The Role of Stigma in the Relationship Between Illness Intrusiveness and Adjustment in Adolescents and Young Adults: A Path Model

Abstract

Objective: Adolescents/Young Adults (AYAs) with a chronic illness display elevated risk for poor psychosocial outcomes, yet relatively little is known about factors that place these individuals at risk. Illness intrusiveness is a known predictor of negative psychosocial outcomes in AYAs. Illness-related stigma, an understudied concept in this population, may also be a key contributor to increased intrusiveness. The present study sought to determine if higher levels of illness-related stigma would be associated with higher levels of depressive and anxious symptoms in AYAs with a chronic illness, and whether this relationship would be mediated by illness intrusiveness.

Methods: College students with a chronic illness completed measures of illness-related stigma, illness intrusiveness, and both depressive and anxious symptoms.

Results: A path model indicated that stigma was significantly related to illness intrusiveness, and illness intrusiveness was significantly related to depressive and anxious symptoms. Both indirect paths from stigma to depressive and anxious outcomes were significant. There were also significant direct effects of stigma on depressive and anxious outcomes. An additional path model was tested to assess anxious and depressive outcomes as multidimensional factors by evaluating the individual factors of both scales as outcomes. This model revealed similar results.

Conclusions: Findings support previous research indicating relationships between stigma, illness intrusiveness, and negative psychosocial outcomes, with illness intrusiveness serving as a possible mediator between illness-related stigma and depressive and anxious symptoms.

Keywords: anxiety; chronic illness; depression.