The Burden of Stigma on Health and Well-Being: A Taxonomy of Concealment, Course, Disruptiveness, Aesthetics, Origin, and Peril Across 93 Stigmas

Personality and Social Psychology Bulletin

Volumn 44, Issue 4, 2018, Pages 451-474

  Pachankis, John E ^a   Hatzenbuehler, Mark L ^b   Wang, Katie ^a   Burton, Charles L ^a   Crawford, Forrest W ^a   Phelan, Jo C ^b   Link, Bruce G ^c  

^a YALE UNIVERSITY   (United States)

^b Och Spine at New York Presbyterian Hospitals   (United States)

^c UNIVERSITY OF CALIFORNIA   (United States)

Author keywords

depression; discrimination; intergroup processes; intersectionality; prejudice

Indexed keywords

ADULT; ALTERNATIVE MEDICINE; FEMALE; HEALTH; HEALTH STATUS; HUMAN; MALE; SELF REPORT; SOCIAL STIGMA;

ADULT; FEMALE; HEALTH; HEALTH STATUS; HUMANS; MALE; MENTAL HEALING; SELF REPORT; SOCIAL STIGMA;

EID: 85042560893     PISSN: 01461672     EISSN: 15527433     Source Type: Journal    
DOI: 10.1177/0146167217741313     Document Type: Article

References (86)

