Self and Identity

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Evidence that anticipated stigma predicts poorer

depressive symptom trajectories among emerging
adults living with concealable stigmatized
identities

Stephenie R. Chaudoir & Diane M. Quinn

To cite this article: Stephenie R. Chaudoir & Diane M. Quinn (2015): Evidence that anticipated
stigma predicts poorer depressive symptom trajectories among emerging adults living with
concealable stigmatized identities, Self and Identity, DOI: 10.1080/15298868.2015.1091378

To link to this article: http://dx.doi.org/10.1080/15298868.2015.1091378

Published online: 10 Nov 2015.

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 Self and Identity, 2015
http://dx.doi.org/10.1080/15298868.2015.1091378

Evidence that anticipated stigma predicts poorer depressive

symptom trajectories among emerging adults living with
concealable stigmatized identities
Stephenie R. Chaudoira and Diane M. Quinnb
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a
Department of Psychology, College of the Holy Cross, Worcester, MA, USA; bDepartment of Psychology,
University of Connecticut, Storrs, CT, USA

ABSTRACT ARTICLE HISTORY

People living with concealable stigmatized identities are vulnerable Received 11 February 2015
to experiencing greater depressive symptoms as a result of occupying Accepted 1 September 2015
a lower social status. In the present research, we examine the effect KEY WORDS
of changes in enacted stigma and changes in anticipated stigma Concealable stigmatized
on trajectories of depressive symptoms over time. A sample of 192 identities; anticipated stigma;
college-aged emerging adults (81.0% female, 81.9% Caucasian, enacted stigma; depressive
Mage = 18.82 years) living with a concealable stigmatized identity (e.g., symptoms
mental illness and sexual minority status) completed measures of
enacted stigma, anticipated stigma, and depressive symptoms at two
time points across eight weeks. Hierarchical linear modeling analyses
indicate that increases in anticipated stigma, but not enacted stigma,
predicted poorer trajectories of depressive symptoms, controlling for
the effect of baseline rumination and other identity-related variables.
These data are among the first to demonstrate that worries about
future devaluation predict poorer depressive symptom trajectories
over time among college-aged emerging adults.

Millions of Americans live with concealable stigmatized identities—socially devalued attrib-

utes that can be hidden from others (Quinn & Chaudoir, 2009; Quinn et al., 2014). Though they
differ in etiology and course, identities such as mental illness, drug and alcohol addiction,
and sexual minority status share the common social experience of being “discreditable”—a
social predicament in which individuals must face ongoing complexities in managing infor-
mation about their devalued attribute (Goffman, 1963). Because these attributes can confer
a lower social status, people living with concealable stigmatized identities are vulnerable
to experiencing actual discrimination, termed enacted stigma, and expectations of future
discrimination, termed anticipated stigma—both of which have been associated with greater
psychological distress (Meyer, 2003; Scambler & Hopkins, 1986). While a considerable amount
of research evidences the effect of acute stigmatization on situational psychological distress
(for reviews, see Pascoe & Smart Richman, 2009; Schmitt, Branscombe, Postmes, & Garcia,
2014), there is a dearth of information about the effect of enacted stigma and, especially,
the effect of anticipated stigma on trait depressive symptoms across time. The purpose of

CONTACT  Stephenie R. Chaudoir  schaudoi@holycross.edu   

© 2015 Taylor & Francis
 2    S. R. Chaudoir and D. M. Quinn

the current research is to address these gaps and examine the effect of enacted stigma and
anticipated stigma on depressive symptoms across time among college-aged emerging
adults living with concealable stigmatized identities.

