[Discrimination, stigma and identity: A literature review]

Objective: This study aimed to update the scientific knowledge concerning the relationship between discrimination, stigma and self-concept.

Methods: A review was conducted and allowed to include 15 peer-reviewed articles for qualitative analysis, consisting of 13 unique samples (n=2830; Mage=37.6). The search was conducted on Pubmed and PsychInfo following this research protocol: "de stigmatization" ([Title/Abstract] or "destigmatization" [Title/Abstract] or "self-stigma" [Title/Abstract] or "Perceived stigma" [Title/Abstract] or "anticipated discrimination" [Title/Abstract] or "experienced discrimination" [Title/Abstract]) and (identi*[Title] or "self-concept" [Title]). The search resulted in 43 articles, plus three articles identified from other sources. Thirty-one articles were excluded because they did not align with the aim of the review.

Results: Among the 15 articles included, there were 11 quantitative studies, two qualitative studies, one literature review and one theoretical article. The stigma was related to a mental disorder (n=8), a physiological or ethnic difference (n=5) or sexual orientation and gender identity (n=2). Among the 11 quantitative studies based on unique samples, all included both males and females (n=2616; Mage=36.7; 61.1% of women). Four studies established a significant impact of perceived stigma on social identity. This impact was negative when there was at least one other parallel social identity perceived favorably by the individual, and positive otherwise. In two studies, this impact was moderated by the importance of the stigmatized social identity in the self-concept. In one study, social identity was correlated to psychological distress. The sign, positive or negative, of this correlation depended on self-stigma. When self-stigma was high (i.e., self-concept is strongly perceived through the prism of negative stereotypes associated with the social identity), then social identity was positively associated with psychological distress. Otherwise, the sign of this association was negative. In one study, four distinct variables were predictors of suicidal ideation: experienced discrimination, perceived stigma, anticipated discrimination and self-stigma. Experienced discrimination predicted suicidal ideation through anticipatory discrimination and self-stigma; and perceived stigma predicted suicidal ideation through anticipated discrimination. Self-stigma and anticipatory discrimination predicted suicidal ideation at the same level.

Conclusions: The results suggest that a key variable to address in order to reduce the negative consequences of discrimination and stigmatization is self-stigma, i.e., the fact of conceiving the self-concept through the filter of the negative stereotypes associated with the characteristic perceived as discriminated. The altered self-concept should therefore be a main transnosographic diagnostic and therapeutic target. An easy-to-use proxy to detect the altered self-concept is the propensity to feel the emotion of shame, which is correlated to self-stigma.