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Examining effects of anticipated stigma, centrality, salience, internalization, and outness on psychological distress for people with concealable stigmatized identities.

ABSTRACT: Understanding how stigmatized identities contribute to increased rates of depression and anxiety is critical to stigma reduction and mental health treatment. There has been little research testing multiple aspects of stigmatized identities simultaneously. In the current study, we collected data from a diverse, urban, adult community sample of people with a concealed stigmatized identity (CSI). We targeted 5 specific CSIs--mental illness, substance abuse, experience of domestic violence, experience of sexual assault, and experience of childhood abuse--that have been shown to put people at risk for increased psychological distress. We collected measures of the anticipation of being devalued by others if the identity became known (anticipated stigma), the level of defining oneself by the stigmatized identity (centrality), the frequency of thinking about the identity (salience), the extent of agreement with negative stereotypes about the identity (internalized stigma), and extent to which other people currently know about the identity (outness). Results showed that greater anticipated stigma, greater identity salience, and lower levels of outness each uniquely and significantly predicted variance in increased psychological distress (a composite of depression and anxiety). In examining communalities and differences across the five identities, we found that mean levels of the stigma variables differed across the identities, with people with substance abuse and mental illness reporting greater anticipated and internalized stigma. However, the prediction pattern of the variables for psychological distress was similar across the substance abuse, mental illness, domestic violence, and childhood abuse identities (but not sexual assault). Understanding which components of stigmatized identities predict distress can lead to more effective treatment for people experiencing psychological distress.

SUBMITTER: Quinn DM

PROVIDER: S-EPMC4016201 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Examining effects of anticipated stigma, centrality, salience, internalization, and outness on psychological distress for people with concealable stigmatized identities.

Quinn Diane M DM Williams Michelle K MK Quintana Francisco F Gaskins Jennifer L JL Overstreet Nicole M NM Pishori Alefiyah A Earnshaw Valerie A VA Perez Giselle G Chaudoir Stephenie R SR

PloS one 20140509 5

Understanding how stigmatized identities contribute to increased rates of depression and anxiety is critical to stigma reduction and mental health treatment. There has been little research testing multiple aspects of stigmatized identities simultaneously. In the current study, we collected data from a diverse, urban, adult community sample of people with a concealed stigmatized identity (CSI). We targeted 5 specific CSIs--mental illness, substance abuse, experience of domestic violence, experien ...[more]

PMID: 24817189

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Project description:Background:Concealable stigmatized identities (CSIs) are identities that can be kept hidden or invisible and that carry negative stereotypes. Depression is one of the most common CSIs among undergraduates. However, to our knowledge, no studies have explored how students manage depression as a CSI in the context of undergraduate research, a high-impact practice for undergraduate science students. Concealing CSIs can cause psychological distress and revealing CSIs can be beneficial; however, it is unknown whether these findings extend to students with depression in the context of undergraduate research experiences. In this study, we interviewed 35 life sciences majors with depression from 12 research-intensive institutions across the United States who participated in undergraduate research. We sought to understand to what extent students reveal their depression in research and to describe the challenges of concealing depression and the benefits of revealing depression in this specific context. Additionally, we explored whether students knew scientists with depression and how knowing a scientist with depression might affect them. Results:Most students did not reveal their depression in their undergraduate research experiences. Those who did typically revealed it to another undergraduate researcher and few revealed it to a faculty mentor. Students who concealed their depression feared the potential consequences of revealing their identity, such as being treated negatively by others in the lab. Students who revealed their depression highlighted a set of benefits that they experienced after revealing their depression, such as receiving support and flexibility from their research mentor. We found that few students knew a specific scientist with depression. However, students perceived that knowing a scientist with depression would help them realize that they are not the only one experiencing depression in science and that people with depression can be successful in science. Conclusions:This study illustrates that students with depression would benefit from research environments that are supportive of students with depression so that they can feel comfortable revealing their depression if they would like to. We also identified that students may benefit from knowing successful scientists with depression. We hope this study encourages undergraduate research mentors to support students with depression and ultimately reduces the stigma around CSIs such as depression.