Concealable stigmatized identities and psychological distress

By definition, possession of a concealable stigmatized identity places individuals in a lower
power social status which confers risk for experiencing institutional and interpersonal forms
of subordination (Fiske, 1993; Link & Phelan, 2001). As result of living in a social milieu that
confers social devaluation, people living with concealable stigmatized identities come to
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adopt a set of beliefs about their personal vulnerability to stigmatization (Link & Phelan,
2001; Vogel, Bitman, Hammer, & Wade, 2013). Enacted stigma (Herek, 2007; Scambler &
Hopkins, 1986, also commonly termed perceived discrimination, Schmitt et al., 2014) is the
degree to which people perceive that they have been targets of discrimination in the past.
In contrast, anticipated stigma (Quinn & Chaudoir, 2009; Quinn et al., 2014, also commonly
termed felt stigma, Herek, 2007; Scambler & Hopkins, 1986) is the degree to which people
perceive that they will be targets of discrimination in the future.
Unlike situational instances of discrimination that momentarily threaten self-worth,
enacted and anticipated stigma provide chronic reminders of one’s subordinate social stand-
ing and relative social disenfranchisement (Scambler & Hopkins, 1986). As such, knowledge
that one has been a target of discrimination or will be in the future may act as chronic stress-
ors that have deleterious effects on psychological distress over time (Major & O’Brien, 2005;
Meyer, 2003). Moreover, the effect of these stigma-related stressors on psychological distress
may be particularly strong during emerging adulthood (ages 18–29), a critical period of
identity development where social belonging concerns are most pronounced (Arnett, 2000).
A number of studies indicate that trait enacted stigma has a deleterious effect on psycho-
logical distress over time among people living with concealable stigmatized identities. For
example, sexual minority adolescents who experience greater rates of discrimination also
prospectively experienced greater depressive symptoms and suicidality at a six-month fol-
low-up (Burton, Marshal, Chisolm, Sucato, & Friedman, 2013). Similarly, among parents of a
special needs child, enacted stigma at baseline predicted greater depression at a four-month
follow-up, controlling for baseline depression (Mickelson, 2001). The effect of enacted stigma
on depressive symptoms among adults living with mental illness has, however, been mixed,
with some evidence finding support (Ilic et al., 2013) and other evidence finding no support
(Lysaker et al., 2012). By and large, these findings are in line with meta-analytic research demon-
strating that trait enacted stigma is related to greater psychological distress across multiple
types of visible and concealable stigmas (Pascoe & Smart Richman, 2009; Schmitt et al., 2014).
However, significantly fewer studies have examined the effect of anticipated stigma on
psychological distress and almost all of these studies have adopted cross-sectional method-
ology which constrains causal inferences. For instance, in a cross-sectional study of emerg-
ing adult college students living with a variety of concealable stigmatized identities (e.g.,
mental illness and drug/alcohol addiction), anticipated stigma predicted greater depressive
symptoms and anxiety (Quinn & Chaudoir, 2009). Additional cross-sectional studies have
demonstrated a similar pattern of effects among adults living with mental illness, substance
abuse, experience of domestic violence, experience of sexual assault, experience of child-
hood abuse (Quinn et al., 2014), concealable chronic illnesses (e.g., inflammatory bowel
 Self and Identity   3

disease; Earnshaw, Quinn, & Park, 2012), and HIV/AIDS (Earnshaw, Smith, Chaudoir, Amico,
& Copenhaver, 2013).
This dearth of available evidence is limiting because anticipated stigma may be particularly
deleterious to psychological well-being. Most concealable stigmatized identities such as men-
tal illness are acquired or, in the case of sexual minority status, are realized during late adoles-
cence or early adulthood (National Institute of Mental Health, 2015; Shilo & Savaya, 2011). The
relatively late developmental onset of these stigmatizing labels means that many emerging
adults living with CSIs have lived much of their lives as dominant group members who have
likely been socialized to endorse negative stereotypes and even participate in discriminatory
behaviors themselves. Thus, people living with CSIs are in a unique position to have partici-
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pated in the subordination of members of a group to which they now belong—experiences

