Neighborhood ethnic composition and social identity threat: the mediating role of perceived discrimination

Ethnic proportions of neighborhoods are a "macro" measure of intergroup contact and can buffer or expose people of color to discrimination. Simultaneously, perceived discrimination can sensitize students of color to social identity threat in environments in which they are numerically underrepresented and negatively stereotyped. In the current research, we integrate these two lines of research to examine whether neighborhood ethnic composition - the percentage of Latinx residents in one's home community - predicts social identity threat for Latinx students attending college at a predominately White institution (PWI). In two studies, Latinx college students attending a PWI provided their 5-digit zip code and completed measures assessing their perceived discrimination and social identity threat. Across both studies, neighborhood ethnic composition (greater percentage of Latinx residents) was associated with greater social identity threat and this association was mediated by greater perceived discrimination. These studies advance research on neighborhood ethnic composition and social identity threat.

Understanding the role of depressive symptoms in academic outcomes: A longitudinal study of college roommates

Rising rates of depression among adolescents raise many questions about the role of depressive symptoms in academic outcomes for college students and their roommates. In the current longitudinal study, we follow previously unacquainted roommate dyads over their first year in college (N = 245 dyads). We examine the role of depressive symptoms of incoming students and their roommates on their GPAs and class withdrawals (provided by university registrars) at the end of the Fall and Spring semesters. We test contagion between the roommates on both academic outcomes and depressive symptoms over time. Finally, we examine the moderating role of relationship closeness. Whereas students' own initial levels of depressive symptoms predicted their own lower GPA and more course withdrawals, they did not directly predict the academic outcomes of their roommates. For roommates who form close relationships, there was evidence of contagion of both GPAs and depressive symptoms at the end of Fall and Spring semesters. Finally, a longitudinal path model showed that as depressive symptoms spread from the student to their roommate, the roommate's GPA decreased. The current work sheds light on a common college experience with implications for the role of interventions to increase the academic and mental health of college students.

Weight stigma and posttraumatic stress disorder symptoms in individuals seeking bariatric surgery

BACKGROUND

After bariatric surgery, some patients experience adverse psychiatric outcomes, including substance use, suicidality, and self-harm. These factors are commonly associated with posttraumatic stress disorder (PTSD) and related symptoms (PTSD-S) that develop following adverse childhood experiences (ACEs) and traumatic events. However, emerging evidence suggests that chronic discrimination also may contribute to PTSD-S. Weight-based discrimination is salient for people with obesity but has received little attention in relation to PTSD-S.

OBJECTIVE

Our study examined factors that may contribute to the link between experienced weight stigma (WS), which is common in individuals seeking bariatric surgery, and PTSD-S.

SETTING

Teaching hospital and surgical weight loss center in the United States.

METHODS

A total of 217 participants completed self-report surveys of experienced and internalized WS, ACEs, and PTSD-S. Demographics and trauma history were obtained from patient medical records. A stepwise multiple regression examined associations between experienced WS and internalized WS with PTSD-S, co-varying demographics, ACEs, and trauma, followed by examination of whether findings held co-varying anxiety/depressive symptoms in a participant subset (n = 189).

RESULTS

After accounting for covariates in step 1 and ACEs and trauma in step 2 (ΔR² = .14), experienced WS and internalized WS accounted for substantial PTSD-S variance in steps 2 and 3 (ΔR² = .12 and .13, respectively; overall model R² =.44; P < .001). Findings held after co-varying anxiety/depressive symptoms.

CONCLUSIONS

Over and above ACEs and trauma, experienced WS and internalized WS may contribute to PTSD-S. Longitudinal research is needed to better elucidate the pathways underlying these associations.

Shame and Self-compassion as Risk and Protective Mechanisms of the Internalized Weight Bias and Emotional Eating Link in Individuals Seeking Bariatric Surgery

BACKGROUND

Emotional eating in bariatric surgery patients is inconsistently linked with poor post-operative weight loss and eating behaviors, and much research to date is atheoretical. To examine theory-informed correlates of pre-operative emotional eating, the present cross-sectional analysis examined paths through which experienced weight bias and internalized weight bias (IWB) may associate with emotional eating among individuals seeking bariatric surgery.

METHODS

We examined associations of experienced weight bias, IWB, shame, self-compassion, and emotional eating in patients from a surgical weight loss clinic (N = 229, 82.1% female, M. BMI: 48 ± 9). Participants completed a survey of validated self-report measures that were linked to BMI from the patient medical record. Multiple regression models tested associations between study constructs while PROCESS bootstrapping estimates tested the following hypothesized mediation model: IWB ➔ internalized shame ➔ self-compassion ➔ emotional eating. Primary analyses controlled for adverse childhood experiences (ACE), a common confound in weight bias research. Secondary analyses controlled for depressive/anxiety symptoms from the patient medical record (n = 196).

RESULTS

After covariates and ACE, each construct accounted for significant unique variance in emotional eating. However, experienced weight bias was no longer significant and internalized shame marginal, after controlling for depressive/anxiety symptoms. In a mediation model, IWB was linked to greater emotional eating through heightened internalized shame and low self-compassion, including after controlling for depressive/anxiety symptoms.

