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An integrated understanding of the mechanisms linking social stigma to mental health among marginalized populations

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From Nature Mental Health

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Abstract

This Perspective presents a model that integrates mechanisms that explain the association between stigma and mental health that are shared across multiple stigmatized populations. By distinguishing among mediating, protective and intensifying factors, the model can be used to achieve two broad aims: to understand the similarities and differences in common and/or comparable mechanisms that explain the effect of stigma on mental health; and to understand how mechanisms linking stigma to mental health are experienced by individuals at the intersection of multiple stigmatized statuses. Applications and opportunities for new research within and across a variety of stigmatized populations are discussed in relation to these aims.

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Fig. 1: Mechanisms that explain and modify the association between experiences of social stigma and mental health outcomes.

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References

  1. Link, B. G., Phelan, J. C. & Hatzenbuehler, M. L. in The Oxford Handbook of Stigma, Discrimination, and Health (eds. Major, B. et al.) 53–68 (Oxford Univ. Press, 2017); https://doi.org/10.1093/oxfordhb/9780190243470.013.4

  2. Frost, D. M. & Meyer, I. H. Minority stress theory: application, critique, and continued relevance. Curr. Opin. Psychol. 51, 101579 (2023).

    Article  PubMed  PubMed Central  Google Scholar 

  3. Williams, D. R. Stress and the mental health of populations of color: advancing our understanding of race-related stressors. J. Health Soc. Behav. 59, 466–485 (2018).

    Article  PubMed  PubMed Central  Google Scholar 

  4. Frost, D. M. Social stigma and its consequences for the socially stigmatized. Soc. Personal Psychol. Compass 5, 824–839 (2011).

    Article  Google Scholar 

  5. Major, B., Dovidio, J. F., Link, B. G. & Calabrese, S. K. in The Oxford Handbook of Stigma, Discrimination, and Health (eds. Major, B. et al.) 3–28 (Oxford Univ. Press, 2017); https://doi.org/10.1093/oxfordhb/9780190243470.013.1

  6. Promoting Mental Health: Concepts, Emerging Evidence, Practice: Summary Report (World Health Organization, 2004).

  7. Goffman, E. Stigma: Notes on the Management of Spoiled Identity (Prentice Hall, 1963).

  8. Herek, G. M. in Contemporary Perspectives on Lesbian, Gay, and Bisexual Identities (ed. Hope, D. A.) 65–111 (Springer, 2009); https://doi.org/10.1007/978-0-387-09556-1_4

  9. Link, B. G. & Phelan, J. C. Conceptualizing stigma. Annu. Rev. Sociol. 27, 363–385 (2001).

    Article  Google Scholar 

  10. Earnshaw, V. A. et al. Integrating time into stigma and health research. Nat. Rev. Psychol. 1, 236–247 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  11. Hatzenbuehler, M. L. & Link, B. G. Introduction to the special issue on structural stigma and health. Soc. Sci. Med. 103, 1–6 (2014).

    Article  PubMed  Google Scholar 

  12. Allport, G. W. The Nature of Prejudice (Addison-Wesley, 1954).

  13. Devine, P. G. Stereotypes and prejudice: their automatic and controlled components. J. Pers. Soc. Psychol. 56, 5–18 (1989).

    Article  Google Scholar 

  14. Major, B. & O’Brien, L. T. The social psychology of stigma. Annu. Rev. Psychol. 56, 393–421 (2005).

    Article  PubMed  Google Scholar 

  15. Fiske, S. T. in The Handbook of Social Psychology (eds. Gilbert, D. T. et al.) 357–411 (McGraw-Hill, 1998).

  16. Sue, D. W. Microaggressions in Everyday Life: Race, Gender, and Sexual Orientation (John Wiley & Sons, 2010).

  17. Schwartz, S. & Meyer, I. H. Mental health disparities research: the impact of within and between group analyses on tests of social stress hypotheses. Soc. Sci. Med. 70, 1111–1118 (2010).

