The role of shame and spontaneous self-affirmation among people with concealable stigmatized identities.

Many Americans report having a concealable stigmatized identity (CSI) - when one belongs to a group that is devalued by society, but membership can be hidden - which is linked with poor health outcomes. One factor consistently linked with poor health among people with CSIs is anticipated stigma. The current study uses structural equation modeling to examine how responses to anticipated stigma (shame, spontaneous self-affirmation) explain the relationship between anticipated stigma and poor health. Using students from a large Midwestern University (N = 314), our model demonstrated that anticipated stigma was indirectly associated with poor health (i.e. psychological and physical quality of life, emotional eating) through shame. Spontaneous self-affirmation was associated with positive health outcomes but was not a significant mediator. This model illustrates the importance of shame and spontaneous self-affirmation as mechanisms of stigma to health relationship among individuals with CSIs, and provides potential targets (shame, spontaneous self-affirmation) for future work.