CONCLUSIONS

Pre-bariatric surgery, IWB may signal risk of emotional eating, with potential implications for post-operative trajectories. Self-compassion may be a useful treatment target to reduce IWB, internalized shame, and related emotional eating in bariatric surgery patients. Further longitudinal research is needed.

Examining the relationship between weight controllability beliefs and eating behaviors: The role of internalized weight stigma and BMI

Body weight is often viewed as personally controllable. This belief, however, ignores the complex etiology of body weight. While such attributions of personal willpower may help some individuals regulate their eating patterns, they have also been associated with increased internalized weight stigma which, itself, is associated with more disinhibited eating. The current investigation aimed to examine how internalized weight stigma, along with BMI, may explain the effect of weight controllability beliefs on disparate dietary behaviors. A community sample of 2702 U.S. adults completed an online survey about their weight controllability beliefs, eating behaviors, and internalized weight stigma, as well as demographic items and self-reported BMI. Results showed that greater weight controllability beliefs were positively related to both more restricted eating, β = 0.135, p < .001, and more disinhibited eating, β = 0.123, p < .001. This ironic effect was partially explained by increased internalized weight stigma. Moreover, BMI moderated the relationship, such that individuals with lower weights demonstrated stronger effects for two of the three eating outcomes than those with higher weights. These findings advance our understanding of the relationship between attributions of personal control for body weight and subsequent health behaviors, and further underscore the need to target internalized weight stigma in dietary interventions.

Weight Bias, Shame, and Self-Compassion: Risk/Protective Mechanisms of Depression and Anxiety in Prebariatic Surgery Patients

OBJECTIVE

Psychopathology in bariatric surgery patients may contribute to adverse postoperative sequelae, including weight regain, substance use, and self-harm. This cross-sectional study aimed to advance the understanding of the risk and protective paths through which weight bias associates with depressive and anxiety symptoms in bariatric surgery candidates (BSC).

METHODS

BSC recruited from a surgical clinic (N = 213, 82.2% women, 43  [SD 12] years, mean BMI: 49  [SD 9] kg/m² ) completed measures of experienced weight bias (EWB), internalized weight bias (IWB), body and internalized shame, and self-compassion; anxiety and depression screeners were accessed from medical charts. Multiple regression and PROCESS bootstrapping estimates tested our hypothesized mediation model as follows: EWB→IWB→body shame→shame→self-compassion→symptoms.

RESULTS

After accounting for EWB and IWB, internalized shame accounted for greater variance in both end points than body shame. EWB was associated with greater anxiety through risk paths implicating IWB, body shame, and/or internalized shame. Protective paths associated EWB with fewer depressive and anxiety symptoms among those with higher self-compassion.

CONCLUSIONS

The findings suggest a potentially important role for weight bias and shame in psychological health among BSC and implicate self-compassion, a trainable affect-regulation strategy, as a protective factor that may confer some resiliency. Future research using longitudinal and causal designs is warranted.

Trying again (and again): Weight cycling and depressive symptoms in U.S. adults

As the prevalence of overweight and obesity have risen over the past few decades, so have weight control attempts. Research has shown, however, that intentional weight loss results are often short-lived, with people regaining the weight over time. This can lead to weight cycling-losing and gaining weight repeatedly. Previous research, mostly done over two decades ago, concluded there was no relationship between weight cycling and psychological health. The goal of the current paper was to re-examine the relationship between weight cycling and depressive symptoms in a national sample of American adults (N = 2702; 50.7% female; mean age = 44.8 years). If, as hypothesized, there is a relationship between more frequent weight cycling and depressive symptoms, then internalized weight stigma will be examined as a potential mediator of the relationship. Results of a cross-sectional survey showed that 74.6% of adults report they have intentionally tried to lose weight. Amongst those who have tried to lose to weight, the average number of weight cycles over the lifetime was 7.82 cycles. Simultaneous regression showed that greater weight cycling was related to greater reported depressive symptoms (β = .15, p < .001), controlling for age, gender, education, income, and body mass index. Internalized weight stigma was a partial mediator of this relationship. Discussion focuses on the potential implications for weight cycling and mental health.

Visible and Concealable Stigmatized Identities and Mental Health: Experiences of Racial Discrimination and Anticipated Stigma

Experiencing and anticipating discrimination because one possesses a visible (e.g., race) or concealable (e.g., mental illness) stigmatized identity has been related to increased psychological distress. Little research, however, has examined whether experiencing and anticipating discrimination related to possessing both a visible and concealable stigmatized identity (e.g., a racial/ethnic minority with a history of mental illness) impacts mental health. In the current study, we test two hypotheses. In the first, we examine whether experienced discrimination due to a visible stigma (race/ethnicity) and anticipating stigma due to a concealable stigma (e.g., substance abuse) each predict unique variance in depressive symptomatology. In the second, we examine whether experienced discrimination due to a visible stigma is related to greater anticipated stigma for a concealable stigma, which in turn is related to more depression. A total of 265 African American and Latinx adults who reported concealing a stigmatized identity at least some of the time completed measures of racial/ethnic discrimination, anticipated stigma of a concealable stigmatized identity, and depressive symptomatology. Results of a simultaneous linear regression revealed that increased racial/ethnic discrimination and anticipated stigma independently predicted greater depressive symptomatology (controlling for each other). A mediation analysis showed that the positive association between increased racial/ethnic discrimination and higher depressive symptomatology was partially mediated by greater anticipated stigma. These results demonstrate that a person can experience increased psychological distress from multiple types of stigma separately, but also may anticipate greater stigma based on previous experiences of racial discrimination, which in turn relates to increased distress.