    Article  PubMed  Google Scholar 

  18. Carter, R. T. et al. A meta-analytic review of racial discrimination: relationships to health and culture. Race Soc. Probl. 11, 15–32 (2019).

    Article  Google Scholar 

  19. de Lange, J., Baams, L., van Bergen, D. D., Bos, H. M. W. & Bosker, R. J. Minority stress and suicidal ideation and suicide attempts among LGBT adolescents and young adults: a meta-analysis. LGBT Health 9, 222–237 (2022).

    Article  PubMed  Google Scholar 

  20. Frost, D. M. Hostile and harmful: structural stigma and minority stress explain increased anxiety among migrants living in the United Kingdom after the Brexit referendum. J. Consult. Clin. Psychol. 88, 75–81 (2020).

    Article  PubMed  Google Scholar 

  21. Oh, H., Waldman, K., Koyanagi, A., Anderson, R. & DeVylder, J. Major discriminatory events and suicidal thoughts and behaviors amongst Black Americans: findings from the National Survey of American Life. J. Affect. Disord. 263, 47–53 (2020).

    Article  PubMed  Google Scholar 

  22. Vargas, S. M., Huey, S. J. & Miranda, J. A critical review of current evidence on multiple types of discrimination and mental health. Am. J. Orthopsychiatry 90, 374–390 (2020).

    Article  PubMed  Google Scholar 

  23. Frost, D. M. et al. Social change and the health of sexual minority individuals: do the effects of minority stress and community connectedness vary by age cohort? Arch. Sex. Behav. 51, 2299–2316 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  24. Quinn, D. M., Camacho, G., Pan-Weisz, B. & Williams, M. K. Visible and concealable stigmatized identities and mental health: experiences of racial discrimination and anticipated stigma. Stigma Health 5, 488–491 (2020).

    Article  PubMed  Google Scholar 

  25. Gómez, F., Cumsille, P. & Barrientos, J. Mental health and life satisfaction on Chilean gay men and lesbian women: the role of perceived sexual stigma, internalized homophobia, and community connectedness. J. Homosex. 69, 1777–1799 (2022).

    Article  PubMed  Google Scholar 

  26. James, D. Self- and group-focused internalized racism, anxiety, and depression symptoms among African American adults: a core self-evaluation mediated pathway. Group Process. Intergroup Relat. 24, 1335–1354 (2021).

    Article  Google Scholar 

  27. Lee, H. et al. Internalized transphobia and mental health among transgender adults: a nationwide cross-sectional survey in South Korea. Int. J. Transgend. Health 21, 182–193 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  28. Roberson, K. & Pieterse, A. L. Internalized racism and self-esteem: do depressive symptoms matter? Cultur. Divers. Ethnic Minor. Psychol. 27, 531–536 (2021).

    Article  PubMed  Google Scholar 

  29. Major, B. & Schmader, T. in The Oxford Handbook of Stigma, Discrimination, and Health (eds. Major, B. et al.) 85–104 (Oxford Univ. Press, 2017); https://doi.org/10.1093/oxfordhb/9780190243470.013.3

  30. Hatzenbuehler, M. L., Nolen-Hoeksema, S. & Dovidio, J. How does stigma ‘get under the skin’? Psychol. Sci. 20, 1282–1289 (2009).

    Article  PubMed  Google Scholar 

  31. Hatzenbuehler, M. L. How does sexual minority stigma ‘get under the skin’? A psychological mediation framework. Psychol. Bull. 135, 707–730 (2009).

    Article  PubMed  PubMed Central  Google Scholar 

  32. Burton, C. L., Wang, K. & Pachankis, J. E. Does getting stigma under the skin make it thinner? Emotion regulation as a stress-contingent mediator of stigma and mental health. Clin. Psychol. Sci. 6, 590–600 (2018).