Project description:BackgroundHealth-related stigma is a complex phenomenon, the experience of which intersects with those of other adversities arising from a diversity of social inequalities and oppressive identities like gender, sexuality, and poverty - a concept called "intersectionality". Understanding this intersectionality between health-related stigma and other forms of social marginalization can provide a fuller and more comprehensive picture of stigma associated with health conditions. The main objective of this paper is to build upon the concept of intersectionality in health-related stigma by exploring the convergence of experiences of stigma and other adversities across the intersections of health and other forms of social oppressions among people living with stigmatized health conditions in Indonesia.MethodsThis qualitative study interviewed 40 people affected by either of four stigmatizing health conditions (HIV, leprosy, schizophrenia, and diabetes) in Jakarta and West Java, Indonesia between March and June 2018. Data was analyzed thematically using an integrative inductive-deductive framework approach.ResultsThe main intersectional inequalities identified by the participants were gender and socioeconomic status (n = 21), followed by religion (n = 13), age (n = 11), co-morbidity (n = 9), disability (n = 6), and sexuality (n = 4). Based on these inequalities/identities, the participants reported of experiencing oppression because of prevailing social norms, systems, and policies (macro-level), exclusion and discrimination from societal actors (meso-level), and self-shame and stigma (micro-level). While religion and age posed adversities that negatively affected participants in macro and meso levels, they helped mitigate the negative experiences of stigma in micro level by improving self-acceptance and self-confidence.ConclusionThis study uncovered how the experience of health-related stigma intersects with other oppressions originating from the various social inequalities in an individual's life. The findings highlight the importance of acknowledging and understanding the multi-dimensional aspect of lives of people living with stigmatized health conditions, and warrant integrated multi-level and cross-cutting stigma reduction interventions to address the intersectional oppressions they experience.

Project description:BackgroundStigma is common among patients with chronic illnesses. It affects the delivery of healthcare for not addressing the psychological components and may interfere with the patient's attendance to necessary health care services. Therefore, a valid and reliable instrument to measure anticipated stigma related to chronic illness is vital to inform possible interventions. This study aimed to translate the Chronic Illness Anticipated Stigma Scale (CIASS) into the Amharic language and evaluate its psychometric properties in Ethiopia.MethodsThe CIASS was translated into Amharic language using standard procedures. The Amharic version was completed by 173 patients (response rate 96%) with chronic illness from three referral hospitals in the Amhara region. Internal consistency was examined through Cronbach's alpha. Construct validity was evaluated by confirmatory factor analysis and convergent validity by using a Pearson correlation of P-value less than or equal to 0.05.ResultsThe internal consistency was estimated at Cronbach alpha of 0.92. By using a structural equation model, and modification indices a model fitness testing was run and shows a root mean squared error of approximation 0.049 (90% CI, 0.012-0.075). The structural validity results in 78.8% of confirmatory factor analysis showed from the extraction of the three-dimension (components). Validity tests for convergent by using Pearson correlation positively correlated with common mental distress and negatively correlated with quality of life-BREF, and the construct validity shows a good valid tool to CIASS.ConclusionThe Amharic language version of the chronic illness anticipated stigma scale shows a satisfactory level of reliability and validity on different psychometric measures of assessment. The tool may be useful for future researchers and patients with chronic illness in the Amharic-speaking population. Moreover, it will be used to see the psychological burden related to chronic illness and for comparison among international population groups.

Dataset Information

Examining effects of anticipated stigma, centrality, salience, internalization, and outness on psychological distress for people with concealable stigmatized identities.

Publications

Examining effects of anticipated stigma, centrality, salience, internalization, and outness on psychological distress for people with concealable stigmatized identities.

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