Overlooked and Understudied: Health Consequences of Weight Stigma in Men

OBJECTIVE

A substantial amount of literature has suggested that weight stigma impairs health. Evidence on gender differences in weight stigma has been mixed, but studies of weight stigma within men have been primarily absent from the literature.

METHODS

In two samples of men recruited nationally from across the United States (N = 1,753), participants completed self-report measures assessing their height, weight, demographics, weight stigma (experienced and internalized), psychological well-being (depression), health behaviors (sleep, alcohol, smoking, binge eating, dieting, physical activity), and self-rated health.

RESULTS

Regression analyses showed that, independent of race, socioeconomic status, and BMI, experienced weight stigma and weight bias internalization among men were associated with poor health, including greater depressive symptoms, increased dieting, lower self-reported health, and increased odds of binge eating. Neither internalized nor experienced weight stigma was consistently associated with physical activity, smoking, drinking, or trouble sleeping.

CONCLUSIONS

These findings suggest that both experienced and internalized weight stigma are associated with several indices of poor health in men. It may be informative for future work to examine how men cope with weight stigma, particularly if certain coping responses to stigma involve behaviors that contribute to poorer health.

Neighborhood Ethnic Composition and Perceived Discrimination Among Young Adult Latina/os: The Mediating Role of Ethnic Centrality

This study examines whether neighborhood ethnic composition (i.e., percentage of Latina/os residing in a given residential community) predicts greater perceived experiences of ethnic discrimination and whether this direct effect is mediated by ethnic centrality (i.e., perceived importance of ethnicity for one’s identity). In a cross-sectional study, 237 self-identified young adult Latina/os reported their five-digit zip codes and sociodemographic information and completed measures of ethnic centrality and perceived ethnic discrimination. A mediation analysis revealed that neighborhood ethnic composition indirectly predicted perceived ethnic discrimination through its effect on ethnic centrality even when accounting for known sociodemographic predictors of perceived discrimination, b = 0.28, SE = .18, 95% confidence interval (CI) = [0.03, 0.71]. These results provide initial evidence that where young adult Latina/os live and grow up impacts the extent to which they find their ethnicity to be an essential part of their identity and, consequently, their perceived frequency of experiencing ethnic discrimination.

Weight Stigma in Men: What, When, and by Whom?

OBJECTIVE

This study assessed the weight stigma experiences of men, examining characteristics of men who experienced weight stigma versus men who did not.

METHODS

Data from three samples of men were examined (N = 1,513). Sample 1 consisted of men with obesity at elevated risk for weight stigma. Sample 2 comprised a convenience online panel. Sample 3 included men from a national online panel of US adults. Men in all samples completed almost identical questionnaires assessing demographics, anthropometrics, weight stigma, and dieting.

RESULTS

Approximately 40% of men reported experiencing weight stigma. Weight stigma was associated with increased odds of having a BMI consistent with underweight or obesity relative to normal weight. Verbal mistreatment was the most common form of weight stigma experienced across all life stages for men. The most common sources of weight stigma were peers, family members, and strangers. Men reporting weight stigma were younger and less likely to be married, had higher BMIs, and were more likely to have tried to lose weight in the past year relative to men not reporting weight stigma.

CONCLUSIONS

Understanding differences among men as a function of weight stigma is important for practitioners, as it can identify men who may most benefit from intervention.

Internalizing Weight Stigma: Prevalence and Sociodemographic Considerations in US Adults

OBJECTIVE

This study aimed to conduct a comprehensive assessment of the presence, severity, and sociodemographic correlates of weight bias internalization (WBI) across three distinct samples of US adults.

METHODS

Levels of WBI were compared in (1) a sample of adults with obesity and heightened risk of weight stigma (N = 456), (2) an online community sample (N = 519), and (3) a national online panel (N = 2,529). Samples 2 and 3 comprised adults with and without obesity. Participants completed identical self-report measures, including demographic variables and weight-related factors, to determine their relationship with low, mean, and high levels of WBI.

RESULTS

At least 44% of adults across samples endorsed mean levels of WBI (as determined by sample 3). The highest levels of WBI were endorsed by approximately one in five adults in the general population samples and by 52% in the sample of adults with obesity. Individuals with the highest WBI were white, had less education and income, were currently trying to lose weight, and had higher BMIs, higher self-perceived weight, and previous experiences of weight stigma (especially teasing).

CONCLUSIONS

Internalized weight bias is prevalent among women and men and across body weight categories. Findings provide a foundation to better understand characteristics of individuals who are at risk for internalizing weight bias.