    Article  PubMed  PubMed Central  Google Scholar 

  33. Kaya, Z. & Oskay, U. Stigma, hopelessness and coping experiences of Turkish women with infertility. J. Reprod. Infant Psychol. 38, 485–496 (2020).

    Article  PubMed  Google Scholar 

  34. Brooks, B. D. et al. Anticipated sexual minority stress and mental health after the 2016 presidential election: examining a psychological mediation framework. J. Homosex. https://doi.org/10.1080/00918369.2022.2087481 (2022).

  35. Hollinsaid, N. L., Pachankis, J. E., Bränström, R. & Hatzenbuehler, M. L. Hypervigilance: an understudied mediator of the longitudinal relationship between stigma and internalizing psychopathology among sexual-minority young adults. Clin. Psychol. Sci. https://doi.org/10.1177/21677026231159050 (2023).

  36. Perlson, J., Scholl, J., Mayer, K. H., O’Cleirigh, C. & Batchelder, A. W. To disclose, not disclose, or conceal: a qualitative study of HIV-positive men with multiple concealable stigmatized identities. AIDS Patient Care STDS 35, 47–55 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  37. Han, S. et al. Perceived discrimination and mental health symptoms among persons living with HIV in China: the mediating role of social isolation and loneliness. AIDS Care 33, 575–584 (2021).

    Article  PubMed  Google Scholar 

  38. Himmelstein, M. S., Puhl, R. M. & Quinn, D. M. Weight stigma and health: the mediating role of coping responses. Health Psychol. 37, 139–147 (2018).

    Article  PubMed  Google Scholar 

  39. Ngamake, S. T., Walch, S. E. & Raveepatarakul, J. Discrimination and sexual minority mental health: mediation and moderation effects of coping. Psychol. Sex Orientat. Gend. Divers. 3, 213–226 (2016).

    Article  Google Scholar 

  40. Chaiton, M. O., Cohen, J. E., O’Loughlin, J. & Rehm, J. A systematic review of longitudinal studies on the association between depression and smoking in adolescents. BMC Public Health 9, 356 (2009).

    Article  PubMed  PubMed Central  Google Scholar 

  41. Follins, L. D., Garrett-Walker, J. J. & Lewis, M. K. Resilience in Black lesbian, gay, bisexual, and transgender individuals: a critical review of the literature. J. Gay Lesbian Ment. Health 18, 190–212 (2014).

    Article  Google Scholar 

  42. Kwon, P. Resilience in lesbian, gay, and bisexual individuals. Pers. Soc. Psychol. Rev. 17, 371–383 (2013).

    Article  PubMed  Google Scholar 

  43. Meyer, I. H. Identity, stress, and resilience in lesbians, gay men, and bisexuals of color. Couns. Psychol. 38, 442–454 (2010).

    Article  Google Scholar 

  44. Hutcheon, E. & Lashewicz, B. Theorizing resilience: critiquing and unbounding a marginalizing concept. Disabil. Soc. 29, 1383–1397 (2014).

    Article  Google Scholar 

  45. Neblett, E. W. Racial, ethnic, and cultural resilience factors in african american youth mental health. Annu. Rev. Clin. Psychol. 19, 361–379 (2023).

    Article  PubMed  Google Scholar 

  46. Raeifar, E., Halkett, A., Lohman, M. C. & Sirey, J. A. The relation between mastery, anticipated stigma and depression among older adults in a primary care setting. J. Nerv. Ment. Dis. 205, 801–804 (2017).

    Article  PubMed  Google Scholar 

  47. Rueda, S. et al. Mastery moderates the negative effect of stigma on depressive symptoms in people living with HIV. AIDS Behav. 16, 690–699 (2012).

    Article  PubMed  Google Scholar 

  48. Miller, C. T. & Kaiser, C. R. A theoretical perspective on coping with stigma. J. Soc. Issues 57, 73–92 (2001).

    Article  Google Scholar 

  49. McIntosh, R. C. & Rosselli, M. Stress and coping in women living with HIV: a meta-analytic review. AIDS Behav. 16, 2144–2159 (2012).