that likely magnify their concerns about future devaluation. Furthermore, personal experiences
of discrimination (e.g., discriminatory hiring practices; Quinn, Williams, & Weisz, 2015), micro-
aggressions (e.g., family recommendations to conceal HIV-positive status; Stutterheim et al.,
2009), and vicarious discrimination (e.g., over-hearing negative stereotypes; Quinn, 2006; Wahl,
1999) can each increase the perception that future marginalization is likely and imminent.
As the cumulative cognitive residue of past life experiences, anticipated stigma continues
to threaten well-being long after the specific experience has ended. Indeed, in one of the
earliest studies examining the effects of living with the concealable stigmatized identity of
epilepsy, participants noted that their fears of future discrimination created more depressive
symptoms (e.g., sadness) than did experiences of past discrimination (Scambler & Hopkins,
1986). However, few quantitative studies have offered a comparative test of this possibility.
Moreover, very few studies have examined the effect of enacted stigma and anticipated
stigma on trajectories of depressive symptoms across time. Emerging adulthood is char-
acterized by multiple types of depressive symptom trajectories—with some individuals
experiencing no change, some experiencing increased symptoms, and some experiencing
decreased symptoms—as a result of their unique cognitive and emotional processing styles
and discrete life events (e.g., Prinzie, van Harten, Deković, van den Akker, & Shiner, 2014;
Wickrama, Conger, Lorenz, & Jung, 2008). Enacted stigma or anticipated stigma attributable
to a concealable stigmatized identity could, therefore, have deleterious effects on depres-
sive symptoms by modifying their underlying trajectory. If individuals are experiencing an
underlying increase in depressive symptoms, stigma beliefs could accelerate the rate of this
increase. In contrast, if individuals are experiencing an underlying decrease in depressive
symptoms, stigma beliefs could decelerate the rate of this decrease.
To our knowledge, only one study has examined the longitudinal effect of enacted stigma
and anticipated stigma on psychological distress. In it, researchers asked a sample of 74 mid-
dle-aged adult gay men to report enacted stigma in the past year, current anticipated stigma,
and depressive symptoms across an 18-month follow-up in the aftermath of having lost their
romantic partner to AIDS. Although participants experienced an overall decline in depressive
symptoms in the aftermath of this significant life stressor, increases in anticipated stigma
during the follow-up period predicted a slower rate of decline in depressive symptoms
(Hatzenbuehler, Nolen-Hoeksema, & Erickson, 2008). In contrast, changes in enacted stigma
during this same time period had no effect on the rate of decline in depressive symptoms.
In other words, the rate at which depressive symptoms subsided following the death of a
loved one was slower among people who experienced increases in sexual minority-related
anticipated stigma during this same time period.
 4    S. R. Chaudoir and D. M. Quinn

Present study
The purpose of the present research is to examine the effect of changes in enacted and
anticipated stigma on depressive symptoms over time among a sample of emerging adults
living with a variety of concealable stigmatized identities. Given the considerable dearth of
evidence examining the prospective effects of anticipated stigma on depressive symptoms,
the present provides critical new data. Moreover, this is the first study to examine the pro-
spective and comparative effects of anticipated stigma and enacted stigma among people
living with a wide array of concealable stigmatized identities during emerging adulthood,
a critical period of development where stigma-related concerns may be particularly conse-
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quential for depressive symptoms and people are most likely to experience their first major
depressive episode.
Enacted stigma and anticipated stigma are dynamic beliefs that fluctuate in response
to changes in the surrounding social milieu. As such, changes in these beliefs over time—
rather than the relative strength of the beliefs—would be expected to predict changes in
depressive symptoms over time. Based on findings from previous research (Hatzenbuehler
et al., 2008), we hypothesized that increases in anticipated stigma would predict poorer
depressive symptom trajectories across and eight-week follow-up.
Moreover, extending previous research, we also controlled for the effect of rumination—a
dispositional cognitive processing style in which individuals disproportionately focus atten-
tion on negative experiences and emotions (Nolen-Hoeksema, 1991). Past cross-sectional
research has shown that rumination is a strong predictor of depressive symptoms among
people living with concealable stigmatized identities (Quinn & Chaudoir, 2009), introducing
the possibility that rumination may also act as unmeasured third variable affecting depressive
symptom trajectories across time. As a result, we control for baseline rumination in the present
study. Because the effect of baseline rumination on depressive symptom trajectories has been
mixed in past research among similar non-clinical participant samples (Bjornsson et al., 2010;
Verstraeten, Vasey, Raes, & Bijttebier, 2010; Wilkinson, Croudace, & Goodyer, 2013), we had no
a priori hypotheses about the direction of the present effects.