Weight stigma and health: The mediating role of coping responses

OBJECTIVE

Considerable evidence has documented links between weight stigma and poor health, independent of weight. However, little research has assessed how individuals cope with weight stigma, and how stigma-specific coping responses contribute to health. The present study examined multiple stigma-specific coping responses as mediators of the relationship between experienced weight stigma and health.

METHOD

A diverse national sample of 912 adults (53.9% female, Mage = 40.33, SD = 15.58) reporting experiences of weight stigma completed questionnaires about stigma, stigma-specific coping responses (i.e., coping with weight stigma via negative affect, maladaptive eating behavior, healthy lifestyle behavior, and exercise avoidance), and health indices including depressive symptoms, physical health, psychological wellbeing, dieting frequency, and self-esteem.

RESULTS

Stigma-specific coping responses mediated the relationship between experienced weight stigma and all health indices, though indirect effects of weight stigma on health varied by coping strategy. Weight stigma was indirectly associated with greater frequency of depressive symptoms, lower scores on psychological wellbeing, self-esteem and physical health through coping via negative affect. Weight stigma indirectly contributed to greater frequency of depressive symptoms and dieting, as well as lower self-esteem and poorer physical health through coping via maladaptive eating. Weight stigma was associated with less frequent depressive symptoms, more frequent dieting, better psychological wellbeing, better self-esteem, and better physical health through coping with healthy lifestyle behaviors.

CONCLUSIONS

These findings suggest that it may be useful to address weight stigma and coping in the context of weight management and obesity treatment programs, to help protect individuals from negative health effects of experiencing weight stigma. (PsycINFO Database Record

Intersectionality: An Understudied Framework for Addressing Weight Stigma

INTRODUCTION

Obesity is an ongoing public health concern in the U.S. Weight stigma is linked to a number of obesogenic health outcomes, which complicate obesity treatment and prevention. Despite higher rates of obesity in female and minority populations, little research has examined weight stigma in non-white women and men. This study investigated intersectionality in weight stigma and health-related coping responses to stigmatizing experiences across racial groups.

METHODS

In 2015, a total of 2,378 adults completed questionnaires about weight stigma, weight bias internalization, and coping strategies. Analyses were conducted in 2016.

RESULTS

No differences in weight stigma emerged as a function of race or gender, but women reported higher weight bias internalization (B=0.19, p=0.004). Further, black men and women reported less weight bias internalization than white men and women (B=-0.43, p=0.009). Compared with white women, black women were less likely to cope with stigma using disordered eating (B=-0.57, p=0.001), whereas Hispanic women were more likely to cope with stigma using disordered eating (B=0.39, p=0.020). Black men were more likely than white men to cope with stigma via eating (B=-0.49, p=0.017).

CONCLUSIONS

Findings highlight that weight stigma is equally present across racial groups, but that groups internalize and cope with stigma in different ways, which exacerbate health risks. Increased research and policy attention should address stigma as an obstacle in prevention and treatment for obesity to reduce weight-based inequities in underserved populations.

The Disruptive Effect of Self-Objectification on Performance

Self-objectification is the act of viewing the self, particularly the body, from a third-person perspective. Objectification theory proposes numerous negative consequences for those who self-objectify, including decreased performance through the disruption of focused attention. In the current study, we examined whether women in a state of self-objectification were slower to respond to a basic Stroop color-naming task. Results showed that regardless of the type of word (color words, body words, or neutral words), participants in a state of self-objectification exhibited decreased performance. This study lends further evidence to objectification theory and highlights the negative performance ramifications of state self-objectification.

Out and healthy: Being more “out” about a concealable stigmatized identity may boost the health benefits of social support

This research examined whether the relationship between perceived social support and health would be moderated by level of outness for people living with different concealable stigmatized identities (mental illness, substance abuse, domestic violence, rape, or childhood abuse). A total of 394 people living with a concealable stigmatized identity completed a survey. Consistent with hypotheses, at high levels of outness, social support predicted better health; at low levels of outness, social support was less predictive of health. People concealing a stigmatized identity may only be able to reap the health benefits of social support if they are “out” about the stigmatized identity.

Discreditable: Stigma Effects of Revealing a Mental Illness History on Test Performance

In three studies, the authors examined the effect of revealing a concealable social stigma—mental illness—on intellectual performance. It was hypothesized that revealing this deeply discrediting stigma would result in performance decrements. College students either with or without a history of mental illness (MI) treatment participated. In Study 1, the type of mental illness was left unselected. In Study 2, only participants who reported a history of depression participated. In Study 3, a comparison group of participants with a history of eating disorder were included. Results showed that the MI participants who revealed their history did worse on the reasoning test than did those in the no reveal condition. There was a trend in the opposite direction for participants with no MI. As predicted, revealing a narrower stigma, eating disorder, did not affect performance. The results are discussed in terms of identity threat and concealable stigmas.