    Article  PubMed  Google Scholar 

  50. Kadianaki, I. The transformative effects of stigma: coping strategies as meaning-making efforts for immigrants living in Greece. J. Community Appl. Soc. Psychol. 24, 125–138 (2014).

    Article  Google Scholar 

  51. Conn, B. M., de Figueiredo, S., Sherer, S., Mankerian, M. & Iverson, E. ‘Our lives aren’t over’: a strengths‐based perspective on stigma, discrimination, and coping among young parents. J. Adolesc. 66, 91–100 (2018).

    Article  PubMed  Google Scholar 

  52. Seawell, A. H., Cutrona, C. E. & Russell, D. W. The effects of general social support and social support for racial discrimination on african american women’s well-being. J. Black Psychol. 40, 3–26 (2014).

    Article  PubMed  Google Scholar 

  53. Trujillo, M. A., Perrin, P. B., Sutter, M., Tabaac, A. & Benotsch, E. G. The buffering role of social support on the associations among discrimination, mental health, and suicidality in a transgender sample. Int. J. Transgend. 18, 39–52 (2017).

    Article  PubMed  Google Scholar 

  54. Chae, D. H., Lee, S., Lincoln, K. D. & Ihara, E. S. Discrimination, family relationships, and major depression among Asian Americans. J. Immigr. Minor. Health 14, 361–370 (2012).

    Article  PubMed  PubMed Central  Google Scholar 

  55. Fuller, K. A. & Riggs, D. W. Family support and discrimination and their relationship to psychological distress and resilience amongst transgender people. Int. J. Transgend. 19, 379–388 (2018).

    Article  Google Scholar 

  56. Reynolds, J. E. & Gonzales-Backen, M. A. Ethnic-racial socialization and the mental health of African Americans: a critical review. J. Fam. Theory Rev. 9, 182–200 (2017).

    Article  Google Scholar 

  57. Ikram, U. Z. et al. Perceived ethnic discrimination and depressive symptoms: the buffering effects of ethnic identity, religion and ethnic social network. Soc. Psychiatry Psychiatr. Epidemiol. 51, 679–688 (2016).

    Article  PubMed  PubMed Central  Google Scholar 

  58. Marciano, A. & Antebi-Gruszka, N. Offline and online discrimination and mental distress among lesbian, gay, and bisexual individuals: the moderating effect of LGBTQ facebook use. Media Psychol. 25, 27–50 (2022).

    Article  Google Scholar 

  59. Chang, C. et al. The mediating role of perceived social support in the relationship between perceived stigma and depression among individuals diagnosed with substance use disorders. J. Psychiatr. Ment. Health Nurs. 29, 307–316 (2022).

    Article  PubMed  Google Scholar 

  60. Kalb, N., Brodkin, S., Goldstein, A. L. & Gillis, J. R. We’re in this together: LGBQ social identity buffers the homonegative microaggressions–alcohol relationship. J. LGBT Youth 19, 379–395 (2022).

    Article  Google Scholar 

  61. Craney, R. S., Watson, L. B., Brownfield, J. & Flores, M. J. Bisexual women’s discriminatory experiences and psychological distress: exploring the roles of coping and LGBTQ community connectedness. Psychol. Sex. Orientat. Gend. Divers. 5, 324–337 (2018).

    Article  Google Scholar 

  62. Ünsal, B. C., Demetrovics, Z. & Reinhardt, M. Stronger together: community participation, structural stigma, and depression among sexual and gender minority adults in 28 European countries. Soc. Psychiatry Psychiatr. Epidemiol. 58, 657–669 (2023).

