The psychological implications of concealing a stigma: A cognitive-affective-behavioral model.

Pachankis, John E.

doi:10.1037/0033-2909.133.2.328

Cited by 1,066 publications

(1,146 citation statements)

References 175 publications

(238 reference statements)

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“…In terms of theory, the findings contribute to the debate on whether it is more advantageous to have a visible or concealable stigma (Frable et al, 1998;Pachankis, 2007;Quinn, 2006). Our findings clearly support the contention that visible stigmas are psychologically and socially more detrimental than concealable ones.…”

Section: Discussionmentioning

confidence: 99%

“…People who choose to "pass" as "normal" by concealing their stigma nevertheless remain "discreditable" as long as there is a potential that the stigma can be revealed (Goffman, 1963). Concerns regarding who to tell and the fear of being discovered are significant sources of psychological distress among those who conceal stigmas (Pachankis, 2007). Those who voluntarily disclose their stigmatized status or those who have conspicuous stigmas must endure potentially being "discredited" in the eyes of others.…”

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confidence: 99%

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Psychological and Social Correlates of HIV Status Disclosure: The Significance of Stigma Visibility

Stutterheim¹,

Bos²,

Pryor³

et al. 2011

AIDS Education and Prevention

108

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HIV-related stigma, psychological distress, self-esteem, and social support were investigated in a sample comprising people who have concealed their HIV status to all but a selected few (limited disclosers), people who could conceal but chose to be open (full disclosers), and people who had visible symptoms that made concealing difficult (visibly stigmatized). The visibly stigmatized and full disclosers reported significantly more stigma experiences than limited disclosers, but only the visibly stigmatized reported more psychological distress, lower self-esteem, and less social support than limited disclosers. This suggests that having a visible stigma is more detrimental than having a concealable stigma. Differences in psychological distress and self-esteem between the visibly stigmatized and full disclosers were mediated by social support while differences between the visibly stigmatized and limited disclosers were mediated by both social support and stigma. These findings suggest that social support buffers psychological distress in people with HIV.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Psychological and Social Correlates of HIV Status Disclosure: The Significance of Stigma Visibility

Stutterheim¹,

Bos²,

Pryor³

et al. 2011

AIDS Education and Prevention

108

View full text Add to dashboard Cite

show abstract

“…Many studies have examined the causes and consequences of disclosure in PLWH (e.g., Chandra et al, 2003;Chaudoir & Fisher, 2010;Pachankis, 2007;Sandelowski et al, 2004). Some studies suggest that disclosing one's HIV status can have beneficial effects such as increased social support, decreased experienced stigma, improved treatment adherence, greater well-being, and healthier behaviors (Peretti-Watel et al, 2006;Skogmar et al, 2006;Smith et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

Advancing methodology in the study of HIV status disclosure: The importance of considering disclosure target and intent

Dima

Stutterheim

Lyimo

et al. 2014

Social Science & Medicine

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Advancing methodology in the study of HIV status disclosure: The importance of considering disclosure target and intent Dima, A.L.; Stutterheim, S.E.; Lyimo, R.; de Bruin, M. General rightsIt is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulationsIf you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: http://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible. Acknowledgements:The authors appreciatively acknowledge the financial assistance from RVVZ from the Netherlands, the participation of PLWH in our target group, and the cooperation of the management in the ART clinics where we conducted the study. Abstract:Disclosure of HIV status has been the focus of three decades of research, which have revealed its complex relations to many behaviors involved in HIV prevention and treatment, and exposed its central role in managing the HIV epidemic. The causes and consequences of disclosure acts have recently been the subject of several theoretical models. Although it is acknowledged that individual disclosure events are part of a broader process of disclosing one's HIV status to an increasing number of people, this process has received less theoretical attention. In quantitative studies of disclosure, researchers have often implicitly assumed that disclosure is a single unidimensional process appropriately measured via the total number of one's disclosure acts. However, there is also evidence that disclosure may have different causes and consequences depending on the types of actors involved (e.g. family members, friends) and on the presence or absence of the discloser's intention, suggesting that the unidimensionality assumption may not hold. We quantitatively examined the dimensionality of voluntary and involuntary disclosure to different categories of actors, using data collected via structured interviews in the spring of 2010 from 158 people living with HIV in Kilimanjaro, Tanzania. For voluntary disclosure, nonparametric item response analyses identified two multi-category clusters, family and community, and two single-category dimensions, partner and children. Involuntary disclosure consisted of several single-or twocategory dimensions. Correlation analyses between the resulting disclosure dimensions and stigma and social support revealed distinct relationships for each disclosure dimension. Our results suggest that treating disclosure as a unidimensional construct is a simplification of disclosure...

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“…Chronic exposure to stigma yields anxious anticipation of future rejection, internalized heterosexism, and stress associated with identity concealment. [1][2][3][4] A growing body of literature suggests that SGM medical students, residents, and physicians experience such stressors throughout medical training and practice.…”

Section: Introductionmentioning

confidence: 99%

Specialty Choice Among Sexual and Gender Minorities in Medicine: The Role of Specialty Prestige, Perceived Inclusion, and Medical School Climate

Sitkin

Pachankis

2016

LGBT Health

Self Cite

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Purpose: Sexual and gender minorities (SGMs) in medicine experience unique stressors in training. However, little is known about SGM specialty choice. This study examined predictors of SGM specialty choice, associations between specialty prestige and perceived SGM inclusion, and self-reported influences on specialty choice. Methods: Medical trainees and practitioners (358 SGM, 1528 non-SGM) were surveyed online. We operationalized specialty choice at the individual level as respondents' specialty of practice; at the specialty level, as a percentage of SGM respondents in each specialty. We examined specialty prestige, perceived SGM inclusivity, and medical school climate as predictors of SGM specialty choice, and we compared additional influences on specialty choice between SGM and non-SGM. Results: The percentage of SGM in each specialty was inversely related to specialty prestige (P = 0.001) and positively related to perceived SGM inclusivity (P = 0.01). Prestigious specialties were perceived as less SGM inclusive (P < 0.001). Medical school climate did not predict specialty prestige (P = 0.82). SGM were more likely than non-SGM to indicate that sexual and gender identity strongly influenced specialty choice (P < 0.01). SGM most frequently rated personality fit, specialty content, role models, and work-life balance as strong influences on specialty choice. Exposure as a medical student to SGM faculty did not predict specialty prestige among SGM. Conclusion: Specialty prestige and perceived inclusivity predict SGM specialty choice. SGM diversity initiatives in prestigious specialties may be particularly effective by addressing SGM inclusion directly. Further research is needed to inform effective mentorship for SGM medical students. Exposure to SGM in medical training reduces anti-SGM bias among medical professionals, and SGM in medicine often assume leadership roles in clinical care, education, and research regarding SGM health. Supporting and promoting SGM diversity across the spectrum of medical specialties, therefore, represents a critical avenue to improve the care delivered to SGM populations and addresses the role of providers in the health disparities experienced by SGM.

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The psychological implications of concealing a stigma: A cognitive-affective-behavioral model.

Cited by 1,066 publications

References 175 publications

Psychological and Social Correlates of HIV Status Disclosure: The Significance of Stigma Visibility

Psychological and Social Correlates of HIV Status Disclosure: The Significance of Stigma Visibility

Advancing methodology in the study of HIV status disclosure: The importance of considering disclosure target and intent

Specialty Choice Among Sexual and Gender Minorities in Medicine: The Role of Specialty Prestige, Perceived Inclusion, and Medical School Climate

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