Living with a concealable stigmatized identity: The impact of anticipated stigma, centrality, salience, and cultural stigma on psychological distress and health.

TLDR

The study offers a framework for how concealable stigmatized identities affect psychological well‑being and health, emphasizing intraindividual processes such as anticipated stigma, identity centrality, salience, and external cultural devaluation. The authors aim to test whether anticipated stigma, identity centrality, salience, and cultural devaluation predict greater psychological distress. The authors conducted two studies, first surveying 300 participants across 13 identities and then replicating with 235 participants while adding health outcomes to the model. The results confirm that anticipated stigma, identity centrality, salience, and cultural devaluation predict higher psychological distress, that associative stigma is linked to lower distress via reduced anticipated stigma, centrality, and salience, and that anticipated stigma and cultural stigma also directly predict poorer self‑reported health.

Abstract

The current research provides a framework for understanding how concealable stigmatized identities impact people's psychological well-being and health. The authors hypothesize that increased anticipated stigma, greater centrality of the stigmatized identity to the self, increased salience of the identity, and possession of a stigma that is more strongly culturally devalued all predict heightened psychological distress. In Study 1, the hypotheses were supported with a sample of 300 participants who possessed 13 different concealable stigmatized identities. Analyses comparing people with an associative stigma to those with a personal stigma showed that people with an associative stigma report less distress and that this difference is fully mediated by decreased anticipated stigma, centrality, and salience. Study 2 sought to replicate the findings of Study 1 with a sample of 235 participants possessing concealable stigmatized identities and to extend the model to predicting health outcomes. Structural equation modeling showed that anticipated stigma and cultural stigma were directly related to self-reported health outcomes. Discussion centers on understanding the implications of intraindividual processes (anticipated stigma, identity centrality, and identity salience) and an external process (cultural devaluation of stigmatized identities) for mental and physical health among people living with a concealable stigmatized identity.