Consuming Images: How Television Commercials that Elicit Stereotype Threat Can Restrain Women Academically and Professionally

Women in quantitative fields risk being personally reduced to negative stereotypes that allege a sex-based math inability. This situational predicament, termed stereotype threat, can undermine women’s performance and aspirations in all quantitative domains. Gender-stereotypic television commercials were employed in three studies to elicit the female stereotype among both men and women. Study 1 revealed that only women for whom the activated stereotype was self-relevant underperformed on a subsequent math test. Exposure to the stereotypic commercials led women taking an aptitude test in Study 2 to avoid math items in favor of verbal items. In Study 3, women who viewed the stereotypic commercials indicated less interest in educational/vocational options in which they were susceptible to stereotype threat (i.e., quantitative domains) and more interest in fields in which they were immune to stereotype threat (i.e., verbal domains).

The Effects of Weight and Achievement Messages on the Self-Esteem of Women

We examined whether priming achievement causes lower self-esteem and more negative mood in women who believe they are overweight and whether it does so by increasing women's dissatisfaction with their bodies or with their performance. Thirty-five self-perceived overweight women and 43 self-perceived normal weight women participated in the experiment. Half of the women read a message stressing the importance of achievement pursuits, and the other half read a message stressing the importance of nonachievement pursuits. All women then completed a measure of global self-esteem, read a message about the negative effects of being overweight, and completed several dependent measures. Controlling for initial self-esteem, overweight women who read the achievement prime had lower mood and global self-esteem and lower performance self-esteem but not lower appearance self-esteem or greater body dissatisfaction when compared to the overweight women who read the nonachievement prime and the normal weight women regardless of prime type.

Weight-based rejection sensitivity: Scale development and implications for well-being

We integrated theories of social stigma and rejection sensitivity to develop a new construct for understanding the effects of day-to-day experiences of interpersonal weight stigma: weight-based rejection sensitivity (W-RS), or a tendency to anxiously expect weight-based rejection. We created a new scale to measure W-RS. Studies 1 and 2 together established the scale as valid and reliable in a college student population. Study 3 examined the outcomes and predictive validity of W-RS by testing the effects of W-RS longitudinally across college students' first semester. Those who were high in W-RS were found to be at additional risk for compromised psychological and physical well-being over time. W-RS also predicted poorer adjustment to college. Overall, W-RS could help to explain individual reactions to stigma and to predict when weight stigmatization may have a greater likelihood of impacting a target.

Objectification in Action

Although the process of sexual objectification is theorized to occur within interpersonal interactions, we believe this is the first study to examine sexual objectification and self-objectification in actual (nonconfederate) interpersonal encounters. Men and women were brought into the laboratory and interacted in mixed-sex dyads. We used dyadic analysis to detect whether partners’ objectification of each other affected state self-objectification, and the resulting feelings of comfort and authenticity during the interaction. After the interaction, participants completed a cognitive performance task, a measure of career aspirations, and a measure of relationship agency. Results showed that for women only, being objectified by their male interaction partner was associated with an increase in state self-objectification, and state self-objectification led to perceptions that the interaction was less comfortable and less authentic. Furthermore, for women but not for men, having authentic interactions was found to relate positively to relationship agency, career aspirations, and cognitive performance. This research shows that self-objectification is not only a self-process but an interpersonal process heightened by the real-time sexual objectification of a male interaction partner. Online slides for instructors who want to use this article for teaching are available to PWQ subscribers on PWQ's website at http://pwq.sagepub.com/supplemental

Objectification in Virtual Romantic Contexts: Perceived Discrepancies between Self and Partner Ideals Differentially affect Body Consciousness in Women and Men

The current study examined whether exposure to sexually objectifying images in a potential romantic partner's virtual apartment affects discrepancies between people's perception of their own appearance (i.e., self-perceptions) and their perception of the body ideal that is considered desirable to a romantic partner (i.e., partner-ideals). Participants were 114 heterosexual undergraduate students (57 women and 57 men) from a northeastern U.S. university. The study used a 2 (Participant Gender) x 2 (Virtual Environment: Sexualized vs. Non-Sexualized) between-subjects design. We predicted that women exposed to sexually objectifying images in a virtual environment would report greater discrepancies between their self-perceptions and partner-ideals than men, which in turn would contribute to women's body consciousness. Findings support this hypothesis and show that perceived discrepancies account for the relationship between exposure to sexually objectifying images and body consciousness for women but not men. We also found gender asymmetries in objectification responses when each component of perceived discrepancies, i.e., self-perceptions versus perceptions of a romantic partner's body ideal, were examined separately. For men, exposure to muscular sexualized images was significantly associated with their self-perceptions but not their perceptions of the body size that is considered desirable to a romantic partner. For women, exposure to thin sexualized images was significantly associated with their perceptions that a romantic partner preferred a woman with a smaller body size. However, exposure to these images did not affect women's self-perceptions. Implications for gender asymmetries in objectification responses and perceived discrepancies that include a romantic partner's perceptions are discussed.

From discrimination to internalized mental illness stigma: The mediating roles of anticipated discrimination and anticipated stigma

OBJECTIVE

Internalizing mental illness stigma is related to poorer well-being, but less is known about the factors that predict levels of internalized stigma. This study explored how experiences of discrimination relate to greater anticipation of discrimination and devaluation in the future and how anticipation of stigma in turn predicts greater stigma internalization.