Method
Participants
Our sample of emerging adults consisted of undergraduate students at the University of
Connecticut during Spring and Fall semesters of 2008. A total of 256 participants enrolled
and indicated their informed consent for participation. The maximum available sample size
was employed. Only participants who indicated having a concealable stigmatized identity
at Time 1 (N = 210) were retained for the current analyses. Participants were predominantly
female (170; 81.0%), Caucasian (172; 81.9%), and the mean age was 18.82 years (SD = 1.09).
Analyses utilize data from the 192 participants who completed both Time 1 and Time 2
surveys (i.e., 91% retention rate).

Procedure
In order to be eligible to enroll in this study, students had to indicate during a mass pre-
screening session that at least one of the thirteen concealable stigmatized identities (e.g.,
 Self and Identity   5

Table 1. Frequency and cultural stigma ratings for concealable stigmatized identities (N = 192).
Identity N (%) Cultural stigma rating
Drug use 8 (4.2) 6.38
Sex-related activity 2 (1.0) 6.29
Mental illness 49 (25.5) 5.29
Weight/appearance concerns 85 (44.3) 5.19
Sexual minority 9 (4.7) 4.94
Family addiction 5 (2.6) 4.80
Abusive family 10 (5.2) 4.88
Childhood sexual abuse 9 (4.7) 4.38
Sexual assault 11 (5.7) 4.37
Hidden medical conditions 4 (2.1) 4.10
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mental illness, history of childhood sexual abuse, etc.; see Table 1 for a full list) applied to
them. Eligible participants were then invited to complete an online longitudinal survey
examining “experiences of having a hidden identity” in exchange for partial course credit.
At baseline (Time 1), participants were first asked to describe their concealable stigmatized
identity and then complete a battery of questionnaires including measures of depression,
anticipated stigma, and enacted stigma. At the eight-week follow-up (Time 2), participants
were asked to complete the same battery of questionnaires again. Covariate measures of
rumination, length of time living with the attribute, and openness were also collected in addi-
tion to several measures not described herein (e.g., disclosure goals). All study procedures
were approved by and conducted in compliance with the institution’s Internal Review Board.

Measures
Concealable stigmatized identity
Consistent with previous research (Quinn & Chaudoir, 2009), we first reminded participants
that they were selected because they had indicated in the prescreening that they had some-
thing about themselves that they regularly kept hidden. Participants were then asked to
describe their identity in their own words and were told that if they had multiple concealable
identities, they should choose only one on which to report.
Two raters coded the open-ended responses into one of the following 10 categories (see
Table 1): Drug use, sexually related activity (e.g., fetishes and affairs), mental illness (e.g.,
depression and obsessive compulsive disorder), weight/appearance concerns (e.g., eating
disorder and preoccupation with dieting or exercise), sexual minority status (e.g., gay and
lesbian), family member with drug or alcohol addiction, history of childhood physical abuse,
history of childhood sexual abuse, history of rape/sexual assault, or concealable medical
condition (e.g., diabetes and epilepsy). Incomplete responses and those that were not con-
cealable stigmatized identities (e.g., death of a family member) were identified as “uncodable.”
Inter-rater reliability was high (κ = .90) and discrepancies were resolved through discussion.

Depressive symptoms
We utilized the 20-item Center for Epidemiologic Studies-Depression (Radloff, 1977) scale to
assess depressive symptoms. Participants were asked to indicate the extent to which they
felt each symptom (e.g., “I felt that everything I did was an effort.”) during the past week on
a scale from 0 (Rarely or none of the time) to 3 (Most or all of the time). A mean score was
calculated at both time points (α = .88 and .92).
 6    S. R. Chaudoir and D. M. Quinn