    Article  PubMed  Google Scholar 

  63. Velez, B. L. & Moradi, B. A moderated mediation test of minority stress. Couns. Psychol. 44, 1132–1157 (2016).

    Article  Google Scholar 

  64. Watson-Singleton, N. N., Mekawi, Y., Wilkins, K. V. & Jatta, I. F. Racism’s effect on depressive symptoms: examining perseverative cognition and Black Lives Matter activism as moderators. J. Couns. Psychol. 68, 27–37 (2021).

    Article  PubMed  Google Scholar 

  65. Hope, E. C., Velez, G., Offidani-Bertrand, C., Keels, M. & Durkee, M. I. Political activism and mental health among Black and Latinx college students. Cultur. Divers. Ethnic Minor. Psychol. 24, 26–39 (2018).

    Article  PubMed  Google Scholar 

  66. Frost, D. M., Fine, M., Torre, M. E. & Cabana, A. Minority stress, activism, and health in the context of economic precarity: results from a national participatory action survey of lesbian, gay, bisexual, transgender, queer, and gender non‐conforming youth. Am. J. Community Psychol. 63, 511–526 (2019).

    Article  PubMed  Google Scholar 

  67. Major, B., McCoy, S., Kaiser, C. & Quinton, W. Prejudice and self-esteem: a transactional model. Eur. Rev. Soc. Psychol. 14, 77–104 (2003).

    Article  Google Scholar 

  68. Eliezer, D., Major, B. & Mendes, W. B. The costs of caring: gender identification increases threat following exposure to sexism. J. Exp. Soc. Psychol. 46, 159–165 (2010).

    Article  Google Scholar 

  69. McCoy, S. K. & Major, B. Group identification moderates emotional responses to perceived prejudice. Pers. Soc. Psychol. Bull. 29, 1005–1017 (2003).

    Article  PubMed  Google Scholar 

  70. Chae, D. H., Lincoln, K. D. & Jackson, J. S. Discrimination, attribution, and racial group identification: implications for psychological distress among Black Americans in the National Survey of American Life (2001–2003). Am. J. Orthopsychiatry 81, 498–506 (2011).

    Article  PubMed  Google Scholar 

  71. Curll, S. L. & Brown, P. M. Weight stigma and psychological distress: a moderated mediation model of social identification and internalised bias. Body Image 35, 207–216 (2020).

    Article  PubMed  Google Scholar 

  72. Quinn, D. M. & Crocker, J. When ideology hurts: effects of belief in the Protestant ethic and feeling overweight on the psychological well-being of women. J. Pers. Soc. Psychol. 77, 402–414 (1999).

    Article  PubMed  Google Scholar 

  73. Napier, J. L., Suppes, A. & Bettinsoli, M. L. Denial of gender discrimination is associated with better subjective well‐being among women: a system justification account. Eur. J. Soc. Psychol. 50, 1191–1209 (2020).

    Article  Google Scholar 

  74. Suppes, A., Napier, J. L. & van der Toorn, J. The palliative effects of system justification on the health and happiness of lesbian, gay, bisexual, and transgender individuals. Pers. Soc. Psychol. Bull. 45, 372–388 (2019).

    Article  PubMed  Google Scholar 

  75. Platow, M. J., Byrne, L. & Ryan, M. K. Experimentally manipulated high in-group status can buffer personal self-esteem against discrimination. Eur. J. Soc. Psychol. 35, 599–608 (2005).

    Article  Google Scholar 

  76. Schmitt, M. T., Branscombe, N. R., Kobrynowicz, D. & Owen, S. Perceiving discrimination against one’s gender group has different implications for well-being in women and men. Pers. Soc. Psychol. Bull. 28, 197–210 (2002).

    Article  Google Scholar 

  77. Pachankis, J. E. et al. The burden of stigma on health and well-being: a taxonomy of concealment, course, disruptiveness, aesthetics, origin, and peril across 93 stigmas. Pers. Soc. Psychol. Bull. 44, 451–474 (2018).