METHOD

Participants were 105 adults with mental illness who self-reported their experiences of discrimination based on their mental illness, their anticipation of discrimination and social devaluation from others in the future, and their level of internalized stigma. Participants were approached in several locations and completed surveys on laptop computers.

RESULTS

Correlational analyses indicated that more experiences of discrimination due to one's mental illness were related to increased anticipated discrimination in the future, increased anticipated social stigma from others, and greater internalized stigma. Multiple serial mediator analyses showed that the effect of experiences of discrimination on internalized stigma was fully mediated by increased anticipated discrimination and anticipated stigma.

CONCLUSION AND IMPLICATIONS FOR PRACTICE

Experiences of discrimination over one's lifetime may influence not only how much future discrimination people with mental illness are concerned with but also how much they internalize negative feelings about the self. Mental health professionals may need to address concerns with future discrimination and devaluation in order to decrease internalized stigma.

Pregnant Women at Work

Research suggests that pregnant women are discriminated against in the workplace and that a significant percentage of new mothers leave the workforce. Few researchers have examined the link between women’s discriminatory experiences and workforce attrition, instead of focusing on either individual-level factors (e.g., income) or workplace factors (e.g., workplace support) that predict turnover. We integrate previous findings on individual and workplace factors within a stigma framework that takes into account pregnant women’s anticipated and experienced stigma. We hypothesized that pregnant women’s anticipated and experienced stigma would mediate the relationships between individual (e.g., gender role attitudes) and workplace factors (e.g., workplace support) and job satisfaction, psychological well-being, and turnover intentions. Using a three-wave longitudinal design, we surveyed 142 pregnant women during and after their pregnancies, and we used path analysis to test mediational models. Results indicated that anticipated stigma partially mediated the relationship between workplace factors and psychological well-being, whereas experienced stigma partially mediated the relationships between workplace factors and job satisfaction, psychological well-being, and turnover intentions. Overall, our study demonstrates both the utility of a stigma framework and the importance of workplace experiences in understanding why women leave their jobs.

Development and psychometric evaluation of the Chronic Illness Anticipated Stigma Scale

The Chronic Illness Anticipated Stigma Scale (CIASS) was developed to measure anticipated stigma (i.e., expectations of prejudice, stereotyping, and discrimination) among people living with chronic illnesses. The CIASS is a 12-item scale with three subscales differentiating among sources of anticipated stigma, including friends and family members, work colleagues, and healthcare workers. Results support the reliability, validity, and generalizability of the CIASS in two samples of people living with chronic illnesses. The CIASS was correlated with other stigma-related constructs as well as indicators of mental health, physical health, and health behaviors. The CIASS can help researchers gauge the degree to which people living with chronic illnesses anticipate stigma, better understand the processes by which anticipated stigma contributes to the health and behavior of people living with chronic illnesses, and compare the extent to which people living with different types of chronic illnesses anticipate stigma.

Influenza Stigma during the 2009 H1N1 Pandemic

The current study examines the extent to which H1N1 was stigmatized at the height of the 2009 H1N1 pandemic in the U.S. and explores the role that H1N1 stigma played in people's desire for physical distance from others with H1N1. H1N1 was the most stigmatized disease, with participants endorsing greater prejudice towards people with H1N1 than people with cancer or HIV/AIDS. Further, H1N1 stigma partially mediated the relationship between participants' perceptions that H1N1 was threatening and their desire for physical distance from people with H1N1. Therefore, H1N1 stigma played a role in, but was not entirely responsible for, the relationship between perceptions that H1N1 was threatening and desire for distance from others with H1N1.

The Intimate Partner Violence Stigmatization Model and Barriers to Help-Seeking

The Intimate Partner Violence (IPV) Stigmatization Model identifies how three stigma components hinder IPV help-seeking behaviors: cultural stigma, stigma internalization, and anticipated stigma. Cultural stigma highlights societal beliefs that de-legitimize people experiencing abuse. Stigma internalization involves the extent to which people come to believe that the negative stereotypes about those who experience IPV may be true of themselves. Anticipated stigma emphasizes concern about what will happen once others know about the partner abuse (e.g., rejection). We provide an integrative literature review that supports the IPV stigmatization model and its role in reducing help-seeking behaviors.

Concealable Stigmatized Identities and Psychological Well-Being

Many people have concealable stigmatized identities: Identities that can be hidden from others and that are socially devalued and negatively stereotyped. Understanding how these concealable stigmatized identities affect psychological well-being is critical. We present our model of the components of concealable stigmatized identities including valenced content - internalized stigma, experienced discrimination, anticipated stigma, disclosure reactions, and counter-stereotypic/positive information - and magnitude - centrality and salience. Research has shown that negatively valenced content is related to increased psychological distress. However, smaller identity magnitude may buffer this distress. We review the research available and discuss important areas for future work.