1. Angermeyer M. C., Matschinger H., (1996). Public attitude towards psychiatric treatment. Acta Psychiatrica Scandinavica, 94, 326-336.
2. Arbuckle J. L., (2006). Amos (Version 7.0) [Computer program]. Chicago, IL: SPSS.
3. Bogart K. R., (2014). The role of disability self-concept in adaptation to congenital or acquired disability. Rehabilitation Psychology, 59, 107-115.
4. Breslau J., Kendler K. S., Su M., Gaxiola-Aguilar S., Kessler R. C., (2005). Lifetime risk and persistence of psychiatric disorders across ethnic groups in the United States. Psychological Medicine, 35, 317-327.
5. Brown R. P., Lee M. N., (2005). Stigma consciousness and the race gap in college academic achievement. Self and Identity, 4, 149-157.
6. Centers for Disease Control and Prevention. (2000). Measuring healthy days. Atlanta, GA: Author.
7. Centers for Disease Control and Prevention. (2014). Behavioral risk factor surveillance system survey questionnaire. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.
8. Chaudoir S. R., Earnshaw V. A., Andel S., (2013). “Discredited” versus “discreditable”: Understanding how shared and unique stigma mechanisms affect psychological and physical health disparities. Basic and Applied Social Psychology, 35, 75-87.
9. Clark A., Georgellis Y., Sanfey P., (2001). Scarring: The psychological impact of past unemployment. Economica, 68, 221-241.
10. Cochran S. D., Mays V. M., (2009). Burden of psychiatric morbidity among lesbian, gay, and bisexual individuals in the California quality of life survey. Journal of Abnormal Psychology, 118, 647-658.
11. Cole E. R., (2009). Intersectionality and research in psychology. American Psychologist, 64, 170-180.
12. Collett N., Pugh K., Waite F., Freeman D., (2016). Negative cognitions about the self in patients with persecutory delusions: An empirical study of self-compassion, self-stigma, schematic beliefs, self-esteem, fear of madness, and suicidal ideation. Psychiatry Research, 239, 79-84.
13. Corrigan P. W., Watson A. C., (2002). The paradox of self-stigma and mental illness. Clinical Psychology: Science and Practice, 9, 35-53.
14. Crandall C. S., Eshleman A., (2003). A justification-suppression model of the expression and experience of prejudice. Psychological Bulletin, 129, 414-446.
15. Crandall C. S., Moriarty D., (1995). Physical illness stigma and social rejection. British Journal of Social Psychology, 34,67-83.
16. Crews J. E., Chou C. F., Zack M. M., Zhang X., Bullard K. M., Morse A. R., Saaddine J. B., (2016). The association of health-related quality of life with severity of visual impairment among people aged 40-64 years: Findings from the 2006-2010 behavioral risk factor surveillance system. Ophthalmic Epidemiology, 23, 145-153.
17. Crews J. E., Chou C. F., Zhang X., Zack M. M., Saaddine J. B., (2014). Health-related quality of life among people aged ≥65 years with self-reported visual impairment: Findings from the 2006–2010 behavioral risk factor surveillance system. Ophthalmic Epidemiology, 21, 287-296.
18. Crocker J., Luhtanen R., Blaine B., Broadnax S., (1994). Collective self-esteem and psychological well-being among White, Black, and Asian college students. Personality and Social Psychology Bulletin, 20, 503-513.
19. Crocker J., Major B., Steele C. M., (1998). Social stigma. In Gilbert D. T., Fiske S. T., Lindzey G., (Eds.), The handbook of social psychology (Vol. 2, pp. 504-553). New York, NY: Oxford University Press.
20. Crocker J., Voelkl K., Testa M., Major B., (1991). Social stigma: The affective consequences of attributional ambiguity. Journal of Personality and Social Psychology, 60, 218-228.
21. Cuddy A. J., Fiske S. T., Glick P., (2007). The BIAS map: Behaviors from intergroup affect and stereotypes. Journal of Personality and Social Psychology, 92, 631-648.
22. Eagly A. H., Ashmore R. D., Makhijani M. G., Longo L. C., (1991). What is beautiful is good, but..: A meta-analytic review of research on the physical attractiveness stereotype. Psychological Bulletin, 110, 109-128.
23. Feldman D. B., Crandall C. S., (2007). Dimensions of mental illness stigma: What about mental illness causes social rejection? Journal of Social & Clinical Psychology, 26, 137-154.
24. Fiske S. T., Cuddy A. J., Glick P., Xu J., (2002). A model of (often mixed) stereotype content: competence and warmth respectively follow from perceived status and competition. Journal of Personality and Social Psychology, 82, 878-902.
25. Frable D. E., Platt L., Hoey S., (1998). Concealable stigmas and positive self-perceptions: Feeling better around similar others. Journal of Personality and Social Psychology, 74, 909-922.
26. Ginsburg I. H., Link B. G., (1993). Psychosocial consequences of rejection and stigma feelings in psoriasis patients. International Journal of Dermatology, 32, 587-591.
27. Goffman E., (1963). Stigma: Notes on a spoiled identity. New York, NY: Simon & Schuster.
28. Goldberg R. T., (1974). Adjustment of children with invisible and visible handicaps: Congenital heart disease and facial burns. Journal of Counseling Psychology, 21, 428-432.
