According to MLT, to avoid further stigmatization, labeled individuals may employ specific coping orientations, such as maintaining secrecy about a psychiatric condition or avoiding potentially uncomfortable or threatening social interactions (Link et al., 1991). Secrecy and avoidance are thought to damage social ties and result in other negative outcomes despite their beneficial appearance (Link et al., 1991). Consistent with this notion, meta-analyses have identified a reliable association between perceived stigma and weakened social support or integration (Livingston and Boyd, 2010). Employing ineffective coping orientations has been linked to diminished self-esteem, self-efficacy, general well being, and job market participation and earnings (Link et al., 1987, 1989, 1997; Wahl, 1999; Wright et al., 2000), and is thought to ultimately increase individuals’ likelihood of relapse and exacerbation of psychiatric conditions (Link et al., 1989). While MLT focuses on social and individual level exchanges, we note that stigma can also result in discrimination at the institutional or structural level (Deacon, 2006; Link and Phelan, 2001; Williams et al., 2012).
