Understanding Associative Stigma: Avoidance Mediates the Relation Between Anticipated Stigma and Psychological Distress

Abstract Individuals who experience associative stigma may find themselves the target of rejection, harassment, and discrimination, not because of their own attributed characteristics, but because of their social ties to people who belong to a stigmatized group. To protect themselves from potential maltreatment, individuals who anticipate stigmatization may use stigma management strategies such as counterfeiting, avoiding, and integrating, though previous research suggests that these behaviors are associated with negative psychological outcomes. The current study tested the hypothesis that higher levels of anticipated stigma would be associated with higher levels of depression, anxiety, and stress and that these associations would be mediated, in part, by increased implementation of counterfeiting and avoiding management strategies, and decreased implementation of integrating strategies. Participants ( N = 272) who reported that they were closely affiliated (e.g., parent, sibling, friend, spouse, etc.) with someone who possessed a concealable stigma completed an online survey. Results showed that avoiding management strategies mediated the relation between anticipated stigma and both depression and stress, but not anxiety. Counterfeiting and integrating management strategies did not mediate the relation between anticipated stigma and all three psychological distress outcomes. Clinicians and healthcare professionals working with clients who experience associative stigma should encourage the use of approach-focused stigma management strategies such as active coping, emotional support-seeking, positive reframing, and acceptance to help mitigate accompanying feelings of sadness and psychological strain.