29. Gratz K. L., Roemer L., (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in Emotion Regulation Scale. Journal of Psychopathology and Behavioral Assessment, 26, 41-54.
30. Hatzenbuehler M. L., (2009). How does sexual minority stigma “get under the skin”? A psychological mediation framework. Psychological Bulletin, 135, 707-730.
31. Hatzenbuehler M. L., (2016). Structural stigma and health inequalities: Research evidence and implications for psychological science. American Psychologist, 71, 742-751.
32. Hatzenbuehler M. L., Corbin W. R., Fromme K., (2011). Discrimination and alcohol-related problems among college students: A prospective examination of mediating effects. Drug and Alcohol Dependence, 115, 213-220.
33. Hatzenbuehler M. L., McLaughlin K. A., Nolen-Hoeksema S., (2008). Emotion regulation and internalizing symptoms in a longitudinal study of sexual minority and heterosexual adolescents. Journal of Child Psychology and Psychiatry, 49, 1270-1278.
34. Hatzenbuehler M. L., Nolen-Hoeksema S., Dovidio J., (2009). How does stigma “get under the skin”? The mediating role of emotion regulation. Psychological Science, 20, 1282-1289.
35. Hatzenbuehler M. L., Phelan J. C., Link B. G., (2013). Stigma as a fundamental cause of population health inequalities. American Journal of Public Health, 103, 813-821.
36. Hebl M. R., Kleck R. E., (2002). Acknowledging one’s stigma in the interview setting: Effective strategy or liability? Journal of Applied Social Psychology, 32, 223-249.
37. Hebl M. R., Tickle J., Heatherton T. F., (2000). Awkward moments in interactions between nonstigmatized and stigmatized individuals. In Heatherton T. F., Kleck R. E., Hebl M. R., Hull J. G., (Eds.), The social psychology of stigma (pp. 275-306). New York, NY: Guilford Press.
38. Jang Y., Borenstein-Graves A., Haley W. E., Small B. J., Mortimer J. A., (2003). Determinants of a sense of mastery in African American and White older adults. The Journals of Gerontology, Series B: Psychological Sciences & Social Sciences, 58, 221-224.
39. Jones E. E., Farina A., Hastorf A. H., Markus H., Miller D. T., Scott R. A., (1984). Social stigma: The psychology of marked relationships. New York, NY: W.H. Freeman.
40. Kurzban R., Leary M. R., (2001). Evolutionary origins of stigmatization: The functions of social exclusion. Psychological Bulletin, 127, 187-208.
41. Kvaale E. P., Gottdiener W. H., Haslam N., (2013). Biogenetic explanations and stigma: A meta-analytic review of associations among laypeople. Social Science & Medicine, 96, 95-103.
42. Langlois J. H., Ritter J. M., Casey R. J., Sawin D. B., (1995). Infant attractiveness predicts maternal behaviors and attitudes. Developmental Psychology, 31, 464-472.
43. Lebowitz M. S., (2014). Biological conceptualizations of mental disorders among affected individuals: A review of correlates and consequences. Clinical Psychology: Science and Practice, 21, 67-83.
44. Levay K. E., Freese J., Druckman J. N., (2016). The demographic and political composition of Mechanical Turk samples. SAGE Open, 6, 1-17.
45. Levy B. R., Pilver C. E., (2012). Residual stigma: Psychological distress among the formerly overweight. Social Science & Medicine, 75, 297-299.
46. Link B. G., (1987). Understanding labeling effects in the area of mental disorders: An assessment of the effects of expectations of rejection. American Sociological Review, 52(6), 96-112.
47. Link B. G., Cullen F. T., Frank J., Wozniak J. F., (1987). The social rejection of former mental patients: Understanding why labels matter. American Journal of Sociology, 92, 1461-1500.
48. Link B. G., Cullen F. T., Struening E., Shrout P. E., Dohrenwend B. P., (1989). A modified labeling theory approach to mental disorders: An empirical assessment. American Sociological Review, 54, 400-423.
49. Link B. G., Phelan J. C., (2001). Conceptualizing stigma. Annual Review of Sociology, 27, 363-385.
50. Link B. G., Phelan J. C., Bresnahan M., Stueve A., Pescosolido B. A., (1999). Public conceptions of mental illness: Labels, causes, dangerousness, and social distance. American Journal of Public Health, 89, 1328-1333.
51. Link B. G., Yang L. H., Phelan J. C., Collins P. Y., (2004). Measuring mental illness stigma. Schizophrenia Bulletin, 30, 511-541.
52. Luhtanen R., Crocker J., (1992). A collective self-esteem scale: Self-evaluation of one’s social identity. Personality and Social Psychology Bulletin, 18, 302-318.
53. Major B., O’Brien L. T., (2005). The social psychology of stigma. Annual Review of Psychology, 56, 393-421.
54. McCall L., (2005). The complexity of intersectionality. Signs, 30, 1771-1800.
55. Meyer I. H., (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129, 674-697.
56. Meyer I. H., Schwartz S., Frost D. M., (2008). Social patterning of stress and coping: Does disadvantaged social statuses confer more stress and fewer coping resources? Social Science and Medicine, 67, 368-379.
57. Pachankis J. E., (2007). The psychological implications of concealing a stigma: A cognitive-affective-behavioral model. Psychological Bulletin, 133, 328-345.
