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Students with mental and/or physical chronic health conditions (CHCs) are at risk for diminished quality of life (QoL) and greater stress. Internalized stigma (the incorporation of a negative stereotype into one’s identity) may help explain this quality of life (QoL) and stress disparity. While prior work demonstrated that internalized stigma affects health outcomes, studies tend to examine single or small sets of outcomes, and studies of internalized stigma in students with mental and/or physical CHCs are sparse. The present study examined the effects of internalized stigma in three cohorts of students with mental and/or physical CHCs (2020-21, 2021-22, 2022-23; n = 313) who were surveyed during Fall, Winter, and Spring quarters. As individual responses were linked across quarters, average and changing effects of internalized stigma and covariates (demographic characteristics, coping and emotion regulation strategies, loneliness) were examined in multilevel linear models predicting each outcome (physical, psychological, social, and environmental QoL; stress). Covariate-controlled models demonstrated that students with co-occurring mental and physical CHCs and those reporting higher levels of internalized stigma tended to report lower levels of physical and psychological domains of QoL as well as greater stress. Findings suggest that internalized stigma is a single factor that may predict several health and stress outcomes. University staff and faculty are encouraged to proactively address internalized negative stereotypes to facilitate wellbeing in students with CHCs.


© American Psychological Association, 2024. This paper is not the copy of record and may not exactly replicate the authoritative document published in the APA journal, Stigma and Health. The final article is available, upon publication, at:

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