Anticipated stigma
Participants completed a 15-item scale asking them to indicate the likelihood that stigmatiz-
ing events (e.g., “Getting poorer service than others do at restaurants or stores”) would occur
if others knew about their concealed identity (1 = not at all likely and 7 = very likely). The
scale was adapted from the “day-to-day” discrimination scale (Kessler, Mickelson, & Williams,
1999) and also included six additional items we thought would be likely to capture the type
of social devaluation about which college students would be concerned (e.g., “People not
wanting to date you”). A mean score was calculated at both time points (αs = .94 and .96).
Because we were interested in examining dynamic change in anticipated stigma across time,
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we created residual change scores. To do so, we conducted a hierarchical linear modeling

(HLM) analysis where the Level-1 model included the predictor of time (0 = Time 1; 1 = Time
2) and the Level-2 model included only the intercept and error terms. Residual estimates
were saved from this analysis and used as predictors in the subsequent study analysis (for
a related example, see Kendler et al., 2011).

Enacted stigma
Participants were asked to indicate whether each of the 15 items used in the anticipated
stigma scale had actually happened to them in their lifetime due to their concealed identity.
At each time point, a sum score was created (range: 0–15), indicating the total number of
types of stigmatizing experiences that have happened to them in the past. Consistent with
previous research demonstrating relatively modest increases in enacted stigma across time
(Hatzenbuehler et al., 2008), only 29.1% of the participants reported an increase in enacted
stigma during the eight-week duration of the study. Because of this limited variability, we
were unable to utilize the residual change score strategy noted above. Therefore, we created
a dummy-coded variable to represent an increase in total enacted stigma over time (0 = no;
1 = yes).

Rumination
In order to control for the effect of cognitive rumination style—a measure that has been
demonstrated to predict depressive symptoms in past research (Aldao, Nolen-Hoeksema, &
Schweizer, 2010)—participants completed the five-item brooding subscale of the Ruminative
Responses Style scale (Treynor, Gonzalez, & Nolen-Hoeksema, 2003). Participants rated items
such as “Think ‘Why do I have problems other people don’t have?’” on a 1 (almost never) to
4 (almost always) scale. A mean score was calculated (α = .86).

Additional covariate measures

We also collected information about identity-relevant information that may impact
change in depressive symptoms over time. Participants were asked to indicate the
length of time (in months) they had been living with their identity. Participants were
also asked to indicate their relative degree of openness at both time points with an
item asking “Overall, how many people know about your concealed identity?” (1 = no
one; 7 = everyone).
Finally, in order to control for the possibility that the degree of cultural stigma, relative
social devaluation associated with each identity, predicts changes in depressive symptoms
over time, we utilized cultural stigma ratings collected in previous research collected within
one year of the present data (Quinn & Chaudoir, 2009). These ratings were obtained from a
 Self and Identity   7

sample of 114 students at the same institution who were asked to rate each of the conceal-
able stigmatized identities (i.e., “How do you think people with this identity are generally
viewed by others?”) on a 1 (very positive) to 7 (very negative) scale. Presentation of the iden-
tities was randomized across participants. The rater reliability (ICC = .99) was high (Shrout &
Fleiss, 1979) and we used the mean rating of each identity as our measure of cultural stigma.

Data analysis approach

We used HLM (Raudenbush & Bryk, 2001) analyses with full maximum likelihood estimation
to examine the degree to which rates of change in depressive symptoms are predicted by
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changes in enacted stigma, anticipated stigma, and covariate measures. The HLM analysis
includes two levels.
Level 1 represents within-person change in depressive symptoms over time. The Level-1
model was specified as:
( )
Yij = 𝛽0j + 𝛽1j ∗ Timeij + rij

where Yij is the depressive symptom at time i (0 = Time 1; 1 = Time 2) for individual j (1 …
192); β0j is the intercept and β1j is the rate of change between Time 1 and Time 2 for individ-
ual j; and rij is the error at time i for individual j. With only two time points of data collection,
HLM analysis would fit a perfect regression line and be unable to estimate measurement
error unless additional information about the outcome measure is added to the model.
Therefore, we use a parallel scales approach (Barnett, Marshall, Raudenbush, & Brennan, 1993)
in order to divide the 10-item depressive symptoms scale into two parallel 5-item measures
of depressive symptoms with similar variability and reliability so that each person has two
outcome measures at Time 1 and Time 2.
Level 2 represents the between-person factors that affect the trajectory of depressive
symptoms. The Level-2 model was specified as:
( ) ( )
𝛽0j = 𝛾00 + 𝛾01 ∗ Enacted Stigma Changej + 𝛾02 ∗ Anticipated Stigma Changej
( ) ( ) ( ) ( )
+ 𝛾03 ∗ Ruminationj + 𝛾04 ∗ Cultural Stigmaj + 𝛾05 ∗ Opennessj + 𝛾06 ∗ Length of Timej + u0j

