Stigma, Discrimination, and Vigilance for Bias
Stigma is defined in multiple ways from the classic definition by Goffman (1961) as a “mark that deeply discredits someone from a whole and usual person to a tainted and discounted one” to more contemporary definitions as a “negative social identity” (Crocker, Major, & Steele, 2001). The mental and physical health consequences of perceiving and experiencing discrimination or bias due to some aspect of the self that can be negatively judged appears to be persistent and pervasive.
For example, in the U.S. individuals stigmatized based on racial categories, such as African Americans, are more likely than individuals not stigmatized by race, such as European Americans, to develop hypertension, cardiovascular disease, and lung cancer, have more years of morbidity, and higher mortality rates (Borrell et al., 2013; Krieger, 2014; Paradies, 2006; see also Dovidio et al., Priest & Williams, 2017; Richman, Pascoe, & Latteanner, 2017). Thus, stigmatized identities are viewed as possible chronic stressors. Measuring perceptions and feelings related to stigma and bias has been approached from multiple perspectives including affective responses, cognitive perceptions, and implicit reactions.
Everyday Discrimination (Williams, Yu, Jackson, & Anderson, 1997)
The everyday discrimination scale is a widely used measure in health psychology, medicine, and public health. The scale aims to capture the frequency with which people experience rude, harassing or discriminatory behavior in their daily lives. The frequency of discrimination measured with this scale has been associated with more self-reported ill health, more days spent ill in bed, poorer well-being, and greater psychological distress. Expanded and shortened versions of this scale have been developed.
Perceived Discrimination (Contrada, et al., 2001)
Similar to many stress measures, discrimination measures often focus on perceptions, experience, and reactions to actual/perceived events. The PEDQ (Perceived Ethnic Discrimination Measure) examines the extent to which people experience verbal rejection, perception of people avoiding them, denial of equal treatment, exclusion, the threat of violence, peoples’ negative expectations—dishonest, violent, dirty, lazy—and experiencing aggression. The PEDQ limits the time to the last three months. View the scale here.
Contrada, R. J., Ashmore, R. D., Gary, M. L., Coups, E., Egeth, J. D., Sewell, A., . . . Chasse, V. (2001). Measures of ethnicity-related stress: Psychometric properties, ethnic group differences, and associations with well-being. Journal of Applied Social Psychology, 31(9), 1775-1820. Retrieved from http://search.proquest.com/docview/619611719?accountid=14525
Race-based Rejection Sensitivity (Mendoza-Denton, Downey, et al).
The race-based rejection sensitivity measure examines the extent to which individuals expect and are anxious about being rejected for reasons related to their racial identity. Each item in the scale consists of a context-specific, ambiguous event – e.g., a teacher fails to call on you – and then participants and asked about the extent to which they expect this treatment to be due to their race and how anxious they would be if they experienced this. View the measure here.
Mendoza-Denton, R., Downey, G., Purdie, V. J., Davis, A., & Pietrzak, J. (2002). Sensitivity to status-based rejection: Implications for African American students' college experience. Journal of Personality and Social Psychology, 83(4), 896-918. Retrieved from http://search.proquest.com/docview/619958380?accountid=14525
Rejection Sensitivity measures have also been developed for Asian Americans and socio-economic class differences:
Chan, W., & Mendoza-Denton, R. (2008). Status-based rejection sensitivity among Asian Americans: Implications for psychological distress. Journal of Personality, 76(5), 1317-1346. Retrieved from http://search.proquest.com/docview/621848335?accountid=14525
Rheinschmidt, M. L., & Mendoza-Denton, R. (2014). Social class and academic achievement in college: The interplay of rejection sensitivity and entity beliefs. Journal of Personality and Social Psychology, 107(1), 101-121. Retrieved from http://search.proquest.com/docview/1539478943?accountid=14525
Intergroup Contact (Islam & Hewstone)
Lack of quality and quantity intergroup contact is implicated in sustained anxiety during inter-racial/intergroup interactions. Assessing the amount and quality of intergroup contact can provide an indicator of negative emotional responses associated with anticipated and actual interaction with outgroup members. In contrast, greater levels of past intergroup interaction has been associated with more positive/beneficial neurobiological responses such as decreased cardiovascular threat responses during intergroup interactions, lower levels of outgroup fear conditioning, faster cardiovascular recovery following stress, and less amygdala responses upon viewing outgroup faces (Blascovich, Mendes, Hunter, Lickel, & Kowai-Bell, 2001; Olsson, Ebert, Banaji, & Phelps, 2005; Page-Gould, Major, & Mendes, 2010). Several intergroup contact measures exist but the advantage of the Islam and Hewstone measure is it provides both quality and quantity assessments of intergroup contact and is easily modified to change the target racial-ethnic group. See the scale here.
