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距，普遍的观点认为，这些差距部分归因于歧视。然而，越来越多的证据表明，生活在基本上可以隐藏的耻辱中的个人-以及基本上不受直接歧视的人-也经历了类似的差异。目前的项目研究的可能性，人际披露的压力，一个经常性的和独特的压力源之间的人生活与隐藏的污名化的身份（即，社会贬低的属性，不易被看到）可能是一个主要途径，通过这种途径，可隐藏的耻辱影响心理和身体健康。具体而言，本研究测试人际披露是否有压力，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。这项拟议中的研究将大大推进对生活在可隐藏的污名化身份中的个人的研究，这些人作为一个整体，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方案工作提供信息，这些工作旨在帮助那些有着可隐藏的污名化身份的个人缓冲社会贬值的影响;帮助决策者和社区利益攸关方努力减少偏见;帮助公共卫生从业人员实现减少健康差距的目标。因此，拟议的研究有可能有助于实现NSF和美国卫生与公众服务部的目标，即确定和改善导致健康差距的心理社会因素。本提案中概述的研究活动还将通过提供体验式研究和学习机会，展示可能影响下游健康差距的复杂生物心理社会过程，从而大大改变该国未来许多医疗服务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.