Predicting Psychological Distress for People with Concealable Stigmatized Identit

描述（由申请人提供）：数十年的耻辱研究表明，存在巨大的差异是否与耻辱身份的人经历增加的心理痛苦。当前应用程序的目标是测试一个模型，该模型检查具有可隐藏的污名化身份的人的脆弱性因素。我们的样本将包括5个可隐藏的污名化身份：精神疾病，儿童虐待（身体，情感，性），强奸，药物滥用和关系暴力。之所以选择这五种身份，是因为它们很常见，被污名化，并且与增加的心理痛苦有关。参与者将从一个多样化的社区样本中抽取，由目前正在寻求心理治疗和未接受治疗的人组成。有三个具体目标：我们的第一个具体目标是测试一个模型的脆弱性因素的心理困扰的人隐藏的污名化的身份。基于污名理论和研究，四个内部的污名目标（预期的耻辱，中心的身份，身份的显着性，和负面刻板印象的内化）和一个外部的污名目标（附加到身份的文化污名水平）的因素被预测解释困扰。使用结构方程模型，我们还将研究一个中介模型，其中预期的耻辱对痛苦的影响是通过增加中心性和显著性介导的。我们假设，预期更多的贬值，由于一个人的污名化的身份将导致增加的身份中心性和显着性，这反过来又导致增加的痛苦。文化耻辱的程度预计只有一个直接影响的痛苦。我们的第二个具体目标是研究我们模型中的脆弱性因素是否能预测一般健康功能，如果是，这种影响是否通过心理困扰来介导。我们的第三个具体目标是比较不同种族的模型拟合。研究表明，少数民族和大多数美国人之间的身体和心理健康差异。我们假设，与欧洲裔美国人相比，非洲裔美国人和拉丁美洲人将表现出加剧的隐藏的耻辱效应，这些效应将被预测的歧视以前的经验。公共卫生相关性：这项研究将提供一个风险因素模型，以预测谁可能容易受到心理困扰和降低健康功能，由于隐藏的污名化身份。最终，这种模式可能会对提高治疗效果产生最大的影响，因为它增加了治疗干预措施的可及性、利用率和治疗效果，并减少了与未经治疗的隐蔽性耻辱相关的沉重残疾负担。

DESCRIPTION (provided by applicant): Decades of stigma research show that an enormous amount of variability exists in whether people with stigmatized identities experience increased psychological distress. The goal of the current application is to test a model that examines vulnerability factors for people with concealable stigmatized identities. Our sample will include 5 concealable stigmatized identities: mental illness, childhood abuse (physical, emotional, sexual), rape, substance abuse, and relationship violence. These five identities were chosen because they are common, stigmatized, and related to increased psychological distress. Participants will be drawn from a diverse community sample, composed of people both currently seeking psychological treatment and those not in treatment. There are three specific aims: Our first specific aim is to test a model of vulnerability factors for psychological distress for people with concealable stigmatized identities. Based on stigma theory and research, four factors internal to the stigma target (anticipated stigma, centrality of the identity, salience of the identity, and internalization of negative stereotypes) and one factor external to the stigma target (level of cultural stigma attached to the identity) are predicted to explain distress. Using structural equation modeling, we will also examine a mediated model in which the effect of anticipated stigma on distress is mediated through increased centrality and salience. We hypothesize that anticipating more devaluation due to one's stigmatized identity will lead to increased identity centrality and salience, which in turn result in increased distress. Level of cultural stigma is predicted to have only a direct effect on distress. Our second specific aim is to examine whether the vulnerability factors in our model predict general health functioning, and if so, whether this effect is mediated through psychological distress. Our third specific aim is to compare model fit across ethnicity. Research has shown both physical and mental health disparities between minority and majority Americans. We hypothesize that, compared to European Americans, African Americans and Latinos will show exacerbated concealed stigma effects and these effects will be predicted by previous experiences with discrimination. PUBLIC HEALTH RELEVANCE: This research will provide a model of risk factors to predict who is likely to be vulnerable to psychological distress and decreased health functioning due to concealable stigmatized identities. Ultimately, such a model may have its greatest impact on the enhancement of treatment outcomes by increasing access, utilization, and treatment effectiveness of therapeutic interventions as well as reducing the heavy disability burden associated with untreated concealed stigmas.