Large health disparities exist between stigmatized and nonstigmatized groups. In addition to experiencing and anticipating greater discrimination, members of stigmatized groups also tend to demonstrate greater ruminative tendencies in response, which may lead to these poor health outcomes. Even among stigmatized groups, differences in the visibility of stigma lead to different mechanisms through which stigma takes its toll. Previous work has primarily focused on the impact of belonging to a single marginalized group; however, people often belong to multiple marginalized groups, and this likely affects both their health outcomes and their anticipation of stigma. In the current study, we focused on individuals with concealable stigmatized identities (CSIs)—socially stigmatized identities that are not immediately apparent to others—and created a measure of concealable marginalization that captures multiple group memberships. We predicted that those possessing a greater number of CSIs would anticipate more stigma from others, and, in turn, ruminate more about the stigma, which would negatively impact the health. Surveying N = 288 adults with CSIs, we found that possessing a greater number of marginalized concealable identities predicted worse self‐reported physical quality of life. These relationships were partially mediated by greater anticipated stigma and brooding rumination in regard to their CSI. This work illuminates a more complete picture of how living with CSIs can take its toll on health.
Experiencing and anticipating discrimination because one possesses a visible (e.g., race) or concealable (e.g., mental illness) stigmatized identity has been related to increased psychological distress. However, little research has examined whether experiencing and anticipating discrimination related to possessing both a visible and concealable stigmatized identity (e.g., a racial/ethnic minority with a history of mental illness) impacts mental health. In the current study, we test 2 hypotheses. In the first, we examine whether experienced discrimination due to a visible stigma (race/ethnicity) and anticipating stigma due to a concealable stigma (e.g., substance abuse) each predict unique variance in depressive symptomatology. In the second, we examine whether experienced discrimination due to a visible stigma is related to greater anticipated stigma for a concealable stigma, which in turn is related to more depression. A total of 265 African American and Latinx adults who reported concealing a stigmatized identity at least some of the time completed measures of racial/ethnic discrimination, anticipated stigma of a concealable stigmatized identity, and depressive symptomatology. Results of a simultaneous linear regression revealed that increased racial/ethnic discrimination and anticipated stigma independently predicted greater depressive symptomatology (controlling for each other). A mediation analysis showed that the positive association between increased racial/ethnic discrimination and higher depressive symptomatology was partially mediated by greater anticipated stigma. These results demonstrate that a person can experience increased psychological distress from multiple types of stigma separately but also may anticipate greater stigma based on previous experiences of racial discrimination, which in turn relates to increased distress.
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