Concealable Stigmatized Identities and Psychological Well‐Being

Many people have concealable stigmatized identities: Identities that can be hidden from others and that are socially devalued and negatively stereotyped. Understanding how these concealable stigmatized identities affect psychological well‐being is critical. We present our model of the components of concealable stigmatized identities including valenced content– internalized stigma, experienced discrimination, anticipated stigma, disclosure reactions, and counter‐stereotypic/positive information – and magnitude– centrality and salience. Research has shown that negatively valenced content is related to increased psychological distress. However, smaller identity magnitude may buffer this distress. We review the research available and discuss important areas for future work.     

Evidence that anticipated stigma predicts poorer depressive symptom trajectories among emerging adults living with concealable stigmatized identities

People living with concealable stigmatized identities are vulnerable to experiencing greater depressive symptoms as a result of occupying a lower social status. In the present research, we examine the effect of changes in enacted stigma and changes in anticipated stigma on trajectories of depressive symptoms over time. A sample of 192 college-aged emerging adults (81.0% female, 81.9% Caucasian, M_age = 18.82 years) living with a concealable stigmatized identity (e.g., mental illness and sexual minority status) completed measures of enacted stigma, anticipated stigma, and depressive symptoms at two time points across eight weeks. Hierarchical linear modeling analyses indicate that increases in anticipated stigma, but not enacted stigma, predicted poorer trajectories of depressive symptoms, controlling for the effect of baseline rumination and other identity-related variables. These data are among the first to demonstrate that worries about future devaluation predict poorer depressive symptom trajectories over time among college-aged emerging adults.     

Pathways Between Concealable Stigmatized Identities and Substance Misuse

Individuals with concealable stigmatized identities often possess no obviously devalued attributes, yet are at greater risk for problematic substance use compared to their privileged counterparts. We present a conceptual model, which proposes that identity‐relevant content and characteristics have important implications for cognitive, affective, and behavioral consequences of stigma‐related stress. In doing so, we synthesize stigma‐related models from the extant literature and attempt to integrate these concepts with previous work detailing potential contributors to substance use behaviors specifically. Finally, we ask readers to consider the various ways in which the content and characteristics of an individual's stigmatized identity might combine with situational and additional individual difference factors to influence the likelihood of substance misuse.     

AIDS‐Related Stigma in Individuals With Other Stigmatized Identities in the USA: A Review of Layered Stigmas

AIDS‐related stigmas have profound negative impacts on people living with and those affected by HIV/AIDS. While a considerable body of work examines AIDS‐related stigma, it is less clear how AIDS stigmas affect individuals in relation to other stigmatized identities, particularly ethnic minorities. This review examines the literature on AIDS‐related stigma among these groups. The limited available research indicates that AIDS stigmas can seriously interfere with HIV testing, treatment, and care. In addition, prevention studies conducted with incarcerated adolescents, a group characterized by stigmatized identities and high risks for HIV, indicate that interventions for this population do not address stigmatized identities and demonstrate limited effects on risk reduction outcomes. Research is needed to examine stigma in primary prevention of HIV with an at‐risk stigmatized group.     

Stigmatized‐Identity Cues and Consumer Applications Revisited

This article responds to thoughtful commentaries provided by Lamberton (2019–this issue) and Wooten & Rank‐Christman (2019—this issue) on Chaney, Sanchez, & Maimon (2019—this issue), an article in which we discussed the implications of social psychological research on stigmatized‐identity safety cues for consumer behavior. In Chaney, et al. (2019–this issue), we contend that stigmatized‐identity cues can signal belonging to marginalized groups via the ideological assumptions made about companies. In this article, we first clarify our definition of stigmatized identities beyond the limitation assumed by Wooten & Rank‐Christman (2019—this issue). In addition, we join the conversation regarding when cues lead to divergent responses in social groups. We also consider how using identity cues can “backfire” and the importance of using marketing goals to assess the extent to which strategies using such cues succeeded. Lastly, we integrate Lamberton's (2019–this issue) framework of dignity architecture and related empirical findings to discuss some of the challenges of research on stigmatized‐identity cues.     

