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

Quinn DM, Williams MK, Quintana F, Gaskins JL, Overstreet NM, Pishori A, Earnshaw VA, Perez G, Chaudoir SR - PLoS ONE (2014)

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychology, University of Connecticut, Storrs, Connecticut, United States of America.

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.

Show MeSH

Related in: MedlinePlus

Interaction between Centrality and Internalization on Psychological Distress.At most levels of identity centrality (below the 75th percentile), the relationship between internalization and psychological distress is not significant. At very high levels of centrality, however, greater internalization is related to greater psychological distress. Note: Plot based on predicted values of distress given values of the predictor variables at the 10th, 25th, 50th, 75th, and 90th percentiles. Predictor variables centered.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4016201&req=5

pone-0096977-g001: Interaction between Centrality and Internalization on Psychological Distress.At most levels of identity centrality (below the 75th percentile), the relationship between internalization and psychological distress is not significant. At very high levels of centrality, however, greater internalization is related to greater psychological distress. Note: Plot based on predicted values of distress given values of the predictor variables at the 10th, 25th, 50th, 75th, and 90th percentiles. Predictor variables centered.

Mentions: In order to explore the interaction, we used the PROCESS program [86] where moderation can be examined while including the 3 demographic factors (education, income, and sex) and the other stigma variables as controls. Figure 1 shows that as hypothesized, when the magnitude of the identity to the self is low – in this case when centrality is low–the level of internalization does not predict distress. However, as the level of centrality rises, the positive relationship of internalization to distress also rises. Another way to describe this result is that the relationship between internalization and distress does not become significant until centrality reaches the 75th percentile (t = 2.30, p = .02). Thus, internalization of negative stereotypes about one's CSI is particularly distressing to the extent that the identity is also highly central to one's self-definition. We did not find any other significant two-way interactions, including between outness and anticipated stigma as we hypothesized.


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

Quinn DM, Williams MK, Quintana F, Gaskins JL, Overstreet NM, Pishori A, Earnshaw VA, Perez G, Chaudoir SR - PLoS ONE (2014)

Interaction between Centrality and Internalization on Psychological Distress.At most levels of identity centrality (below the 75th percentile), the relationship between internalization and psychological distress is not significant. At very high levels of centrality, however, greater internalization is related to greater psychological distress. Note: Plot based on predicted values of distress given values of the predictor variables at the 10th, 25th, 50th, 75th, and 90th percentiles. Predictor variables centered.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4016201&req=5

pone-0096977-g001: Interaction between Centrality and Internalization on Psychological Distress.At most levels of identity centrality (below the 75th percentile), the relationship between internalization and psychological distress is not significant. At very high levels of centrality, however, greater internalization is related to greater psychological distress. Note: Plot based on predicted values of distress given values of the predictor variables at the 10th, 25th, 50th, 75th, and 90th percentiles. Predictor variables centered.
Mentions: In order to explore the interaction, we used the PROCESS program [86] where moderation can be examined while including the 3 demographic factors (education, income, and sex) and the other stigma variables as controls. Figure 1 shows that as hypothesized, when the magnitude of the identity to the self is low – in this case when centrality is low–the level of internalization does not predict distress. However, as the level of centrality rises, the positive relationship of internalization to distress also rises. Another way to describe this result is that the relationship between internalization and distress does not become significant until centrality reaches the 75th percentile (t = 2.30, p = .02). Thus, internalization of negative stereotypes about one's CSI is particularly distressing to the extent that the identity is also highly central to one's self-definition. We did not find any other significant two-way interactions, including between outness and anticipated stigma as we hypothesized.

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychology, University of Connecticut, Storrs, Connecticut, United States of America.

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.

Show MeSH
Related in: MedlinePlus