Living with a concealable stigmatized identity: The impact of anticipated stigma, centrality, salience, and cultural stigma on psychological distress and health.

Abstract

The current research provides a framework for understanding how concealable stigmatized identities impact people's psychological well-being and health. The authors hypothesize that increased anticipated stigma, greater centrality of the stigmatized identity to the self, increased salience of the identity, and possession of a stigma that is more strongly culturally devalued all predict heightened psychological distress. In Study 1, the hypotheses were supported with a sample of 300 participants who possessed 13 different concealable stigmatized identities. Analyses comparing people with an associative stigma to those with a personal stigma showed that people with an associative stigma report less distress and that this difference is fully mediated by decreased anticipated stigma, centrality, and salience. Study 2 sought to replicate the findings of Study 1 with a sample of 235 participants possessing concealable stigmatized identities and to extend the model to predicting health outcomes. Structural equation modeling showed that anticipated stigma and cultural stigma were directly related to self-reported health outcomes. Discussion centers on understanding the implications of intraindividual processes (anticipated stigma, identity centrality, and identity salience) and an external process (cultural devaluation of stigmatized identities) for mental and physical health among people living with a concealable stigmatized identity. Keywords stigma; psychological distress; courtesy stigma; mental illness; identity Recent reviews in psychology and sociology and from the Department of Health and Human Services have concluded that stigma has large and varied effects on people's life outcomes (e.g., Major & O'Brien, 2005; U.S. Department of Health and Human Services [DHHS], 1999;Williams, Neighbors, & Jackson, 2003). The goal of the current research is to propose and test a novel model for understanding how stigma impacts psychological and health wellbeing among people who live with a concealable stigmatized identity. Concealable stigmatized identities are vastly understudied in comparison to visible stigmatized identities. Despite the acknowledgment that stigma can have a variety of negative effects, there is Correspondence concerning this article should be addressed to Diane M. Quinn, Department of Psychology, University of Connecticut, 406 Babbidge Road, U-1020, Storrs, CT 06269-1020. diane.quinn@uconn.edu. HHS Public AccessAuthor manuscript J Pers Soc Psychol. Author manuscript; available in PMC 2015 July 22. Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript currently no conceptual framework to understand how possessing a concealable stigmatized identity impacts psychological and physical distress. We seek to fill that gap.Because stigma is socially constructed, we believe it is critical to examine both intraindividual and external stigma processes that can impact well-being. Whereas most psychological research has focused solely on the psychological processes internal to individuals that...

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