( ) ( )
𝛽1j = 𝛾10 + 𝛾11 ∗ Enacted Stigma Changej + 𝛾12 ∗ Anticipated Stigma Changej
( ) ( ) ( ) ( )
+ 𝛾13 ∗ Ruminationj + 𝛾14 ∗ Cultural Stigmaj + 𝛾15 ∗ Opennessj + 𝛾16 ∗ Length of Timej + u1j

where γ00 through γ06 represent the effect of the predictor variables on the individual
intercepts; γ10 through γ16 represent the effect of the predictor variables on the individual
rates of change between Time 1 and Time 2; and u0j and u1j represent residual variances.
Enacted stigma was dummy coded (0 = no change from Time 1; 1 = increase from Time
1), anticipated stigma was a standardized residual, and the rumination, cultural stigma,
openness, and length of time living with the identity were Time 1 covariates. In order to
improve interpretability of results (Hox, 2010), all Time 1 covariates (i.e., rumination, cul-
tural stigma, openness, and length of time living with the identity) were centered around
their mean.
 8    S. R. Chaudoir and D. M. Quinn

Table 2. Means and standard deviations of study variables at each time point (N = 192).
Time 1 Time 2
Anticipated stigma 2.63 (1.34) 2.53 (1.41)
Enacted stigma 1.78 (2.36) 1.62 (2.36)
Depressive symptoms 0.96 (0.58) 0.81 (0.54)
Sum scores 19.03 (11.38) 16.16 (10.79)
Rumination 2.27 (0.78) n/a
Cultural stigma 5.13 (0.42) n/a
Length of time 61.07 (45.62) n/a
Openness 3.11 (1.40) n/a
Notes: Cultural stigma, anticipated stigma, and openness were assessed on a 1–7 scale. Enacted stigma was assessed on a
0–15 scale. Rumination was assessed on a 1–4 scale. Depressive symptoms were assessed on a 0–3 scale.
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Table 3. Correlations among study predictors and covariates (N = 192).

1. 2. 3. 4. 5. 6.
1. Enacted stigma
2. Anticipated stigma .13†
3. Depressive symptoms .07 .07
4. Cultural stigma .03 .09 .17*
5. Rumination .10 .08 .64** .12
6. Length of time −.07 .11 −.10 −.28** −.15*
7. Openness .04 .00 −.07 −.14† −.04 −.01
Notes: Correlations with depressive symptoms, cultural stigma, rumination, length of time, and openness utilize Time 1
values. †p < .10; *p < .05; **p < .01.

Results
Descriptive statistics
Please see Table 2 for the means and standard deviations of study variables across Times 1
and 2. On average, participants in this sample possess concealable stigmatized identities that
were each viewed negatively (i.e., all cultural stigma ratings were above the scale midpoint).
Time 1 self-reported anticipated and enacted stigma levels were low relative to the scaling of
these respective measures. Furthermore, participants reported average Time 1 openness levels
that were at or below the scale midpoint,1 but average rumination levels that were above the
scale midpoint. Additionally, we found that 55.7% of our sample met scale criteria (i.e., score
of 16 or greater; Lewinsohn, Seeley, Roberts, & Allen, 1997) to be considered at risk for clinical
depression at Time 1. Time 1 mean levels of anticipated stigma and depressive symptoms were
similar to levels reported in previous research with college-aged emerging adult samples
(Quinn & Chaudoir, 2009). Bivariate correlations among study variables are provided in Table 3.
Although we had a relatively low attrition rate, we examined the possibility that partici-
pants who were lost to follow-up were different than those who were retained at Time 2 on
our main study variables. There were no differences between these two groups of participants
on any Time 1 variable, except that participants who were lost to follow-up report less Time
1 openness than participants who completed both surveys, t(201) = −2.09, p < .05, d = .52.

