Although interracial relationships have been legalized and become more common (Livingston & Brown, 2017), individuals in interracial relationships still face relationship stigma (Pittman et al., 2024; Rosenthal et al., 2019). We explored potential protective factors for psychological and relational well-being among racially diverse adults in interracial relationships (N = 232). Moderation analysis indicated that ethnic identity buffers the negative psychological effect of relationship stigma and anxiety from discrimination. Additionally, results demonstrated that partners' cultural humility promotes relationship commitment despite the negative relational impacts of relationship stigma. Implications for counseling interventions for interracial relationships are discussed.
Despite growing research on nonsuicidal self-injury (NSSI) in university settings and evidence that the risk of engaging in NSSI increases when they know someone who does, little is known about the relationship between social exposure to NSSI and students' perceptions of public stigma regarding NSSI. Drawing on intergroup contact theory, which posits that increased contact with stigmatized groups reduces prejudice, understanding how knowing someone who self-injures relates to stigma is particularly important. This study addressed these gaps by examining these factors among university students from three countries. Potential commonalities across countries and the moderating role of personal NSSI history were also examined. A total of 1,059 students (77.4% female, M-age = 21, age range = 17-53 years) participated, having been recruited on the basis that they knew someone who engaged in NSSI. Participants (50.8% Australian, 33.4% Belgian, 15.8% Canadian) completed a survey reporting on their own experiences with NSSI, the perceived NSSI experiences of the person they know who self-injures, and perceptions of public attitudes and stigma toward NSSI. Participants most commonly identified friends as the individuals they knew who self-injured. Pearson's correlations revealed positive interrelations among social exposure to NSSI and perceived public NSSI stigma. Hierarchical regression and moderation analysis showed this association was moderated by country, but not by personal NSSI history. Analysis of variance results indicated Canadian students perceived significantly lower levels of public NSSI stigma compared to Australian and Belgian counterparts. These findings underscore the importance of implementing stigma-reduction strategies sensitive to country-specific contextual factors. Future research should further explore the role of knowing someone who self-injures, as well as cultural and national influences on stigma perceptions.
Disclosure research has largely focused on invisible stigmatized identities, assuming that, for people with visible stigmas, there is no need to "disclose the obvious." However, people with observable disabilities do face disclosure decisions, precisely because their disabilities are observable. Pressure to disclose-from staring and intrusive questions-threatens disclosure autonomy. Drawing on self-determination theory-which posits basic psychological needs for autonomy, competence, and relatedness-this study investigated the influence of antecedent factors on disclosure autonomy, disclosure processes, and ultimately, well-being. In the first study of disclosure among people with diverse observable disabilities, semistructured interviews with 25 adults with observable disabilities (e.g., mobility disability, blindness, deafness) explored non/disclosure experiences. Directed qualitative content analysis supported a model indicating that context (e.g., setting, access needs), disability factors (observability, type), and personal factors (intersecting identities) impact perceived disclosure autonomy, approach versus avoidance motivation, and disclosure depth. In turn, these processes relate to well-being outcomes, including satisfaction of self-determination theory needs. Threats to disclosure autonomy were common, with participants feeling compelled to disclose due to access needs or intrusive questions. Autonomous disclosure was associated with positive outcomes like competence and belonging, while compelled disclosure was linked to distress. Findings underscore the need for systemic changes, including universal design, to reduce the burden of compelled disclosure. This study advances theory by providing the first disclosure model in psychology to include the experiences of people with observable disability. Future work will examine potential causal pathways within the proposed model and assess how it might extend existing disclosure frameworks.
