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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.

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Means and Standard Errors for Anticipated Stigma for each CSI group.Analyses controlling for income, education, and sex found significant differences in mean levels of anticipated stigma reported across the groups. Bonferroni corrected post-hoc comparisons show that the substance abuse groups reported greater levels of anticipated stigma than the child abuse (p<.001), sexual assault (p<.001), and domestic violence groups (p = .03) but not more than the mental illness group. Similarly, the mental illness group reported more anticipated stigma than the child abuse (p<.001) and sexual assault groups (p = .003) but not the domestic violence group.
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pone-0096977-g002: Means and Standard Errors for Anticipated Stigma for each CSI group.Analyses controlling for income, education, and sex found significant differences in mean levels of anticipated stigma reported across the groups. Bonferroni corrected post-hoc comparisons show that the substance abuse groups reported greater levels of anticipated stigma than the child abuse (p<.001), sexual assault (p<.001), and domestic violence groups (p = .03) but not more than the mental illness group. Similarly, the mental illness group reported more anticipated stigma than the child abuse (p<.001) and sexual assault groups (p = .003) but not the domestic violence group.

Mentions: The means and standard errors for anticipated stigma for each CSI are shown in Figure 2. As hypothesized, participants in the mental illness and substance abuse groups reported the greatest amounts of anticipated stigma. A 1-way ANCOVA, covarying income, education, and sex was conducted with type of CSI (childhood abuse, sexual assault, domestic violence, mental illness, and substance abuse) as the between-subjects factor. The ANCOVA was significant, F (4, 383)  = 10.59, p<.001, ηp2 = .10. Post-hoc comparisons revealed that the mean for the substance abuse group differed significantly from all other groups except the mental illness group. Similarly, the mental illness group differed from child abuse group and the sexual assault group but not the domestic violence group. The childhood abuse, sexual assault, and domestic violence groups did not differ from each other in level of anticipated stigma. The mental illness and substance abuse groups are above the midpoint of the scale, signifying they believe it to be likely that others will denigrate and socially distance from them if their CSI becomes known. The domestic violence mean is just under the midpoint of the scale, showing relative uncertainty about what might happen if they tell others.


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)

Means and Standard Errors for Anticipated Stigma for each CSI group.Analyses controlling for income, education, and sex found significant differences in mean levels of anticipated stigma reported across the groups. Bonferroni corrected post-hoc comparisons show that the substance abuse groups reported greater levels of anticipated stigma than the child abuse (p<.001), sexual assault (p<.001), and domestic violence groups (p = .03) but not more than the mental illness group. Similarly, the mental illness group reported more anticipated stigma than the child abuse (p<.001) and sexual assault groups (p = .003) but not the domestic violence group.
© Copyright Policy
Related In: Results  -  Collection

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

pone-0096977-g002: Means and Standard Errors for Anticipated Stigma for each CSI group.Analyses controlling for income, education, and sex found significant differences in mean levels of anticipated stigma reported across the groups. Bonferroni corrected post-hoc comparisons show that the substance abuse groups reported greater levels of anticipated stigma than the child abuse (p<.001), sexual assault (p<.001), and domestic violence groups (p = .03) but not more than the mental illness group. Similarly, the mental illness group reported more anticipated stigma than the child abuse (p<.001) and sexual assault groups (p = .003) but not the domestic violence group.
Mentions: The means and standard errors for anticipated stigma for each CSI are shown in Figure 2. As hypothesized, participants in the mental illness and substance abuse groups reported the greatest amounts of anticipated stigma. A 1-way ANCOVA, covarying income, education, and sex was conducted with type of CSI (childhood abuse, sexual assault, domestic violence, mental illness, and substance abuse) as the between-subjects factor. The ANCOVA was significant, F (4, 383)  = 10.59, p<.001, ηp2 = .10. Post-hoc comparisons revealed that the mean for the substance abuse group differed significantly from all other groups except the mental illness group. Similarly, the mental illness group differed from child abuse group and the sexual assault group but not the domestic violence group. The childhood abuse, sexual assault, and domestic violence groups did not differ from each other in level of anticipated stigma. The mental illness and substance abuse groups are above the midpoint of the scale, signifying they believe it to be likely that others will denigrate and socially distance from them if their CSI becomes known. The domestic violence mean is just under the midpoint of the scale, showing relative uncertainty about what might happen if they tell others.

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