58. Pachankis J. E., Cochran S. D., Mays V. M., (2015). The mental health of sexual minority adults in and out of the closet: A population-based study. Journal of Consulting and Clinical Psychology, 83, 890-901.
59. Pachankis J. E., Goldfried M. R., Ramrattan M. E., (2008). Extension of the rejection sensitivity construct to the interpersonal functioning of gay men. Journal of Consulting and Clinical Psychology, 76, 306-317.
60. Park J. H., Schaller M., Crandall C. S., (2007). Pathogen-avoidance mechanisms and the stigmatization of obese people. Evolution & Human Behavior, 28, 410-414.
61. Pearlin L. I., Menaghan E. G., Lieberman M. A., Mullan J. T., (1981). The stress process. Journal of Health and Social Behavior, 22, 337-356.
62. Phelan J. C., (2002). Genetic bases of mental illness–a cure for stigma? Trends in Neurosciences, 25, 430-431.
63. Phelan J. C., (2005). Geneticization of deviant behavior and consequences for stigma: The case of mental illness. Journal of Health and Social Behavior, 46, 307-322.
64. Phelan J. C., Link B. G., Dovidio J. F., (2008). Stigma and prejudice: One animal or two? Social Science & Medicine, 67, 358-367.
65. Pinel E. C., (1999). Stigma consciousness: The psychological legacy of social stereotypes. Journal of Personality and Social Psychology, 76, 114-128.
66. Plascak J. J., Molina Y., Wu-Georges S., Idris A., Thompson B., (2016). Latino residential segregation and self-rated health among Latinos: Washington state behavioral risk factor surveillance system, 2012–2014. Social Science & Medicine, 159, 38-47.
67. Quinn D. M., Chaudoir S. R., (2009). Living with a concealable stigmatized identity: The impact of anticipated stigma, centrality, salience, and cultural stigma on psychological distress and health. Journal of Personality and Social Psychology, 97, 634-651.
68. Radloff L. S., (1977). The CES-D scale a self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385-401.
69. R Core Team. (2016). R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing. Available from http://www.R-project.org/
70. Rosenberg M., (1965). Society and the adolescent self-image. Princeton, NJ: Princeton University Press.
71. Santuzzi A. M., Ruscher J. B., (2002). Stigma salience and paranoid social cognition: Understanding variability in metaperceptions among individuals with recently-acquired stigma. Social Cognition, 20, 171-197.
72. Schabert J., Browne J. L., Mosely K., Speight J., (2013). Social stigma in diabetes. The Patient-Patient-Centered Outcomes Research, 6, 1-10.
73. Schmalz D. L., Kerstetter D. L., (2006). Girlie girls and manly men: Children’s stigma consciousness of gender in sports and physical activities. Journal of Leisure Research, 38, 536-557.
74. Shrout P. E., Fleiss J. L., (1979). Intraclass correlations: Uses in assessing rater reliability. Psychological Bulletin, 86, 420-428.
75. Siefert K., Finlayson T. L., Williams D. R., Delva J., Ismail A. I., (2007). Modifiable risk and protective factors for depressive symptoms in low-income African American mothers. American Journal of Orthopsychiatry, 77, 113-123.
76. Smart L., Wegner D. M., (1999). Covering up what can’t be seen: Concealable stigma and mental control. Journal of Personality and Social Psychology, 77, 474-486.
77. Solomon A., (2012). Far from the tree: Parents, children and the search for identity. New York, NY: Simon & Schuster.
78. Spielberger C. D., Gorsuch R. L., Lushene R., Vagg P. R., Jacobs G. A., (1983). Manual for the state-trait anxiety inventory. Palo Alto, CA: Consulting Psychologists Press.
79. Stahly G. B., (1988). Psychosocial aspects of the stigma of cancer: An overview. Journal of Psychosocial Oncology, 6(3-4), 3-27.
80. Stutterheim S. E., Bos A. E., Pryor J. B., Brands R., Liebregts M., Schaalma H. P., (2011). Psychological and social correlates of HIV status disclosure: The significance of stigma visibility. AIDS Education and Prevention, 23, 382-392.
81. Sutin A. R., Stephan Y., Carretta H., Terracciano A., (2015). Perceived discrimination and physical, cognitive, and emotional health in older adulthood. The American Journal of Geriatric Psychiatry, 23, 171-179.
82. Treynor W., Gonzalez R., Nolen-Hoeksema S., (2003). Rumination reconsidered: A psychometric analysis. Cognitive Therapy and Research, 27, 247-259.
83. Weiner B., Perry R. P., Magnusson J., (1988). An attributional analysis of reactions to stigmas. Journal of Personality and Social Psychology, 55, 738-748.
84. Williams D. R., Neighbors H. W., Jackson J. S., (2008). Racial/ethnic discrimination and health: Findings from community studies. American Journal of Public Health, 93, 200-208.
85. Williams D. R., Yu Y., Jackson J. S., Anderson N. B., (1997). Racial differences in physical and mental health socio-economic status, stress and discrimination. Journal of Health Psychology, 2, 335-351.
86. Zimet G. D., Powell S. S., Farley G. K., Werkman S., Berkoff K. A., (1990). Psychometric characteristics of the multidimensional scale of perceived social support. Journal of Personality Assessment, 55, 610-617.