RUI: Disclosing concealable stigmatized identities: An analysis of intraindividual and sociocultural factors predicting stress reactivity and well-being

在美国社会中，被污名化的个人经历着一些最可怕的健康差异，普遍的观点认为，这些差异在一定程度上可归因于歧视。然而，越来越多的证据表明，患有很大程度上可以隐藏的污名的人——以及基本上不受直接歧视的人——也经历着类似的差异。目前的项目研究人际披露压力的可能性，这种压力是生活在具有可隐藏的污名化身份（即不容易看到的社会贬值属性）的人群中反复出现的独特压力源，可能是可隐藏的污名影响心理和身体健康的主要途径。具体而言，本研究检验了人际披露是否具有压力，以及个人对污名化的长期恐惧和周围社区的偏见是否加剧了这些压力效应和下游的心理和身体健康。拟议中的研究将显著推进对生活在隐蔽性污名化身份下的个体的研究，作为一个整体，这些个体构成了一个未被充分研究的美国人口。这一知识有可能为干预和规划工作提供信息，旨在帮助生活在可隐藏的污名化身份中的个人缓冲自己免受社会贬值的影响；决策者和社区利益攸关方努力减少偏见；公共卫生从业人员的目标是减少健康差距。因此，拟议的研究有可能有助于实现美国国家科学基金会和美国卫生与公众服务部确定和改善导致健康差异的社会心理因素的目标。本提案中概述的研究活动还将通过提供展示可能影响下游健康差异的复杂生物心理社会过程的体验式研究和学习机会，大大改变该国许多未来医疗提供者和社会科学家的培训环境。

Stigmatized individuals experience some of the most formidable health disparities in American society, and prevailing views suggest that these disparities are attributable in part to discrimination. However, growing evidence suggests that individuals living with stigmas that are largely concealable - and who are largely shielded from direct discrimination - also experience similar disparities. The current project examines the possibility that the stress of interpersonal disclosure, a recurrent and unique stressor among people living with concealable stigmatized identities (i.e., socially devalued attributes that cannot readily be seen) may be a primary pathway by which concealable stigmas affect psychological and physical health. Specifically, this research tests whether interpersonal disclosure is stressful and whether individuals' chronic fears of stigmatization and the surrounding community's prejudice exacerbate these stress effects and downstream psychological and physical health. The proposed research will significantly advance the study of individuals living with concealable stigmatized identities, which, as a whole, constitute an understudied population of Americans. This knowledge has the potential to inform intervention and programmatic efforts designed to help individuals living with concealable stigmatized identities to buffer themselves against the effects of social devaluation; policy makers and community stakeholders in their efforts to reduce prejudice; and public health practitioners in their goals to reduce health disparities. As such, the proposed research has the potential to aid in reaching the NSF and U.S. Department of Health and Human Services' goal of identifying and ameliorating the psychosocial factors that contribute to health disparities. Research activities outlined in this proposal will also substantially transform the training environment for many of the country's future medical providers and social scientists by providing experiential research and learning opportunities that demonstrates the complex biopsychosocial processes that could affect downstream health disparities.