Internalized stigma and HIV status disclosure among HIV-positive black men who have sex with men

Black men who have sex with men (BMSM) are severely affected by the HIV epidemic, yet research on the relationship between HIV stigma and status disclosure is relatively limited among this population. Within this epidemic, internalized HIV stigma, the extent to which people living with HIV/AIDS endorse the negative beliefs associated with HIV as true of themselves, can negatively shape interpersonal outcomes and have important implications for psychological and physical health. In a sample of HIV-positive BMSM (N=156), the current study examined the effect of internalized stigma on HIV status disclosure to sexual partners, which can inform sexual decision-making in serodiscordant couples, and HIV status disclosure to family members, which can be beneficial in minimizing the psychological distress associated with HIV. Results revealed that greater internalized stigma was associated with less HIV status disclosure to participants' last sexual partner and to family members. Findings from this study provide evidence that internalized negative beliefs about one's HIV status are linked to adverse interpersonal consequences. Implications of these findings are discussed with regard to prevention and intervention efforts to reduce HIV stigmatization.

Anticipated stigma and quality of life among people living with chronic illnesses

OBJECTIVES

We examined the process by which anticipated stigma relates to quality of life among people living with chronic illnesses. We hypothesized that stress, social support and patient satisfaction mediate the relationships between three sources of anticipated stigma and quality of life.

METHODS

Data were collected from adults living with chronic illnesses recruited from support groups and online communities, and were analysed with path analysis.

RESULTS

Results demonstrated that stress mediated the relationships between anticipated stigma from friends and family, and work colleagues with quality of life; social support mediated the relationships between anticipated stigma from friends and family, and work colleagues with quality of life; and patient satisfaction mediated the relationship between anticipated stigma from healthcare providers with quality of life. The final path model fit the data well (χ (2) (8) = 8.66, p = 0.37; RMSEA = 0.02; CFI = 0.99; SRMR = 0.03), and accounted for 60% of the variance in participants' quality of life.

DISCUSSION

This work highlights potential points of intervention to improve quality of life. It calls attention to the importance of differentiating between sources of anticipated stigma in clinical settings, interventions and research involving people living with chronic illnesses.

Contingencies of Self-Worth and Appearance Concerns

Heightened body surveillance can have negative effects on physical and psychological well-being, but little is known about the factors that contribute to this chronic surveillance. The authors tested a model that examined whether staking self-worth in certain domains was associated with decreased or increased body surveillance and appearance satisfaction in a sample of 115 Black and 222 White college women. Results indicated that investing self-worth in appearance and approval from others was associated with increased body surveillance and reduced appearance satisfaction whereas self-worth based in academic competence, God’s love, and family support was associated with less body surveillance and more appearance satisfaction. Tests of racial differences revealed that our model operated similarly across race. However, the structural paths of appearance contingency to body surveillance, academic competence contingency to body surveillance, and family support contingency to appearance satisfaction were stronger for White than Black women. This work outlines potential strategies to counteract body surveillance and appearance dissatisfaction by emphasizing domains of self-worth that are not appearance based and are staked in love and support. Implications of these findings for building positive body esteem and reducing disordered eating symptomatology are also discussed.

The impact of stigma in healthcare on people living with chronic illnesses

Approximately half of adults are living with a chronic illness, many of whom may feel stigmatized by their chronic illness in different contexts. We explored the impact of internalized, experienced, and anticipated stigma within healthcare settings on the quality of life of 184 participants living with chronic illnesses (e.g. diabetes, inflammatory bowel disease, asthma). Results of a path analysis demonstrate that participants who internalized stigma and experienced stigma from healthcare workers anticipated greater stigma from healthcare workers. Participants who anticipated greater stigma from healthcare workers, in turn, accessed healthcare less and experienced a decreased quality of life.

Revealing concealable stigmatized identities: The impact of disclosure motivations and positive first disclosure experiences on fear of disclosure and well-being

People who live with concealable stigmatized identities face complex decisions regarding disclosure. In the current work, we examine how people's motivations for disclosing a concealable stigmatized identity for the first time affect the quality of their first disclosure experiences and how these experiences, in turn, affect current well-being. Specifically, we found that people who disclosed for ecosystem, or other-focused, reasons report more positive first disclosure experiences which, in turn, were related to higher current self-esteem. Analyses suggest that one reason why this first disclosure experience is related to current well-being is because positive first disclosure experiences may serve to lessen chronic fear of disclosure. Overall, these results highlight the importance of motivational antecedents for disclosure in impacting well-being and suggest that positive first disclosure experiences may have psychological benefits over time because they increase level of trust in others.

Interacting like a body: objectification can lead women to narrow their presence in social interactions

The present experiment tested the impact of sexual objectification on women's behavior in social interactions. We predicted that when objectified, women would narrow their social presence by spending little time talking, particularly when interacting with men. Participants (males and females) gave an oral introduction of themselves to an alleged interaction partner (male or female). Objectification was manipulated by having participants believe their bodies were either visually inspected or not inspected during this introduction. Specifically, participants introduced themselves through a closed-circuit device in one of three conditions: body (videotaped from the neck down), face (videotaped from the neck up), or audio (no videotaping). Women who were in the body condition and thought they were interacting with men spent less time talking than participants in all other groups. In addition, the majority of women disliked the body condition, indicating that they found having their bodies gazed at aversive. Implications for women's behavior in mixed-sex contexts are discussed.