Emerging evidence suggests that weight-biased attitudes are present in early childhood, yet research examining these biases and their association with positive body image in young, diverse populations remains limited. The present study aimed to examine the prevalence of weight-biased attitudes and their relationship with body appreciation among children aged 4-6 years in the United Kingdom and to explore differences by school year, gender, ethnicity, and socioeconomic status. Secondary data analysis was conducted on baseline data from 381 children participating in a randomized controlled trial evaluating media-based interventions for positive body image. Weight-biased attitudes were measured using child-friendly, image-based ratings of peers differing in body size, while body appreciation was assessed with two age-appropriate items. Results indicated that 82.3% of children rated smaller bodied peers more favorably, with the largest differences observed for perceived appearance, intelligence, and dancing skill. Year 1 children (5-6 years) exhibited significantly greater weight bias than Reception children (4-5 years; p < .05, d = -.261), whereas no significant differences were observed across gender, ethnicity, or socioeconomic status (ps > .05). There was a significant negative association between weight bias and body appreciation (r(s) = -.184, p < .001), suggesting that children who endorsed stronger weight-biased attitudes reported lower body appreciation. These findings highlight the early emergence of weight-biased attitudes and their potential impact on positive body image. Interventions targeting weight bias and fostering body appreciation from preschool years may support healthier developmental trajectories and promote inclusion from an early age.
People living with schizophrenia (SZ) and substance use disorders (SUD) face high levels of public stigma. Although these conditions frequently co-occur, little is known about public responses to individuals who experience both SZ and SUD. To address this gap, 461 university students completed an online survey and responded to one of 11 vignettes describing a person living with single or co-occurring diagnoses of SZ and alcohol or amphetamine use disorders, with or without treatment, or no disorder (control). The study measured three dimensions of public stigma: stereotyped cognitions, prejudicial affect, and discriminatory behavioral intentions. Statistical analyses revealed significant interactions between SZ and SUD for all three dimensions of public stigma. Overall, responses to people living with co-occurring SZ and SUD were generally less negative than those toward people living with SUD alone but more negative than toward individuals living with SZ alone. This pattern was most pronounced for stereotypes related to responsibility. Treatment status also significantly affected endorsement of responsibility stereotypes, with participants perceiving characters who received treatment as less responsible for their conditions than those who did not. Cognitive, affective, and intended behavioral responses were more negative toward characters living with any type of SUD than those without, but there were no significant differences in responses to those who experienced alcohol versus amphetamine use disorders. The findings suggest that co-occurring SZ may attenuate certain forms of public stigma toward people living with SUD, particularly perceived responsibility. The results align with attribution theory and interactive models of multiple stigmas.
Diagnostic overshadowing (DO) refers to biased clinical decision making in which a patient's current symptoms are misattributed to an already established diagnosis, typically a cognitive disability or mental illness. In the present study, we modify a measure of DO-the Concerns with Diagnostic Overshadowing Scale (Fahmi & Mussap, 2025)-to measure DO due to a patient's body weight (the CDOS-w). Participants were 418 adults 18-83 years of age (M = 36.9, SD = 13.4) who completed an online survey containing the CDOS-w along with measures of health care-related delays, trust in health professionals and systems, and personal well-being. Factor analysis supported a three-factor model consisting of DO experiences (exposure to weight-biased health care), concealment (anticipation of weight biases in health care), and internalization (of weight-biased health beliefs). Measurement invariance tests revealed configural and metric invariance of the CDOS-w in terms of gender (women vs. men) and body mass index group (people of "normal weight" [18.5-24.9 kg/m(2)] vs. people of "higher weight" [>= 25 kg/m(2)]), but failure of scalar invariance due to higher baseline levels of DO in women and participants of higher weight. Path analyses were consistent with the idea that medical delays are in part experienced as weight-related DO and that this is associated with an erosion of trust in health professionals and systems, concealment of weight-related information from them, and lower personal well-being. These results suggest that weight-related DO, while more prevalent in women and in people of higher weight, is not limited to them, and that when DO is experienced, it is associated with potentially unhealthy responses.