    Article  PubMed  Google Scholar 

  78. Turan, J. M. et al. Challenges and opportunities in examining and addressing intersectional stigma and health. BMC Med. 17, 7 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  79. Williamson, T. J., Mahmood, Z., Kuhn, T. P. & Thames, A. D. Differential relationships between social adversity and depressive symptoms by HIV status and racial/ethnic identity. Health Psychol. 36, 133–142 (2017).

    Article  PubMed  Google Scholar 

  80. Hatzenbuehler, M. L. in The Oxford Handbook of Stigma, Discrimination, and Health (eds. Major, B. et al.) 105–122 (Oxford Univ. Press, 2017); https://doi.org/10.1093/oxfordhb/9780190243470.013.13

  81. Hatzenbuehler, M. L. Structural stigma: research evidence and implications for psychological science. Am. Psychol. 71, 742–751 (2016).

    Article  PubMed  PubMed Central  Google Scholar 

  82. Reid, A. E., Dovidio, J. F., Ballester, E. & Johnson, B. T. HIV prevention interventions to reduce sexual risk for African Americans: the influence of community-level stigma and psychological processes. Soc. Sci. Med. 103, 118–125 (2014).

    Article  PubMed  PubMed Central  Google Scholar 

  83. Stangl, A. L. et al. The Health Stigma and Discrimination Framework: a global, crosscutting framework to inform research, intervention development, and policy on health-related stigmas. BMC Med. 17, 31 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  84. Ryan, C., Russell, S. T., Huebner, D., Diaz, R. & Sanchez, J. Family acceptance in adolescence and the health of LGBT young adults. J. Child Adolesc. Psychiatr. Nurs. 23, 205–213 (2010).

    Article  PubMed  Google Scholar 

  85. Earnshaw, V. A. et al. Intersectional internalized stigma among Black gay and bisexual men: a longitudinal analysis spanning HIV/sexually transmitted infection diagnosis. J. Health Psychol. 26, 465–476 (2021).

    Article  PubMed  Google Scholar 

  86. Balsam, K. F., Molina, Y., Beadnell, B., Simoni, J. & Walters, K. Measuring multiple minority stress: the LGBT people of color microaggressions scale. Cultur. Divers. Ethnic Minor. Psychol. 17, 163–174 (2011).

    Article  PubMed  PubMed Central  Google Scholar 

  87. Kalichman, S. C., Shkembi, B. & Eaton, L. A. A novel psychometric approach to assessing intersectional HIV stigma: the geometric intersectional stigma scales. J. Behav. Med. 45, 804–811 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  88. Bauer, G. R. et al. Intersectionality in quantitative research: a systematic review of its emergence and applications of theory and methods. SSM Popul. Health 14, 100798 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  89. Bauer, G. R. & Scheim, A. I. Methods for analytic intercategorical intersectionality in quantitative research: discrimination as a mediator of health inequalities. Soc. Sci. Med. 226, 236–245 (2019).

    Article  PubMed  Google Scholar 

  90. Berger, M. & Sarnyai, Z. ‘More than skin deep’: stress neurobiology and mental health consequences of racial discrimination. Stress 18, 1–10 (2015).

    Article  PubMed  Google Scholar 

  91. Nolen-Hoeksema, S., Wisco, B. E. & Lyubomirsky, S. Rethinking rumination. Perspect. Psychol. Sci. 3, 400–424 (2008).

    Article  PubMed  Google Scholar 

  92. Timmins, L., Rimes, K. A. & Rahman, Q. Minority stressors, rumination, and psychological distress in lesbian, gay, and bisexual individuals. Arch. Sex. Behav. 49, 661–680 (2020).

    Article  PubMed  Google Scholar 

  93. Gross, J. J. & Jazaieri, H. Emotion, emotion regulation, and psychopathology. Clin. Psychol. Sci. 2, 387–401 (2014).

    Article  Google Scholar 

  94. Mata-Greve, F. & Torres, L. Ethnic discrimination, sexism, and depression among Latinx women: the roles of anxiety sensitivity and expressive suppression. J. Latinx Psychol. 8, 317–331 (2020).