Living with a concealable stigmatized identity: the impact of anticipated stigma, centrality, salience, and cultural stigma on psychological distress and health

The current research provides a framework for understanding how concealable stigmatized identities impact people's psychological well-being and health. The authors hypothesize that increased anticipated stigma, greater centrality of the stigmatized identity to the self, increased salience of the identity, and possession of a stigma that is more strongly culturally devalued all predict heightened psychological distress. In Study 1, the hypotheses were supported with a sample of 300 participants who possessed 13 different concealable stigmatized identities. Analyses comparing people with an associative stigma to those with a personal stigma showed that people with an associative stigma report less distress and that this difference is fully mediated by decreased anticipated stigma, centrality, and salience. Study 2 sought to replicate the findings of Study 1 with a sample of 235 participants possessing concealable stigmatized identities and to extend the model to predicting health outcomes. Structural equation modeling showed that anticipated stigma and cultural stigma were directly related to self-reported health outcomes. Discussion centers on understanding the implications of intraindividual processes (anticipated stigma, identity centrality, and identity salience) and an external process (cultural devaluation of stigmatized identities) for mental and physical health among people living with a concealable stigmatized identity.

When Grades Determine Self-Worth: Consequences of Contingent Self-Worth for Male and Female Engineering and Psychology Majors

The impact of grades on daily self-esteem, affect, and identification with major was examined in a sample of 122 male and female students majoring in engineering and psychology. Self-esteem, affect, and identification with major increased on days students received good grades and decreased on days they received poor grades; basing self-esteem on academic competence moderated the effect of bad grades. Bad grades led to greater drops in self-esteem but not more disidentification with the major for women in engineering. Instability of self-esteem predicted increases in depressive symptoms for students initially more depressed.

LY294002, an inhibitor of phosphatidylinositol-3-kinase, causes preferential induction of apoptosis in human multidrug resistant cells

Protein kinase B (PKB), a kinase downstream of phosphatidylinositol 3-kinase (PI3-kinase) provides anti-apoptotic and survival signals via phosphorylation of various targets. Inhibiting PI3-kinase with a 12 h exposure to 10 microM LY294002 induces levels of apoptosis of 30.39+/-1.53% in the KB-V1 multidrug resistant (MDR) cell line compared to 4.54+/-1.00% in drug sensitive KB-3-1 cells (P<0.001). This occurred in conjunction with a preferential reduction in activated PKB in MDR cells. These results suggest the PI3-kinase/PKB signalling pathway is important for the survival of MDR cells and inhibition of this pathway results in the selective induction of apoptosis in MDR cells.

The preferential induction of apoptosis in multidrug-resistant KB cells by 5-fluorouracil

It has been previously been shown that multidrug resistance may be associated with biochemical changes which increase the sensitivity of resistant cells to the induction of apoptosis by certain agents. We have shown here that 48 h exposure to 5-fluorouracil (5-FU) induces both a significantly greater proportion of apoptotic cells and much greater cleavage of the apoptosis-related protein poly-(ADP-ribose)-polymerase in the multidrug-resistant (MDR) carcinoma cell line, KB-A1, than in corresponding drug-sensitive control KB-3.1 cells. Exposure to 5-FU also reduced the level of the anti-apoptotic protein, protein kinase B, in the MDR cells, but not in the control cells.

Importance of arginines 63 and 423 in modulating the bile salt-dependent and bile salt-independent hydrolytic activities of rat carboxyl ester lipase

Previous studies using chemical modification approach have shown the importance of arginine residues in bile salt activation of carboxyl ester lipase (CEL) activity. However, the x-ray crystal structure of CEL failed to show the involvement of arginine residues in CEL-bile salt interaction. The current study used a site-specific mutagenesis approach to determine the role of arginine residues 63 and 423 in bile salt-dependent and bile salt-independent hydrolytic activities of rat CEL. Mutations of Arg(63) to Ala(63) (R63A) and Arg(423) to Gly(423) (R423G) resulted in enzymes with increased bile salt-independent hydrolytic activity against lysophosphatidylcholine, having 6.5- and 2-fold higher k(cat) values, respectively, in comparison to wild type CEL. In contrast, the R63A and R423A mutant enzymes displayed 5- and 11-fold decreases in k(cat), in comparison with wild type CEL, for bile salt-dependent cholesteryl ester hydrolysis. Although taurocholate induced similar changes in circular dichroism spectra for wild type, R63A, and R423G proteins, this bile salt was less efficient in protecting the mutant enzymes against thermal inactivation in comparison with control CEL. Lipid binding studies revealed less R63A and R423G mutant CEL were bound to 1,2-diolein monolayer at saturation compared with wild type CEL. These results, along with computer modeling of the CEL protein, indicated that Arg(63) and Arg(423) are not involved directly with monomeric bile salt binding. However, these residues participate in micellar bile salt modulation of CEL enzymatic activity through intramolecular hydrogen bonding with the C-terminal domain. These residues are also important, probably through similar intramolecular hydrogen bond formation, in stabilizing the enzyme in solution and at the lipid-water interface.