Implicit Association Test (Greenwald, Banaji, and Nosek)
While self-report measures are the most commonly used psychological assessment measures, there are limitations to self-report responses and this is particularly true when studying factors related to discrimination, bias, and racism. Either due to unwillingness or inability to accurately report on one's thoughts and feelings associated with these potentially complicated and politically charged issues, individuals may alter their explicit responses in ways that do not reflect their genuine thoughts or beliefs. One way to circumvent distortions in explicit self-reports is to use implicit measures that rely on reaction time responses as a way to understand deep-rooted cognitive associations with racial categories. The most commonly used implicit measure is the Implicit Association Test. This reaction time measure estimates biased responding by calculating difference scores between associations of two different comparisons categories: for example White and Black persons, with valenced categories of: good and bad. To the extent that individuals associate specific racial categories faster with positive compared to negative words (White-good; Black-bad; versus Black-good; White-bad) provides an estimate of bias. This bias measure has been associated with neurobiological responses, behavior such as doctor diagnosis and treatment, hiring decisions, and quick judgments of guilt or innocence of hypothetical individuals. The implicit association test can be found here.
Greenwald, A. G., Nosek, B. A., & Banaji, M. R. (2003). Understanding and using the implicit association test: I. An improved scoring algorithm. Journal of personality and social psychology, 85(2), 197.
Author and Reviewer(s):
The above summaries were prepared by Wendy Berry Mendes, PhD and reviewed by the Stress Network leadership team. If you have any comments on these measures, email Wendy.Mendes@ucsf.edu. Version date: March 2017.
Sexual Identity and Racial/Ethnic Identity Intersectionality Stress Measure
Intersectionality theory provides a comprehensive lens by which the lived experiences of individuals belonging to multiple stigmatized social groups (e.g., lesbian, gay, bisexual, transgender, and queer (LGBTQ) people of color) can be examined (Crenshaw, 1989). Predominant models of minority stress have not examined the unique stressful experiences linked to oppression associated with sexual orientation, ethnicity, or race identities in conjunction with one another (Cole, 2009). Described below is one existing measure that captures the unique stressful experiences of LGB people of color that is inherently intersectional.
Conflict in Allegiances (CIA)
LGBT people of color experience stigmatization of their sexual orientation within their ethnic or racial communities (Díaz, Ayala, Bein, Henne, & Marin, 2001; Díaz, Bein, & Ayala, 2006; Espín, 1993; Morales, 2013, Ryan et al., 2009), and macroaggressions and segregation based on their ethnic and racial background within the mainstream LGBTQ White communities (Balsam, et al., 2011; Espín, 1993; Morales, 1989). For LGBTQ people of color, this position may engender conflicts in allegiances (CIA) with their multiple social group status (Morales, 1989; Santos & VanDaalen, 2016; Sarno, Mohr, Jackson, & Fassinger, 2015), such that a strong connection to one group may increase an individual’s exposure to discrimination regarding the other group identity. This connection can pose greater challenges to the developmental task of integrating their multiple group identities. Experiences of conflict between one’s sexual minority group identity and one’s ethnic or racial group identity yield challenges for an individual’s ability to integrate his, her, eir, zir, or their multiple social group identities (Morales, 1989), a process that has shown to be stressful.