    Article  Google Scholar 

  95. Abramson, L. Y., Metalsky, G. I. & Alloy, L. B. Hopelessness depression: a theory-based subtype of depression. Psychol. Rev. 96, 358–372 (1989).

    Article  Google Scholar 

  96. Salentine, C. M., Hilt, L. M., Muehlenkamp, J. J. & Ehlinger, P. P. The link between discrimination and worst point suicidal ideation among sexual and gender minority adults. Suicide Life Threat. Behav. 50, 19–28 (2020).

    Article  PubMed  Google Scholar 

  97. Mata-Greve, F. & Torres, L. Examining hopelessness as a link between discrimination and depression among Latinx women: a brief report. Stigma Health 8, 262–265 (2023).

    Article  Google Scholar 

  98. Alang, S., VanHook, C., Judson, J., Ikiroma, A. & Adkins-Jackson, P. B. Police brutality, heightened vigilance, and the mental health of Black adults. Psychol. Violence 12, 211–220 (2022).

    Article  Google Scholar 

  99. Zavaleta, D., Samuel, K. & Mills, C. Measures of social isolation. Soc. Indic. Res. 131, 367–391 (2017).

    Article  Google Scholar 

  100. Pachankis, J. E. et al. Structural stigma and sexual minority men’s depression and suicidality: a multilevel examination of mechanisms and mobility across 48 countries. J. Abnorm. Psychol 130, 713–726 (2021).

    Article  PubMed  Google Scholar 

  101. Hu, T., Zhang, D. & Wang, J. A meta-analysis of the trait resilience and mental health. Pers. Individ. Dif. 76, 18–27 (2015).

    Article  Google Scholar 

  102. Dunn, T. L., Gonzalez, C. A., Costa, A. B., Nardi, H. C. & Iantaffi, A. Does the minority stress model generalize to a non-U.S. sample? An examination of minority stress and resilience on depressive symptomatology among sexual minority men in two urban areas of Brazil. Psychol. Sex. Orientat. Gend. Divers. 1, 117–131 (2014).

    Article  Google Scholar 

  103. Scandurra, C., Amodeo, A. L., Valerio, P., Bochicchio, V. & Frost, D. M. Minority stress, resilience, and mental health: a study of Italian transgender people. J. Soc. Issues 73, 563–585 (2017).

    Article  Google Scholar 

  104. Folkman, S. & Moskowitz, J. T. Coping: pitfalls and promise. Annu. Rev. Psychol. 55, 745–774 (2004).

    Article  PubMed  Google Scholar 

  105. West, L. M., Donovan, R. A. & Roemer, L. Coping with racism: what works and doesn’t work for black women? J. Black Psychol. 36, 331–349 (2010).

    Article  Google Scholar 

  106. Chaudoir, S. R. et al. Coping with HIV stigma: do proactive coping and spiritual peace buffer the effect of stigma on depression? AIDS Behav. 16, 2382–2391 (2012).

    Article  PubMed  Google Scholar 

  107. Pearlin, L. I. & Schooler, C. The structure of coping. J. Health Soc. Behav. 19, 2 (1978).

    Article  PubMed  Google Scholar 

  108. Louie, P. & Upenieks, L. Vicarious discrimination, psychosocial resources, and mental health among Black Americans. Soc. Psychol. Q. 85, 187–209 (2022).

    Article  Google Scholar 

  109. Mosley, A. J. & Branscombe, N. R. Benefit-finding improves well-being among women who have experienced gender discrimination. Sex Roles 84, 404–417 (2021).

    Article  Google Scholar 

  110. Botha, M., Dibb, B. & Frost, D. M. ‘Autism is me’: an investigation of how autistic individuals make sense of autism and stigma. Disabil. Soc. 37, 427–453 (2022).

