated this relationship, indicating that higher social support predicted reduced shame, which in turn enhanced well-being. Perceived social support significantly enhances well being among patients with substance use disorders, with internalized shame serving as a partial mediator. These findings suggest that boosting social support and reducing shame can jointly foster better subjective well being in rehabilitation settings.