Disclosure costs: The impact of bipolar diagnosis and social desirability on stigma.

Background: The previous literature concerned with understanding stigma affecting patients with bipolar disorder relies predominantly on qualitative and survey approaches, and rarely contends with the potential role of social desirability on disclosure. The current project employs a 2 × 2 experimental approach to establish the presence of stigmatizing attitudes in a context with real social consequences (i.e., college housing decisions).

Method: Participants believed they were participating in a collaborative study with campus residential life. The project was designed to establish the presence of stigmatizing attitudes affecting patients with bipolar disorder compared to an unaffected control, as well as testing whether employing pressure to respond honestly (via bogus pipeline) affects stigma disclosure.

Results: Study 1 results revealed that after reviewing a peer's housing application, stigma consequences were observable when a student disclosed a bipolar diagnosis at a large, public southeastern university (N = 182) across all outcomes (increased desire for social distance and perceived dangerousness, decreased relatability). In this sample social desirability did not appear to influence responding. In Study 2, at a small, private northeastern college (N = 168), stigma was observable on the dangerousness and relatability outcomes, but only demonstrable in terms of social distance under the conditions of the bogus pipeline.

Discussion: Together, these findings contribute persuasive experimental evidence affirming the scope and impact of stigma in the lives of patients with bipolar disorder, and underscores the capacity for social desirability to mask the presence of stigma, which has significant implications for the interpretation of past stigma research.