污名现象及其心理效应

污名本质上是一种消极的刻板印象,是社会对某些个体或群体贬低性的、侮辱性的标签,对被污名者有着深刻的影响。文章从三个方面对污名的相关研究做了简要的回顾。首先介绍了几种污名的相关定义;然后介绍了污名的心理效应,包括污名他人的功能,污名对群体和个体的影响,以及社会公众对污名的态度和应对过程;第三介绍了两个污名研究的主要领域：一个是污名群体知觉、应对歧视规律的污名歧视研究,另一个是可隐匿污名的相关研究,如隐匿污名的心理过程,隐匿的情绪反应以及揭示污名的心理意义等。最后,提出了未来研究的几点展望,可隐匿污名的相关研究,内隐社会认知研究和消除污名消极影响的干预研究     

Making the invisible visible: fear and disclosure of sexual orientation at work

Stigma theory was used to examine the fears underlying the disclosure of a gay identity at work. Using a national sample of 534 gay, lesbian, and bisexual employees, this study examined the antecedents that affect the degree of disclosure of a gay identity at work and, for those who had not disclosed, the factors that influence their fears about full disclosure. Employees reported less fear and more disclosure when they worked in a group that was perceived as supportive and sharing their stigma. Perceptions of past experience with sexual orientation discrimination were related to increased fears but to greater disclosure. For those who had not fully disclosed their stigma, the fears associated with disclosure predicted job attitudes, psychological strain, work environment, and career outcomes. However, actual disclosure was unrelated to these variables. The utility of fear of disclosure for understanding processes underlying the disclosure of gay and other invisible stigmatized identities in the workplace is discussed.     

The effect of feeling stereotyped on social power and inhibition

An experience sampling study examined the degree to which feeling stereotyped predicts feelings of low power and inhibition among stigmatized and nonstigmatized individuals. For 7 days, participants with a concealable (gay and lesbian), a visible (African American), or no identifiable stigma recorded feelings of being stereotyped, of powerlessness, and of inhibition immediately following social interactions. For members of all three groups, feeling stereotyped was associated with more inhibition, and this relation was partially mediated by feeling low in power. Although stigmatized participants reported feeling stereotyped more often than nonstigmatized participants, they reacted less strongly to the experience, consistent with the presence of buffering mechanisms developed by those living with stigma. African Americans appeared to buffer the impact of feeling stereotyped more effectively than gay and lesbian participants, an effect that was partly attributable to African Americans' higher identity centrality.     

污名应对研究：发展脉络、理论取向与展望

污名应对是指被污名者运用不同策略来反抗社会赋予他们的贬低性标签的动态过程。这一领域的研究正在从站在污名施予者的立场考察污名的影响转向到强调被污名者作为主动应对者。目前,对污名应对的研究有三种理论取向：权衡比较取向、认同威胁取向和个人与情境互动取向。污名应对研究对于改善被污名者的心理健康和改进消除污名影响的政策等有重要意义。未来应进一步加强对可隐藏性污名应对的研究,综合使用量化和质性研究范式,关注污名应对的纵向研究,加强污名应对理论的实际应用     

Marginalized Identities,Trump-Related Distress,and the Mental Health of Underrepresented College Students

The current study sought to determine whether holding targeted marginalized identities was associated with greater experiences of distress related to Trump's presidency and whether participants’ level of Trump-related distress predicted decrements in mental health. Participants in the current longitudinal study included 338 underrepresented college students attending a predominantly White institution. Results indicated that individuals who held targeted marginalized identities reported greater Trump-related distress compared to their non-targeted counterparts, and that holding multiple targeted marginalized identities was associated with greater levels of Trump-related distress. Findings also indicated that Trump-related distress was associated with increases (relative to previous trajectories) in anxious but not depressive symptoms. Overall, our results suggest that a shift in sociopolitical circumstances that promulgates bigotry may be harmful to those who possess targeted marginalized identities.     

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

Many assume that individuals with a hidden stigma escape the difficulties faced by individuals with a visible stigma. However, recent research has shown that individuals with a concealable stigma also face considerable stressors and psychological challenges. The ambiguity of social situations combined with the threat of potential discovery makes possessing a concealable stigma a difficult predicament for many individuals. The increasing amount of research on concealable stigmas necessitates a cohesive model for integrating relevant findings. This article offers a cognitive-affective-behavioral process model for understanding the psychological implications of concealing a stigma. It ends with discussion of potential points of intervention in the model as well as potential future routes for investigation of the model.     

