Decades of stigma research show that an enormous amount of variability exists in whether people with stigmatized identities experience increased psychological distress. The goal of the current application is to test a model that examines vulnerability factors for people with concealable stigmatized identities. Our sample will include 5 concealable stigmatized identities: mental illness, childhood abuse (physical, emotional, sexual), rape, substance abuse, and relationship violence. These five identities were chosen because they are common, stigmatized, and related to increased psychological distress. Participants will be drawn from a diverse community sample, composed of people both currently seeking psychological treatment and those not in treatment. There are three specific aims: Our first specific aim is to test a model of vulnerability factors for psychological distress for people with concealable stigmatized identities. Based on stigma theory and research, four factors internal to the stigma target (anticipated stigma, centrality of the identity, salience of the identity, and internalization of negative stereotypes) and one factor external to the stigma target (level of cultural stigma attached to the identity) are predicted to explain distress. Using structural equation modeling, we will also examine a mediated model in which the effect of anticipated stigma on distress is mediated through increased centrality and salience. We hypothesize that anticipating more devaluation due to one's stigmatized identity will lead to increased identity centrality and salience, which in turn result in increased distress. Level of cultural stigma is predicted to have only a direct effect on distress. Our second specific aim is to examine whether the vulnerability factors in our model predict general health functioning, and if so, whether this effect is mediated through psychological distress. Our third specific aim is to compare model fit across ethnicity. Research has shown both physical and mental health disparities between minority and majority Americans. We hypothesize that, compared to European Americans, African Americans and Latinos will show exacerbated concealed stigma effects and these effects will be predicted by previous experiences with discrimination.

Public Health Relevance

This research will provide a model of risk factors to predict who is likely to be vulnerable to psychological distress and decreased health functioning due to concealable stigmatized identities. Ultimately, such a model may have its greatest impact on the enhancement of treatment outcomes by increasing access, utilization, and treatment effectiveness of therapeutic interventions as well as reducing the heavy disability burden associated with untreated concealed stigmas.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Project (R01)
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Social Psychology, Personality and Interpersonal Processes Study Section (SPIP)
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Otey, Emeline M
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University of Connecticut
Schools of Arts and Sciences
United States
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Quinn, Diane M; Williams, Michelle K; Weisz, Bradley M (2015) From discrimination to internalized mental illness stigma: The mediating roles of anticipated discrimination and anticipated stigma. Psychiatr Rehabil J 38:103-8
Quinn, Diane M; Williams, Michelle K; Quintana, Francisco et al. (2014) Examining effects of anticipated stigma, centrality, salience, internalization, and outness on psychological distress for people with concealable stigmatized identities. PLoS One 9:e96977
Quinn, Diane M; Earnshaw, Valerie A (2013) Concealable Stigmatized Identities and Psychological Well-Being. Soc Personal Psychol Compass 7:40-51
Overstreet, Nicole M; Quinn, Diane M (2013) The Intimate Partner Violence Stigmatization Model and Barriers to Help-Seeking. Basic Appl Soc Psych 35:109-122