Abstract
Previous research suggests that chronic illnesses can elicit stigma, even when those illnesses are concealable. Such stigmatization is assumed to lead to a stigmatized identity. Additionally, chronic illness affects one's self-concept, as one reconstructs a sense of self with illness incorporated. However, no research has examined the interplay between stigma and self-concept in those with concealable chronic illnesses. Therefore, we investigated the extent to which experienced, anticipated, and internalized stigma are associated with illness self-concept in individuals living with concealable chronic illnesses. Furthermore, we explored if the aforementioned aspects of stigma are associated with enrichment in the self-concept in the same cohort. An online correlational survey of people with concealable chronic illness (N = 446). Participants completed self-report measures of chronic illness-specific measures of stigma and illness self-concept, both negative and positive. Results indicated that there is a positive relationship between experienced, anticipated, and internalized stigma and illness self-concept, indicating that stigma is associated with increased preoccupation and perceived impact of one's illness on the self. Although there is also a negative relationship between anticipated and internalized stigma and enrichment, only internalized stigma is associated with enrichment over and above the effects of control variables such as personal control. Our findings bridge the existing literature on illness self-concept and stigma for chronic illness groups, with a specific focus on those with concealable chronic illnesses. More varied approaches to coping with illness should be encouraged, including encouraging enrichment aspects to potentially act as a buffer between the effects of stigma and illness self-concept.
Highlights
Every individual has a varied sense of self-concept, comprising aspects of their identity that they choose such as their profession, and ones that they are born into such as their nationality (Tajfel & Turner, 1979)
According to O’Brien (2007), tolerance statistics < .20 and variation inflation factors (VIF) > 5 are both deemed as problematic levels of multicollinearity
As the tolerance statistics for the three stigma variables ranged from .31 to .39 and the VIF ranged from 2.60 to 3.21, the analysis did not indicate problematic multicollinearity between the aspects of stigma
Summary
Every individual has a varied sense of self-concept, comprising aspects of their identity that they choose such as their profession, and ones that they are born into such as their nationality (Tajfel & Turner, 1979). The empirical literature suggests that such a diagnosis, even when the illness is concealable, can have a stigmatizing effect (Quinn & Earnshaw, 2013), in that others view the person as different in a negative manner, due to being ‘ill’ (Goffman, 1963). There is an effect of chronic illness on the self-concept: The person must acclimatize to a new idea of self when this illness is taken into account (Ferro & Boyle, 2013). Not much is currently known about how these two illness-specific processes might impact each other, or essentially how chronic illness-related stigma might be associated with illness self-concept in those with concealable chronic illnesses. We address this gap by investigating the extent to which three aspects of stigma are associated with illness self-concept, in both negative and positive ways
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