From stigma to trust: A paradigm shift for understanding perceptions of individuals with bipolar disorder.

Abstract

Individuals with bipolar disorder (BD) face professional and personal challenges such as underemployment. Navigating these challenges involves the dilemma of whether to disclose their illness or conceal it and risk presenting symptoms. Examinations of these challenges are often anchored in stigma, which has attributed negative employment outcomes for individuals with BD to adverse reactions from managers following disclosure. Across three experiments, including a managerial sample and a novel chatbot interaction, and eight supplemental studies (N = 8,112), the present research proposes and tests a trust-based attributional model. Mania, the hallmark symptom of BD, signals activation-based unpredictability, which serially erodes the perceived trustworthiness of an employee, ultimately compromising a manager's trust and willingness to retain the employee. The current findings demonstrate that disclosure is not uniformly harmful and that stigma operates as a distal moderator. An employee disclosing in the absence of mania can appear less predictable, and managers high in preexisting stigma toward BD generally view employees as less predictable. However, when manic symptoms are visible, disclosure buffers against their negative impact by providing an explanation for the erratic behavior. Together, this research reveals that moving beyond stigma-centric accounts clarifies managerial perceptions of employees with BD, with disclosure and stigma shaping this trust-based process. (PsycInfo Database Record (c) 2026 APA, all rights reserved).