“Discredited” Versus “Discreditable”: Understanding How Shared and Unique Stigma Mechanisms Affect Psychological and Physical Health Disparities

Abstract

In his classic treatise, Goffman (1963) delineates between people who are discredited—whose stigma is clearly known or visible—and people who are discreditable—whose stigma is unknown and can be concealable. To what extent has research in the past 50 years advanced Goffman’s original ideas regarding the impact of concealability on stigma management strategies and outcomes? In the current article, we outline a framework that articulates how stigma can “get under the skin” in order to lead to psychological and physical health disparities. Further, we consider when and to what degree concealability moderates these effects, creating divergent outcomes for the discredited and discreditable. Does the stigmatized individual assume his differentness is known about already or is evident on the spot, or does he assume it is neither known about by those present nor immediately perceivable by them? In the first case one deals with the plight of the discredited, in the second with that of the discreditable. This is an important difference.— Goffman (1963, p. 4)

TB and HIV stigma compounded by threatened masculinity: implications for TB health-care seeking in Malawi

“…47 There have been growing demands for greater attention to be paid to the structural and social determinants of TB disease and the ways in which TB disease exacerbates poverty at individual, household and community levels. 48 The accounts detailed here from a diverse group of participants highlight TB stigma linked to a combination of 'vulnerability' to debilitating disease, threatened masculinity amid high HIV prevalence, worsening economic conditions and limited social protection.…”

Perceptions of stigma among people affected by early- and late-onset Alzheimer’s disease

“…It would be of great interest to explore whether similar perceptions of stigma are reported in people experiencing more 'advanced' symptoms of Alzheimer's disease, particularly given the increased visibility of symptoms and potential 'intrusiveness' (Chaudoir et al, 2013;Hellstrom & Torres, 2013). Further, it would provide useful insights into whether people with more 'advanced' symptoms of Alzheimer's disease are able to employ the same positivity biases to cope with experiences as participants in this research (Mark, 2012;Reed & Carstensen, 2012).…”

The Fracture of Relational Space in Depression: Predicaments in Primary Care Help Seeking

“…As the interviewer asked why his other friends did not know, John interrupted: “Oh, I don't tell people I take all these medications.” Referencing a recent surgery, he continued, “They know what I've been through…[and]… I'm sure anybody would guess that somebody who has been through surgery is going to take medications.” When the interviewer asked if he felt the need to hide the fact that he took antidepressants from anyone in particular, he replied, “Ummm…Not right now. I think when I, when I have to, probably, head back into work, get back into the working [world]… if I'm asked, I might have to say that I don't [take them].” He elaborated that, “I don't want to tell them that I've got ‘Brian Wilson Syndrome’ or something.” In other words, he believed that if others knew, he would be labeled, distanced, and devalued: an experience of Goffman's discreditable identity (Chaudoir, et al 2013) and Steele's stereotype threat (Steele, et al 2002). …”