Sarno and colleagues (2015) developed the 6-item CIA scale to capture conflict associated with LGB people of color’s perceived integration of ethnic or racial identity and LGB identity. Individuals rate statements such as “I feel as if my sense of cultural identity is at odds with my LGB identity” and “I have not yet found a way to integrate being LGB with being a member of my cultural group” on a 7-point Likert- type scale where 1 = Strongly Disagree to 7 = Strongly Agree. The responses are averaged and higher scores indicate greater conflict between ethnic or racial and LGB identities. Sarno et al. (2015) reported an alpha of .86, and Santos & VanDaalen (2016) reported an alpha of .80. In these investigations, LGB people of color with strong ethnic group orientation reported more CIA and less engagement in LGBTQ communities (Sarno et al., 2015) and high CIA was associated with having more depression symptoms (Santos & VanDaalen, 2016). See the CIA scale here.
A comparable measure for people of color who identify as transgender, queer, or another sexual minority has been identified (LGBT People of Color Microaggressions Scale; Balsam et al. 2011) and will be reviewed at a future time. We are also aware of research teams who have created or who are developing and evaluating new measures of intersectionality stress for LGBTQ people of color. This page will be updated when such measures are published.
Author and Reviewer(s):
This summary was prepared by Luis Armando Parra, M.S. and Paul D. Hastings, Ph.D and reviewed by the Stress Network leadership team. If you have any comments on these measures, email firstname.lastname@example.org. Version date: December 2017.
Balsam, K. F., Molina, Y., Beadnell, B., Simoni, J., & Walters, K. (2011). Measuring multiple minority stress: the LGBT People of Color Microaggressions Scale. Cultural Diversity and Ethnic Minority Psychology, 17(2), 163-174.
Cole, E. R. (2009). Intersectionality and research in psychology. American Psychologist, 64(3), 170-180.
Crenshaw, K. (1989). Demarginalizing the intersection of race and sex: A Black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics. University of Chicago Legal Forum, 139-167.
Diaz, R. M., Ayala, G., Bein, E., Henne, J., & Marin, B. V. (2001). The impact of homophobia, poverty, and racism on the mental health of gay and bisexual Latino men: findings from 3 US cities. American Journal of Public Health, 91(6), 927-932.
Diaz, R.M., Bein, E., & Ayala, G. (2006). Homophobia, poverty, and racism: Triple oppression and mental health outcomes in Latino gay men. In A. M. Omoto & H. S. Kurtzman (Eds.), Sexual orientation and mental health (pp. 207-224). Washington, DC: American Psychological Association.
Espín, O. M. (1993). Issues of identity in the psychology of Latina lesbians. In L. D. Garnets & D. C. Kimmel (Eds.), Between men—between women: Lesbian and gay studies. Psychological perspectives on lesbian and gay male experiences (pp. 348-363). New York: Columbia University Press.
Morales, E. S. (1989). Ethnic minority families and minority gays and lesbians. Marriage & Family Review, 14(3-4), 217-239.
Morales, E. (2013). Latino lesbian, gay, bisexual, and transgender immigrants in the United States. Journal of LGBT Issues in Counseling, 7(2), 172-184.
Ryan, C., Huebner, D., Diaz, R. M., & Sanchez, J. (2009). Family rejection as a predictor of negative health outcomes in white and Latino lesbian, gay, and bisexual young adults. Pediatrics, 123, 346–352.
Santos, C. E., & VanDaalen, R. A. (2016). The associations of sexual and ethnic–racial identity commitment, conflicts in allegiances, and mental health among lesbian, gay, and bisexual racial and ethnic minority adults. Journal of Counseling Psychology, 63(6), 668-676.
Sarno, E. L., Mohr, J. J., Jackson, S. D., & Fassinger, R. E. (2015). When identities collide: Conflicts in allegiances among LGB people of color. Cultural Diversity and Ethnic Minority Psychology, 21(4), 550-559.