Postpartum urinary incontinence (PPUI) affects 30%-33% of postpartum individuals, yet fewer than one third seek care. This study aimed to conceptualize stigma associated with PPUI and explore its influence on three key health behaviors: (a) accessing health care; (b) engaging in physical activity, including pelvic floor muscle training; and (c) social support. This qualitative description study, grounded in postpositivism, explored the influence of PPUI-related stigma on health behaviors. Fifteen postpartum individuals in Canada, representing diverse racial backgrounds and within 2 years postpartum, participated in semistructured interviews. We aimed to understand experiences of PPUI stigma and implications on health care, physical activity, and social support. Interviews were analyzed using inductive content analysis, and findings were interpreted through the Health Stigma and Discrimination Framework. Participants described PPUI stigma as feelings of embarrassment, shame, and fear of judgment, contributing to delayed health care-seeking and avoidance of high-impact physical activity. While pelvic floor muscle training was widely acknowledged, confusion about technique and time constraints limited adherence. Many participants reported avoiding disclosure to friends, family, and partners due to cultural silence or fear of being dismissed. Racial and cultural identities further influenced stigma experiences, with racialized participants describing greater discomfort discussing PPUI due to health care mistrust or gendered cultural norms. Findings illustrate how PPUI stigma shapes postpartum experiences and limits engagement with health care, physical activity, and social support. Interventions should prioritize early pelvic health education, routine postpartum screenings that address PPUI, and culturally sensitive peer support networks to reduce stigma and improve care-seeking.
Workplace stigma toward individuals with mental illness remains a significant barrier to employment equity, career development, and well-being. This study aimed to develop and validate a brief Workplace Mental Illness Stigma Scale for the general working population. A telephone survey was conducted with 1,008 full-time working adults across diverse industries, occupations, and educational backgrounds in Hong Kong. Exploratory and confirmatory factor analyses supported a six-item, two-factor stigma scale measuring perceived capability at work and anticipated work difficulties with coworkers with mental illness. The scale demonstrated low associations with flourishing and anxiety symptoms. These findings highlighted the scale's utility as a brief, valid instrument to assess workplace mental illness stigma in a general working population context.
Substance use disorders (SUDs) remain one of the most highly stigmatized health conditions, even within health care and behavioral health settings. Provider-based stigma has been identified as a major barrier to treatment access and quality of care. This study examined stigma toward SUDs in comparison to mental and physical illnesses among future health care providers at two stages of professional development. Participants (N = 383) were randomly assigned to read one of three vignettes describing a patient with either SUD, depression, or breast cancer, all framed as genetically influenced conditions. Following each vignette, participants completed the Attribution Questionnaire-9, assessing cognitive, emotional, and behavioral dimensions of stigma. Results indicated that participants in both stages of professional development (preprofessional stage and early interest stage) rated patients with SUDs as significantly more blameworthy and dangerous and were more likely to endorse coercion and segregation compared to patients with depression or cancer. Early-stage participants also reported greater anger and fear toward SUD patients and reported more avoidance and lower willingness to help. These findings suggest that stigma toward SUD persists even when addiction is framed as a medical condition and may be particularly pronounced among individuals with limited training or experience.
Stigma is often perceived as having primarily negative consequences for those who are stigmatized.Although past research has also identified ways that people may grow from stigma experiences, thereremains a need to clarify the mechanisms of stigma-related experiences and their effects with time. Thisstudy afforded a unique view through a survey in which participants were asked to share narratives ofchallenging stories relating to substance use (including those involving stigma) and then to reflect on howthey feel about the incidents in the present day. We employed Prolific, a platform for online behavioralresearch, to recruit participants with problematic use of alcohol, cannabis, or opioids using validatedscreening instruments. We performed quota sampling to achieve diversity of representation in terms of race/ethnicity. Our sample comprised 510 participants. The average age was 34.6 (SD=10.9, range=18-72).With respect to gender, the sample was 50.4% male, 42.0% female, and 3.7% other, with a diverse range interms of education level. Consistent with our sampling strategy, the sample was diverse with respect to raceand ethnicity. We performed qualitative data analysis using an inductive method involving multipleanalysts. We report four main themes: (1) the ways people grew from stigma-related experiences; (2) thelessons learned; (3) facilitators of change; and (4) participants'retrospective views of the experiences. Ourwork contributes to extant knowledge on how stigma-related experiences become integrated into one'sworldview, how doing so may affect well-being with time, and the conceptualization of resilience.
