Examining Effects of Anticipated Stigma, Centrality, Salience, Internalization, and Outness on Psychological Distress for People with Concealable Stigmatized Identities
Examining Effects of Anticipated Stigma, Centrality, Salience, Internalization, and Outness on Psychological Distress for People with Concealable Stigmatized Identities
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DOI：
10.1371/journal.pone.0096977
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发表时间：
2014-05-09
期刊：
影响因子：
3.7
通讯作者：
Chaudoir, Stephenie R.
中科院分区：
文献类型：
--
作者：
Quinn, Diane M.;Williams, Michelle K.;Chaudoir, Stephenie R.
了解被污名化的身份如何导致抑郁和焦虑的发生率增加，对于减少污名化和心理健康治疗至关重要。很少有研究同时测试被污名化的身份的多个方面。在当前的研究中，我们收集了来自不同城市的成人社区样本的数据，这些样本都是隐藏污名化身份（CSI）的人。我们针对5种特定的csi——精神疾病、药物滥用、家庭暴力经历、性侵犯经历和童年虐待经历——这些被证明会使人们面临更大的心理困扰风险。我们收集了以下方面的测量数据：如果身份为人所知，人们对被他人贬低的预期（预期的耻辱）、被污名化的身份定义自己的程度（中心性）、思考该身份的频率（突出性）、认同该身份的负面刻板印象的程度（内化的耻辱）以及其他人目前对该身份的了解程度（外向性）。结果表明，更大的预期耻辱，更大的身份显著性和更低水平的外向性各自独特且显著地预测了增加的心理困扰（抑郁和焦虑的组合）的方差。在检查五种身份之间的社区和差异时，我们发现耻辱变量的平均水平在不同身份之间存在差异，药物滥用和精神疾病患者报告的预期和内化耻辱更大。然而，心理困扰变量的预测模式在药物滥用、精神疾病、家庭暴力和童年虐待身份（但不包括性侵犯）中是相似的。了解被污名化的身份的哪些组成部分预示着痛苦，可以为经历心理痛苦的人带来更有效的治疗。
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.