Identity Concealment and Chronic Illness: A Strategic Choice

Abstract

The research presented here investigates potential psychological and health consequences of concealing a chronic illness. Data were collected from 2,500 individuals living with multiple sclerosis (MS), as part of an ongoing longitudinal research project. Questions on identity concealment and psychosocial reserve (a broad measure of well‐being) were embedded in a semi‐annual national survey. Responses were linked to each participant's concurrent responses to questions about their disability status, and prospectively to the same measure of disability status 1 year later. Just over 16% of respondents indicated that it was mostly true to very true that they actively concealed their MS and most indicated at least some degree of concealment. For people at lower levels of disability, decisions to conceal or disclose were not related to their levels of psychosocial reserve. However, with rising disability, concealment predicted lower levels of psychosocial reserve. Concealment was also associated with improved disability status 1 year later. A mediation analysis suggests that this may be in part because people who concealed were more likely to be employed. Taken together, the current research adds to the evidence that consequences of concealment often may be multifaceted and depend on a variety of moderators, including degree of disability.

Issue Introduction: Identity Concealment: Multilevel Predictors, Moderators, and Consequences

“…However, given the potential costs to those who disclose, researchers and policy makers should be cautious in adopting a blanket recommendation for disclosure over concealment. We conclude the issue with a hard look at the costs and consequences of concealment for social policy and social change while maintaining a focus on the needs of individuals (Pasek, Filip‐Crawford, & Cook, ).…”

“…Cook, Salter, and Stadler () go in a different direction by examining the effects of concealment of a chronic and progressive disease: multiple sclerosis (MS). Their sample was composed of participants who were at the early stages of MS where the disease could be concealed from others.…”

“…Thus, concealing may feel like a protective strategy to shield the self from workplace discrimination, but it can also lead to overall more negative views towards the workplace. Cook, Salter, and Stadler (2017) go in a different direction by examining the effects of concealment of a chronic and progressive disease: multiple sclerosis (MS). Their sample was composed of participants who were at the early stages of MS where the disease could be concealed from others.…”

People Like Me Don't Belong Here: Identity Concealment is Associated with Negative Workplace Experiences

“…Future research may benefit from examining individual differences that render people living with particular stigmatized identities more or less vulnerable to these ramifications. For example, the consequences of identity concealment are moderated by factors such as rejection sensitivity (Cole, Kemeny, & Taylor, 1997), socioeconomic status (McGarrity & Huebner, 2014), and disability status (Cook, Salter, & Stadler, 2017). Understanding who may be particularly likely to benefit from openness about a stigmatized identity will help with efforts to create supportive organizational environments for all employees.…”

Identity Concealment and Social Change: Balancing Advocacy Goals Against Individual Needs

“…These effects may be in part because people who conceal, particularly those high in internalized stigma, may pursue an avoidance regulatory strategy (Lattanner & Richman, ). While these studies might lead us to associate concealment with uniformly negative outcomes, Cook, Salter, and Stadler () find that consequences of concealment can depend on individual differences, like severity of symptoms among people with a chronic illness. These articles highlight negative personal outcomes associated with concealment, but also suggest how these may vary as a function of individual differences and characteristics of a given stigma.…”