Stigma as ego depletion: how being the target of prejudice affects self-control

This research examined whether stigma diminishes people's ability to control their behaviors. Because coping with stigma requires self-regulation, and self-regulation is a limited-capacity resource, we predicted that individuals belonging to stigmatized groups are less able to regulate their own behavior when they become conscious of their stigmatizing status or enter threatening environments. Study 1 uncovered a correlation between stigma sensitivity and self-regulation; the more Black college students were sensitive to prejudice, the less self-control they reported having. By experimentally activating stigma, Studies 2 and 3 provided causal evidence for stigma's ego-depleting qualities: When their stigma was activated, stigmatized participants (Black students and females) showed impaired self-control in two very different domains (attentional and physical self-regulation). These results suggest that (a) stigma is ego depleting and (b) coping with it can weaken the ability to control and regulate one's behaviors in domains unrelated to the stigma.     

Identification Reduces Stigma of Mental Ill‐Health: A Community‐Based Study

The stigma surrounding mental ill‐health is an important issue that affects likelihood of diagnosis and uptake of services, as those affected may work to avoid exposure, judgment, or any perceived loss in status associated with their mental ill‐health. In this study, we drew upon social identity theory to examine how social group membership might influence the stigma surrounding mental ill‐health. Participants from two urban centers in Ireland (N = 626) completed a survey measuring stigma of mental health, perceived social support as well as identification with two different social groups (community and religion). Mediation analysis showed that subjective identification with religious and community groups led to greater perceived social support and consequently lower perceived stigma of mental ill‐health. Furthermore, findings indicated that high identification with more than one social group can lead to enhanced social resources, and that identification with a religious group was associated with greater community identification. This study thus extends the evidence base of group identification by demonstrating its relationship with stigma of mental ill‐health, while also reinforcing how multiple identities can interact to enhance social resources crucial for well‐being.     

Stigmatized‐Identity Cues in Consumer Spaces

Consumers with stigmatized identities may be especially attentive to organizational cues that signal to them whether or not they are welcomed and valued consumers. These stigmatized‐identity cues can become a part of a company's brand, influencing the attractiveness of the company and consumer loyalty, and allowing consumers to draw inferences about an organization's ideologies and attitudes toward multiple stigmatized groups. Consumers with stigmatized identities attend to stigmatized‐identity cues that signal inclusion (or exclusion) toward other stigmatized groups, resulting in stigmatized‐identity cue transfers, especially when similarity mindsets are activated, and among consumers who are high in stigma solidarity. Because identity is central in consumer behavior, stigmatized‐identity threat cues can at times result in anti‐consumption, including boycotts, allowing consumers and companies to engage in collective action. This article reviews this growing body of research, demonstrating the important influence of stigmatized‐identity cues on consumer behavior and discussing ways in which companies can better signal their inclusive attitudes and ideologies to attract consumers.     

Being and Feeling Unique: Statistical Deviance and Psychological Marginality

ABSTRACT Two studies tested the hypothesis that people with culturally stigmatized and concealable conditions (e.g., gays, epileptics, juvenile delinquents, and incest victims) would be more likely to feel unique than people with culturally valued or conspicuous conditions (e.g., the physically attractive, the intellectually gifted, the obese, and the facially scarred). In Study 1, culturally stigmatized individuals with concealable conditions were least likely to perceive consensus between their personal preferences and those of others. In Study 2, they were most likely to describe themselves as unique and to make these self-relevant decisions quickly. Marginality is a psychological reality, not just a statistical one, for those with stigmatized and concealable "master status" conditions.     

Relationships between stigma-identity constructs and psychological health outcomes among adults who stutter

PurposeIn the current study, stuttering was conceptualized as a concealable stigmatized identity (CSI). The purpose of this investigation was to determine if four specific stigma-identity constructs that contribute to variability in psychological distress among people in other CSI groups also contribute among adult who stutter (AWS).Method505 AWS completed an online survey that included measures of four stigma-identity constructs in addition to general demographics and measures of self-rated stuttering severity, distress, and adverse impact of stuttering on quality of life. Hierarchical regression was performed to determine the extent that stigma-identity constructs explained variability in psychological health outcomes among AWS. Self-rated stuttering severity was investigated as a moderator in these relationships.ResultsThe stigma-identity constructs accounted for a significant proportion of the variability in distress (∼25 %) and adverse impact of stuttering on quality of life (∼30 %) among AWS. Further, the constructs of salience, centrality, and concealment were positively predictive of distress and adverse impact of stuttering after controlling for demographics and neuroticism. Compared to the other predictor variables (self-rated stuttering severity, demographic characteristics, neuroticism, and the three other stigma-identity constructs), concealment was the strongest predictor of adverse impact of stuttering on quality of life. Finally, self-rated stuttering severity was a moderating variable.ConclusionsThe results from this study suggest that there are useful applications in conceptualizing stuttering as a type of CSI. Speech-language pathologists should be aware of the relationships that stigma has with psychological health outcomes among AWS and should consider the implications for intervention.     

