- Interpersonal and intrapersonal stigma, especially discrimination, social exclusion, shame, and devaluation, are the strongest predictors of psychological distress and PTSD symptoms.
- A cumulative stigma index shows a dose-response relationship; each additional exposure corresponds to significantly higher mental health symptom levels.
- Policies and clinical interventions must reduce symbolic violence and integrate culturally responsive, trauma-informed mental health care to mitigate disparities amid restrictive immigration climates.
Am J Psychiatry. 2026 Nov 4:appiajp20250980. doi: 10.1176/appi.ajp.20250980. Online ahead of print.
ABSTRACT
OBJECTIVE: This study examines migration stigma as a manifestation of symbolic violence and its association with psychological distress and posttraumatic stress disorder symptoms among Asian, Black, and Latinx immigrant-origin adults in the United States.
METHODS: Using data from a demographically diverse, national quota sample (N=908), stigma was assessed at macro (perceptions of government and policy makers), interpersonal (social exclusion, discrimination, and threat of deportation), and intrapersonal (anticipating rejection, internalized embarrassment and shame, and perceived devaluation) levels. A series of ordinary least-squares regression models was used to isolate the unique and combined effects of demographic, immigration-related, and stigma-related predictors on two outcomes: psychological distress (using the Kessler 6-item Psychological Distress Scale) and posttraumatic stress disorder symptoms.
RESULTS: Racial-ethnic disparities in mental health outcomes were attenuated after accounting for immigration-related factors and stigma exposure. Interpersonal and intrapersonal stigma, specifically experiences of discrimination, social exclusion, shame, and devaluation, emerged as the most robust predictors of mental health outcomes. A cumulative stigma index demonstrated a dose-response relationship, with each additional exposure associated with significantly higher symptom levels, underscoring the compounding mental health burden of layered stigma.
CONCLUSIONS: The findings highlight the need for policies and clinical interventions that reduce exposure to symbolic violence and address the psychological toll of stigma on immigrant-origin populations. Integrating culturally responsive, trauma-informed approaches into mental health services is essential for mitigating disparities and supporting mental health well-being in increasingly restrictive immigration climates.
PMID:42978080 | DOI:10.1176/appi.ajp.20250980
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