    Article  Google Scholar 

  111. House, J. S., Umberson, D. & Landis, K. R. Structures and processes of social support. Annu. Rev. Sociol 14, 293–318 (1988).

    Article  Google Scholar 

  112. Molero, F., Silván-Ferrero, P., Fuster-Ruiz de Apodaca, M. J., Nouvilas-Pallejá, E. & Pérez-Garín, D. Subtle and blatant perceived discrimination and well-being in lesbians and gay men in Spain: the role of social support. Psichotema 29, 475–481 (2017).

    Google Scholar 

  113. Frable, D. E. S., Platt, L. & Hoey, S. Concealable stigmas and positive self-perceptions: feeling better around similar others. J. Pers. Soc. Psychol. 74, 909–922 (1998).

    Article  PubMed  Google Scholar 

  114. Frost, D. M. & Meyer, I. H. Measuring community connectedness among diverse sexual minority populations. J. Sex. Res. 49, 36–49 (2012).

    Article  PubMed  Google Scholar 

  115. García-Cid, A., Gómez-Jacinto, L., Hombrados-Mendieta, I., Millán-Franco, M. & Moscato, G. Discrimination and psychosocial well-being of migrants in Spain: the moderating role of sense of community. Front. Psychol. 11, 2235 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  116. Ramirez-Valles, J., Fergus, S., Reisen, C. A., Poppen, P. J. & Zea, M. C. Confronting stigma: community involvement and psychological well-being among HIV-positive Latino gay men. Hisp. J. Behav. Sci. 27, 101–119 (2005).

    Article  Google Scholar 

  117. van Zomeren, M. & Iyer, A. Introduction to the social and psychological dynamics of collective action. J. Soc. Issues 65, 645–660 (2009).

    Article  Google Scholar 

  118. Jost, J. T. & Brenda, M. in The Psychology of Legitimacy: Emerging Perspectives on Ideology, Justice, and Intergroup Relations (eds. Jost, J. T. & Major, B.) 3–30 (Cambridge Univ. Press, 2001).

  119. Hansen, N. & Sassenberg, K. Exploring the self-directed anger of the stigmatized. Group Process. Intergroup Relat. 14, 807–818 (2011).

    Article  Google Scholar 

  120. Jones, E. et al. Social Stigma. The Psychology of Marked Relationships (Freeman, 1984).

  121. Major, B. et al. Perceiving personal discrimination: the role of group status and legitimizing ideology. J. Pers. Soc. Psychol. 82, 269–282 (2002).

    Article  PubMed  Google Scholar 

  122. Kerbo, H. R. Social Stratification and Inequality: Class Conflict in Historical and Global Perspective (McGraw-Hill, 2003).

  123. Jiang, S. & Dong, L. The effects of teacher discrimination on depression among migrant adolescents: mediated by school engagement and moderated by poverty status. J. Affect. Disord. 275, 260–267 (2020).

    Article  PubMed  Google Scholar 

  124. Goldberg, A. E. & Smith, J. Z. Stigma, social context, and mental health: lesbian and gay couples across the transition to adoptive parenthood. J. Couns. Psychol. 58, 139–150 (2011).

    Article  PubMed  PubMed Central  Google Scholar 

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  1. Social Research Institute, University College London, London, UK

    David M. Frost & Diego Castro

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  1. David M. Frost
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  2. Diego Castro
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D.M.F. conceptualized an earlier version of the model presented in this paper. Both authors contributed equally to the refinement of the model, development of the aims, review of the literature and writing of the paper.

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Correspondence to David M. Frost.

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Frost, D.M., Castro, D. An integrated understanding of the mechanisms linking social stigma to mental health among marginalized populations. Nat. Mental Health 2, 645–654 (2024). https://doi.org/10.1038/s44220-024-00264-8

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