Midwives on the Margins: Stigma Management among Out-of-Hospital Midwives

Out-of-hospital midwives’ occupational practices can be interpreted as “dirty work” because of their responsibility to touch women’s genitals and the perceived danger of providing healthcare separate from a hospital. Thus, midwives experience prejudice in their interactions with healthcare providers and the public alike. Using 30 interviews with out-of-hospital midwives, this research explores sources and forms of prejudice and techniques with which participants managed their stigmatized professional identity. Specifically, midwives used strategies of information control, including controlling disclosure and controlling interactions. While previous research documents such techniques, I add theoretical complexity by expanding our knowledge on concealable stigmatized identities.     

The stigmatized perceiver: Exploring the implications of social stigma for cross-race face processing and memory

The human face is an important source of information, such as race or ethnicity, which can guide social interaction and outcomes. Research suggests that compared to majority and dominant group members, minority and subordinate group members tend to experience chronic stigma, resulting in more negative life outcomes (e.g., educational and occupational attainment). We argue that theory and research exploring face perception has not led to models that incorporate how the chronic experience of stigma may impact judgments, reflecting a gap with potential consequences for the validity and generalizability of the theories developed. We propose a framework for understanding how experiencing a socially stigmatized racial identity may lead perceivers to engage in face processing differently from their non-stigmatized counterparts. With a focus on the literature examining the cross-race effect, we explore the potential impact of chronic social stigma on three theorized moderators guiding processing and memory for same-versus cross-race faces. Our analysis suggests that future research focusing on stigmatized perceivers could help to explain some variation in findings, lead to novel theoretical development, and ultimately produce more generalizable research across several domains of inquiry.     

Intergroup Contact and Prejudice Against People With Schizophrenia

There is a growing awareness that responses to mental health disorders differ according to the label. Still, research on contact and prejudice against people with mental health disorders has generally focused on the broader label, “mental illness,” as though various disorders were interchangeable. The present research specifically investigated the relationship between intergroup contact and avoidance of people with schizophrenia—a particularly stigmatized and challenging group—as well as mediators of that relationship. In Study 1, 78 students completed measures of their prior contact with and prejudice against people with schizophrenia. Prior contact predicted less desired avoidance of people with schizophrenia, and this relationship was mediated by more favorable attitudes. Study 2 (N = 122) replicated the results of Study 1, and also found that less fear and less intergroup anxiety mediated the relationship between contact and avoidance. This suggests that contact may effectively reduce prejudice, even against this highly stigmatized group.     

Psychological distance reduces the effect of internalized stigma on mental health treatment decisions

Although stigma is a major barrier to treatment for those with mental health concerns, it is poorly understood when stigma is more or less influential in mental health treatment decisions. In the current work, we examined whether psychological distance—the removal of an event from direct experience—reduced the influence of internalized stigma on willingness to seek treatment. Specifically, we tested the hypothesis that psychological distance versus proximity (e.g., seeking treatment in three months vs. in two days, respectively) decreases the negative influence of stigma on willingness to seek treatment. We focused on a population for whom mental health treatment decisions are personally-relevant: individuals who had previously sought mental health treatment. Experiment 1 showed that the extent to which these individuals internalized (i.e., personally endorsed) stigma about mental illness predicted lower intentions to make an appointment with a mental health care provider for themselves (but not another person). Experiment 2 replicated this result using a different measure of psychological distance (temporal distance) and extended this finding to behavior (time spent reading mental health resources). Overall, this research demonstrated that internalized stigma disrupts mental health treatment-seeking intentions and behaviors when they are psychologically proximal, but not when they are distant. Potential applications of these results are discussed.