How Does Stigma “Get Under the Skin”?

TLDR

Stigma is a risk factor for mental health problems, yet its pathway to psychological distress remains underexplored. The study investigates whether emotion‑regulation strategies explain the link between stigma and distress. Rumination, which rises during stigma‑related stress, mediates the stigma‑distress relationship; suppression also increases, social support’s protective effect depends on stigma concealability (LGB participants report more isolation and less support), and an experimental manipulation confirms that rumination causally prolongs distress.

Abstract

Stigma is a risk factor for mental health problems, but few studies have considered how stigma leads to psychological distress. The present research examined whether specific emotion-regulation strategies account for the stigma-distress association. In an experience-sampling study, rumination and suppression occurred more on days when stigma-related stressors were reported than on days when these stressors were not reported, and rumination mediated the relationship between stigma-related stress and psychological distress. The effect of social support on distress was moderated by the concealability of the stigma: Lesbian, gay, and bisexual (LGB) respondents reported more isolation and less social support than African American respondents subsequent to experiencing stigma-related stressors, whereas African Americans reported greater social support than LGB participants. Social isolation mediated the stigma-distress association among LGB respondents. In a second experimental study, participants who ruminated following the recall of an autobiographical discrimination event exhibited prolonged distress on both implicit and explicit measures relative to participants who distracted themselves; this finding provides support for a causal role of rumination in the stigma-distress relationship.