HLM analyses
We first tested the average growth model (i.e., unconditional model) in order to deter-
mine whether the average depressive symptoms’ intercept and slope differed from zero
(i.e., fixed effects) and whether there was variability in the average intercept and slope
 Self and Identity   9

Table 4.  Unstandardized coefficients and standard errors for predictors of change in depressive
­symptoms (N = 192).
Predictors B (SE)
Time 1 depressive symptoms
Intercept 0.96 (0.04)***
Enacted stigma 0.01 (0.08)
Anticipated stigma 0.006 (0.03)
Rumination 0.47 (0.04)***
Cultural stigma 0.13 (0.08)
Length of time 0.0001 (0.0007)
Openness −0.01 (0.02)
Rate of change in depressive symptoms
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Intercept −0.17 (0.03)***

Enacted stigma 0.09 (0.08)
Anticipated stigma 0.08 (0.03)*
Rumination −0.21 (0.05)***
Cultural stigma 0.01 (0.08)
Length of time 0.001 (0.0008)
Openness −0.02 (0.03)
Notes: Enacted stigma (increase), 0 = no; 1 = yes.
*p < .05; ***p < .001.

0.9
Depressive Symptoms

0.8 -1 SD Anticipated Stigma

Change

0.7 +1 SD Anticipated Stigma

Change

0.6

0.5
Time 1 Time 2

Figure 1. Depressive symptom trajectories as a function of change in anticipated stigma. Predicted values
were computed at 1 SD below and above the mean between-participant standard deviation of change
in anticipated stigma.

(i.e., random effects) that could be explained by our between-person predictors and covar-
iates. We found that the average baseline level of depressive symptoms of 1.96 (SD = .58)
was significantly different than zero, t(191) = 46.67, p < .001, and that there was a significant
decline in depressive symptoms over time for this sample, B = −.15, SE = .04, t(191) = −4.08,
p < .001. Furthermore, we found that there was significant variability in both the intercept, var-
iance = .31, χ2(191) = 1988.88, p < .001 and the slope, variance = .20, χ2(191) = 789.04, p < .001.
We then tested a model estimating the change over time in depressive symptoms using
the predictors of anticipated stigma, enacted stigma, and our covariates (rumination, open-
ness, length of time, and cultural stigma). See Table 4 for full results. Time 1 rumination
predicted higher baseline levels of depressive symptoms, B = .47, SE = .04, p < .001. No other
variables were significant, all p-values > .11. On average, this sample exhibited a decrease
 10    S. R. Chaudoir and D. M. Quinn

in depressive symptoms over time and baseline rumination predicted a stronger rate of
decline. However, controlling for the effect of Time 1 rumination, cultural stigma, length of
time, and openness, change in anticipated stigma, B = .08, SE = .03, p = .02, but not enacted
stigma, B = .09, SE = .08, p = .29, predicted a slower rate of decline in depressive symptoms
(see Figure 1). Using a nested model comparison approach to estimate effect sizes (Hox,
2010), anticipated stigma accounted for 3.96% of between-person variance and the full
model explained 21.48% of between-person variance in change in depressive symptoms.

