(PS11-B35) Expectations vs. Evidence: Associations of Self-stigma and Expected Stigma with Functional Outcomes in Survivors of Significant Trauma

Self-stigma and the expectation of stigma from others is well-documented in survivors of significant trauma. Less clear is what members of the public – those serving as potential friends, family, and support members – actually believe about the consequences of exposure. Also unclear is how self-stigma and expected stigma from others may uniquely influence domains of post-trauma functioning. The current study looked to 1.) compare levels of survivor self-stigma and expected stigma from others with levels actually reported in a general sample, and 2.) explore the unique effects of survivor self- and expected stigma on PTSD symptom severity, perceived support, and overall impairment.

Participants were trauma-exposed students involved in an ongoing study of post-exposure outcomes (N = 380) as well as an independent sample of general undergraduates (N = 906). Trauma stereotypes in the general student sample were examined using the Trauma Beliefs Scale (TBS; Clapp et al., 2023), a 51-item survey capturing negative beliefs about survivors (e.g., People exposed to serious trauma are generally unreliable; People exposed to serious trauma are damaged). Those in the trauma sample completed a modified form of the TBS, with items assessing (a) whether survivors personally believe individual stereotypes [self-stigma] and (b) whether they feel that members of the general public believe specific stereotypes to be true [expected stigma]. Survivors also completed the Clinician-Administered PTSD Scale for DSM-5 as an index of PTSD severity. Perceived support and functional impairment were examined using the Multidimensional Scale of Perceived Social Support and the Barkley Functional Impairment Scale.

t-tests were used to compare survivor-reported self- and expected stigma against levels endorsed by the general student sample. Unique effects of survivor self- and expected stigma on posttrauma outcomes were examined in a series of regressions. Analyses controlled for both participant sex and survivor index trauma (accident/disaster, physical violence, sexual violence, combat, unexpected death).

Scores for survivor self-stigma (M = 29.84, SD = 12.45) were marginally lower than stigma levels noted in the general student sample (M = 34.37, SD = 16.02; p < .001, d = .30). However, survivor expected stigma far exceeded the level actually reported by their peers (M = 63.43, SD = 19.97; p < .001; d = 1.68). Regression analyses for CAPS-5 scores identified a unique effect of expected stigma on increased symptom severity (β = .18, p = .001) with additional evidence for elevated levels of PTSD in survivors of sexual assault (β = .32, p < .001) and combat trauma (β = .21, p < .001). By contrast, results indicated a unique effect of self-stigma on reductions in perceived support (β = -.21, p < .001). Both self-stigma (β = .27, p < .001) and expected stigma (β = .12, p = .037) were associated with elevations in global impairment.

While survivors may overestimate stigmatized beliefs held in the larger community, results confirm that problematic views of trauma are in fact common. Data also suggest that self-stigma holds negative associations with trauma symptoms and global functioning, although expected stigma from others may serve as a unique barrier to critical social support.