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Abortion as stigma: cognitive and emotional implications of concealment
Abstract
This study examined the stigma of abortion and psychological implications of concealment among 442 women followed for 2 years from the day of their abortion. As predicted, women who felt stigmatized by abortion were more likely to feel a need to keep it a secret from family and friends. Secrecy was related positively to suppressing thoughts of the abortion and negatively to disclosing abortion-related emotions to others. Greater thought suppression was associated with experiencing more intrusive thoughts of the abortion. Both suppression and intrusive thoughts, in turn, were positively related to increases in psychological distress over time. Emotional disclosure moderated the association between intrusive thoughts and distress. Disclosure was associated with decreases in distress among women experiencing intrusive thoughts of their abortion, but was unrelated to distress among women not experiencing intrusive thoughts.
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“Studies involving members of other stigmatized groups have demonstrated that concealment is associated with intrusive thoughts, increased psychological distress, anxiety, and depression [59–61].”
From The Stigma of Suicide Survivorship and Related Consequences—A Systematic Review (2016) · cites this paper as [60]
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“Much scholarly attention has been devoted to examining the well-being outcomes of CSI disclosure.(9,19,32) A lot less is known about the role of how individuals disclose such sensitive information (i.”
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“Because women who conceal an abortion when compared to those who do not are more likely to suppress thoughts of the abortion, experience intrusive abortion-related cognitions, and feel psychological distress (Major and Gramzow 1999), the incidence of negative consequences such as the use of substances should be lower…”
Wilson, J. C., Powell, M. B., Raju, S., et al. (2004) · Applied Cognitive Psychology · doi:10.1002/acp.972 · Cited by 9
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BackgroundGiovannelli, I., Mannarini, T., Spaccatini, F., et al. (2022) · Feminism & Psychology · doi:10.1177/09593535221106653 · Cited by 7
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BackgroundClinical Research Involving Pregnant Women Seeking Abortion Services: United States Perspectives
Harris, L. H. (2016) · Research ethics forum · doi:10.1007/978-3-319-26512-4_15 · Cited by 4
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“Women who experienced abortion-related stigma were more likely to feel the need to keep their abortion secret from family and friends, which was related to greater thought suppression, and in turn was related to greater psychological distress (Major & Gramzow, 1999).”
InfluentialNalubega, M. J., & Omona, K. (2021) · International Journal of Health · doi:10.14419/ijh.v8i1.31366 · Cited by 3
Vásquez, C. L., Montañez, R. A. C., & Mendoza, Z. C. U. (2018) · Sexualidad Salud y Sociedad (Rio de Janeiro) · doi:10.1590/1984-6487.sess.2018.28.05.a · Cited by 3
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“Having secrets can result in negative consequences for the secret-keeper: Keeping a secret is associated with rumination due to suppression of thoughts and more intrusive thinking [4, 5], it can be stressful, and can harm health; for an summary, see [6].”
Ouédraogo, R. (2016) · Parcours anthropologiques · doi:10.4000/pa.486 · Cited by 2
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“157 est as feelings of guilt and loss [15].”
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“…due to one’s abortion experiences), b) perceived stigma (anticipating disapproval from others because one’s abortion experiences), and c) internalized stigma (self-directed disapproval due to one’s abortion experiences; Hanschmidt et al., 2016; Major & Gramzow, 1999; Shellenberg et al., 2011).”
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BackgroundLessons From Reparative Therapy Applied to Post-Abortion Grief Counseling
Panozzo, D. (2015) · Journal of Homosexuality · doi:10.1080/00918369.2015.1112194 · Cited by 1
“These messages are known not to be in the interests of women, particularly those who have undergone abortions (DeVito, 2012; Major & Gramzow, 1999).”
BackgroundMediating Role of Guilt in Disclosure Process Among Sexual Minorities Living with Concealable Stigma
Srivastava, S., & Singh, P. (2022) · Sexuality & Culture · doi:10.1007/s12119-022-10020-8 · Cited by 1
“Major & Gramzow (1999) found that those Disclosure Indirect effect Boot SE Boot LLCI Boot ULCI Limited disclosure -0.045 0.013 -0.072 -0.019 Disclosure to a large extend 0.013 0.018 -0.019 0.049 1 3 Mediating Role of Guilt in Disclosure Process Among Sexual Minorities… women who expected…”
BackgroundInfluentialA test of the rejection identification model among gay men in Turkey
Utku, C. F., & Sayılan, G. (2023) · Psychology and Sexuality · doi:10.1080/19419899.2023.2295945 · Cited by 2
“…gay men to conceal their identity (Hatzenbuehler et al., 2009; Pachankis et al., 2015; Smart & Wegner, 2000), and the constant cognitive burden associated with identity concealment efforts may deteriorate their social and psychological functioning (Chaudoir & Fisher, 2010; Major & Gramzow, 1999).”
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“As we have pointed out many times in past publications [3 /6], there is evidence indicating that women who are unwilling to disclose an abortion are more likely to experience abortionrelated psychological distress [7].”
ResultColeman, P. K., Reardon, D. C., Rue, V. M., et al. (2003) · American Journal of Obstetrics and Gynecology · doi:10.1067/s0002-9378(03)00636-7 · Cited by 1
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Ryan, A. M., & Wessel, J. L. (2009) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780199234738.003.0022
(2013) · Wiley eBooks · doi:10.1002/9781118523384.refs
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Whittaker, A. M. (2004) · Routledge eBooks · doi:10.4324/9780203429440-14
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BackgroundDavies, S. J. C., Rushworth, I., & Fisher, P. (2023) · Counselling and Psychotherapy Research · doi:10.1002/capr.12648 · Cited by 3
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Rüsch, N. (2021) · Elsevier eBooks · doi:10.1016/b978-3-437-23520-7.00004-0
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Metadata
- Authors
- Major, B., & Gramzow, R. H.
- Affiliations
- University of California, Santa Barbara (US)
- ORCID
- Major, Brenda
- Venue
- Journal of Personality and Social Psychology
- Published
- 1999-10
- Volume
- 77
- Issue
- 4
- Pages
- 735-745
- ISSN
- 0022-3514 (ISSN-L)
- 1939-1315
- OpenAlex
- W2049950431
- Cited by
- 378
- References
- 0
- Citations by year
- 2026: 3 · 2025: 12 · 2024: 5 · 2023: 13 · 2022: 13 · 2021: 15 · 2020: 17 · 2019: 17 · 2018: 17 · 2017: 24 · 2016: 20 · 2015: 27 · 2014: 22 · 2013: 20 · 2012: 17
- FWCI
- 6.68
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Personality and Social Psychology (publishedVersion)
- PubMed (publishedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Funders
- National Institutes of Health (7r01mh047989-05)
- National Institute of Mental Health (5R01MH47989)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Social Sciences › Psychology › Developmental and Educational Psychology › Identity, Memory, and Therapy
- Social Sciences › Sociology and Political Science › Social and Intergroup Psychology
- Keywords
- abortion, stigma, concealment, secrecy, thought suppression, intrusive thoughts, emotional disclosure, psychological distress, women's mental health
- MeSH terms
- Abortion, Induced, Adult, Cognition, Emotions, Female, Follow-Up Studies, Humans, Social Adjustment, Stress, Psychological, Truth Disclosure
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