Discussion
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As a result of living in social climates that devalue them, people living with concealable stig-
matized identities maintain beliefs about their personal experience of past discrimination
and continued vulnerability to future discrimination. The purpose of this study was to exam-
ine the association between changes in enacted and anticipated stigma and trajectories of
depressive symptoms across time among college-aged emerging adults living with a variety
of concealable stigmatized identities. We found that increases in anticipated stigma, but not
enacted stigma, predicted a slower rate of decline in depressive symptoms eight weeks later.
Our findings support the hypothesis that increases in anticipated stigma are deleteri-
ous to psychological well-being over time. These findings extend cross-sectional research
demonstrating the deleterious effect of anticipated stigma on depressive symptoms among
college-aged emerging adults (Quinn & Chaudoir, 2009) and adult community members
(Quinn et al., 2014) living with a variety of concealable stigmatized identities. In the only
extant longitudinal and comparative study of the effect of enacted stigma and anticipated
stigma on depressive symptoms, Hatzenbuehler et al. (2008) found that anticipated stigma,
but not enacted stigma, predicted a slower rate of decline in depressive symptoms among
bereaved middle-aged adult gay men. Our findings are consistent with this previous research
and extend the generalizability of these findings to an emerging adult sample with a wider
array of concealable stigmatized identities. Moreover, by controlling for rumination—a cog-
nitive processing style strongly related to depressive symptoms—we were able to extend
these findings and rule out the possibility that the effect of anticipated stigma and the null
effect of enacted stigma were merely attributable to cognitive rumination.
Our findings underscore the importance of broadening current empirical attention to
measure the effect of both past experiences of discrimination and chronic worries about
future discrimination on psychological well-being. Indeed, such an argument was offered
several decades ago (Scambler, 1989; Scambler & Hopkins, 1986), yet has received rela-
tively little attention in psychological research. To date, the vast majority of psychological
research—including research focused solely on concealable stigmatized identities—(e.g.,
Burton et al., 2013; Mickelson, 2001) has assessed the effect of enacted stigma and ignored
the effect of anticipated stigma (Pascoe & Smart Richman, 2009; Schmitt et al., 2014).
Therefore, our findings suggest that the assessment of multiple manifestations of stig-
matization—such as enacted stigma, anticipated stigma, and internalized stigma (Earnshaw
& Chaudoir, 2009; Herek, 2007; Quinn et al., 2015)—will enable future research to better
understand how different types of chronic stigma-related stressors impact psychological
well-being over time. Future research that examines these hypotheses among a more racially
and socioeconomically diverse and gender-balanced sample will also strengthen the gen-
eralizability of the present findings. Furthermore, additional research that utilizes multiple
 Self and Identity   11

assessments across time or adopts a longer follow-up period will provide additional insight
into the long-term effects of stigma on depressive symptoms. Research that adopts a longer
follow-up period will be particularly important in order to understand the effect of enacted
stigma across time. In order for participants to increase in enacted stigma in the present
study, they would have needed to experience one of the fifteen discrimination scenarios
for the first time within the eight-week follow-up period. Therefore, future studies assessing
enacted stigma over a longer period of months or years—perhaps using measures that assess
the frequency of discrimination experiences—is needed.
Individuals living with concealable stigmatized identities contend with multiple stig-
ma-related stressors over the life course. The present findings suggest that managing chronic
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expectations of future discrimination—the cognitive residue of living in socially devaluing

contexts—are particularly pernicious for psychological well-being. More broadly, because
all individuals living with stigmatized identities likely harbor some degree of concern about
future discrimination, the present data may also have implications for understanding the
psychological costs of managing a stigmatized attribute, regardless of its concealability.
Given these costs, psychosocial stress reduction interventions that improve the ability of
individuals living with concealable—and perhaps, visible—stigmatized identities to cope
effectively with anticipated stigma concerns may also provide the psychological means to
mitigate these deleterious effects for well-being.

Author note
Thanks to Aline Sayer, Holly Laws, and Alison Ludden for their assistance with analyses, and
Norma Gomez and Stefania Khoda for help with manuscript preparation. Data collection was
supported by a University of Connecticut Research Foundation Faculty Grant awarded to the
second author. Manuscript preparation was supported in part by the Robert L. Ardizzone
Fund for Junior Faculty Excellence, College of the Holy Cross.

Disclosure statement
No potential conflict of interest was reported by the authors.

Note
1. 
Participants who reported having concerns about weight and appearance reported an openness
level slightly below that of the rest of the sample (M = 2.85, SD = 1.34 vs. M = 3.39, SD = 1.46),
corroborating our assertion that participants were reporting on a concealable, rather than a
visible identity (i.e., concerns about weight/appearance rather than weight/appearance per se).

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