Neural correlates of stigma: A systematic review.

Objective: Understanding neural mechanisms underlying the experience and enactment of stigma is needed to address the public health challenge posed by both experienced and enacted stigma. In this systematic review, we synthesized the literature on neural correlates of stigma from the perspective of (a) the stigmatizer (enacted stigma) and (b) the stigmatized (experienced stigma).

Method: We searched PsychInfo, PubMed, Web of Science, Medline, and SCOPUS for articles assessing stigma using neuroimaging.

Results: Thirty-one articles were included covering a variety of stigmatized identities (i.e., mental health, medical conditions, homelessness), with 20 articles on enacted stigma and 11 on experienced stigma. There was a large variety in methodological approaches, including varying experimental paradigms, analytical approaches (e.g., whole-brain vs. region-of-interest analyses), samples, and degree to which stigma is assessed and/or verified (as opposed to assumed to be present in response to exclusion or in response to specific stimuli). Regardless, our review indicates that a widespread network of brain regions is implicated in the enactment of stigma (in the stigmatizer), including frontal, cingulate, parietal, occipital, and subcortical regions, which are characterized by inconsistencies that likely result from methodological differences. In contrast, a blunted medial prefrontal cortex response to experienced stigma is relatively consistently observed (in the stigmatized).

Conclusions: Our review is the first to comprehensively synthesize studies examining neural correlates of stigma, revealing tangible brain patterns reflecting its experience and enactment, enhancing our understanding of stigma and its assessment. Last, we highlight the complexity of this research area and discuss insights and considerations for future work. (PsycInfo Database Record (c) 2025 APA, all rights reserved).