Mental health organizations frequently publish personal stories of mental illness. According to the intergroupcontact, narrative persuasion, and entertainment-education literatures, these may reduce the damaging stigmaassociated with mental illness. However, researchers have not yet ascertained whether personal stories influencepublic stigma in both participants with and without mental illness themselves and whether self-stigma is reduced.As a result of being more similar to the narrator and thus experiencing greater transportation and identificationand lower counterarguing, effects may be more pronounced in participants with mental illness. To test this,student participants completed measures of public (stereotyping and social distance) and self-stigma before andafter reading a personal story of anxiety and depression and completed measures of transportation, identification,and counterarguing. Stereotyping and self-stigma were unchanged from pre- to postnarrative, while socialdistance improved for participants without a mental illness (n=198) but worsened for participants with a mentalillness (n=132). Contrary to previous research, transportation and identification (in parallel) and counterarguing(in serial) did not mediate the difference in stigma change between the two participant groups. Mental healthorganizations should urgently examine their published stories, ensuring theydonotincreasestigma.Futurestudies should consider psychological reactance and social comparison processes, the alignment betweennarratives and stigma measures, specific narrative elements, and effects in other groups ofparticipants.
Intersectionality theory suggests that because stigma arises from the interplay of multiple marginalized identities, Black women with obesity may face stronger negative attitudes than White women when using GLP-1 agonists, a newer class of obesity medications often perceived as an 'easy way out.' This experimental study tested how exposure to different weight loss methods affected stigma toward a Black or White woman with obesity, as well as the influence of participant race on stigma. A sample of 402 Black and White women with overweight or obesity were randomly assigned to read about a Black or White woman named Evette who lost 15% of her total body weight with either diet/exercise or a GLP-1. Participants reported stigmatizing attitudes toward Evette (fat phobia, dislike, desire for social distance, and blame) and beliefs that she took a weight loss shortcut. Stigma was higher when Evette lost weight with a GLP-1 (vs. diet/exercise) and, contrary to hypotheses, when Evette was depicted as White (vs. Black). Moderated mediation analyses demonstrated that GLP-1-assisted weight loss (vs. diet/exercise) led to higher fat phobia, dislike, desire for social distance, and blame via stronger shortcut beliefs and this effect was more pronounced when Evette was portrayed as White. Participant race did not influence how weight loss with a GLP-1 and Evette's race, together, affected stigma through shortcut beliefs. Findings highlight the importance of challenging societal narratives about what constitutes 'acceptable' weight loss strategies for women with obesity to reduce stigma and protect long-term health.
Antistigma campaigns can reduce mental health stigma; however, messages can be interpreted differently depending on the message recipient. Focusing on major depressive disorder, we developed a lenticular message: one intentionally designed to be processed differently based on, in this case, whether the person is experiencing depression. Participants, asymptomatic or symptomatic of depression, received no message or an attribution-based message delivered one of two ways: (a) overheard for symptomatic respondents but direct for asymptomatic respondents ("Do you know someone who is experiencing depression?") or (b) direct for symptomatic respondents but overheard for asymptomatic respondents ("Are you experiencing depression?"). Employing a dual-dependent variable approach, we investigated different outcomes depending on whether the participant was symptomatic. Results indicated that for symptomatic individuals, help-seeking attitudes and intentions were more favorable among those who received the "Do you?" message compared to those receiving no message; this was not the case for those who received the "Are you?" message, whose help-seeking attitudes and intentions were not significantly different from the "Do you?" or no-message conditions. Symptomatic participants who received the "Do you?" message reported more favorable help-seeking outcome expectations than those who received the "Are you?" message; both groups reported more favorable help-seeking outcome expectations than symptomatic participants who did not receive a message. Among asymptomatic participants, both messages increased willingness to support some one experiencing depression through lower anger and higher social support outcome expectations. The results illustrate the utility of lenticular messaging for reducing stigma among asymptomatic individuals while simultaneously increasing help seeking inclinations among symptomatic individuals.
