{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T06:07:02Z","timestamp":1784268422266,"version":"3.55.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100011684","name":"Crohn\u2019s and Colitis Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100011684","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000062","name":"National Institute for Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["F32DK134043"],"award-info":[{"award-number":["F32DK134043"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32 DK062708"],"award-info":[{"award-number":["T32 DK062708"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 DK125687"],"award-info":[{"award-number":["R01 DK125687"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 DK 118154"],"award-info":[{"award-number":["R01 DK 118154"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"American College of Gastroenterology Junior Faculty Career Development"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Internalized stigma impacts the wellbeing of inflammatory bowel disease (IBD) patients and has complex relationships with experiences of discrimination and disease disclosure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We surveyed 1263 IBD Partners e-cohort participants. Discrimination and internalized stigma were measured using the Everyday Discrimination Scale (EDS) and the Paradox of Self Stigma (PaSS-24) scale. IBD disclosure was measured using a modified \u201coutness\u201d scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 48.8% of respondents reported discrimination, and there was a strong association between discrimination and internalized stigma (Pearson rho\u2009=\u20090.436, P\u2009&amp;lt;\u2009.001). Individuals who experienced discrimination were significantly more likely to be female, sexual or gender minorities (SGM), younger, and non-white. EDS score had a weak negative correlation with IBD disclosure (Pearson rho\u2009=\u2009\u22120.152, P&amp;lt;\u20090.001), indicating higher reported levels of discrimination correlated with lower rates of IBD disclosure. Internalized stigma was common and significantly associated with active disease (median PaSS-24 score 53 for respondents with active disease vs a score of 43 for respondents in remission; P\u2009&amp;lt;\u2009.001). Internalized stigma had a moderate negative correlation with disclosure of IBD (Pearson rho\u2009=\u2009\u22120.397, P\u2009&amp;lt;\u2009.001), indicating that more disease disclosure correlated with lower levels of internalized stigma. In a mediation analysis, disease disclosure was a significant mediator of the effect of discrimination on internalized stigma, mediating 15% of the overall estimated effect (P\u2009&amp;lt;\u2009.001)<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this large cohort of adults with IBD, experiences of discrimination and internalized stigma were common and associated with active disease. Disease disclosure may mediate the relationship between discrimination and internalized stigma. This emphasizes the importance of psychosocial support for individuals with IBD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ecco-jcc\/jjaf192","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T12:57:19Z","timestamp":1762865839000},"source":"Crossref","is-referenced-by-count":0,"title":["Direct and indirect impacts of discrimination, internalized stigma, and disease disclosure on inflammatory bowel disease patient health outcomes"],"prefix":"10.1093","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8279-1111","authenticated-orcid":false,"given":"Kira L","family":"Newman","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Michigan , Ann Arbor, MI,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica P","family":"Naftaly","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Michigan , Ann Arbor, MI,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia A","family":"Wren","sequence":"additional","affiliation":[{"name":"Department of Public Health, Wayne State University , Detroit, MI,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Millie D","family":"Long","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of North Carolina , Chapel Hill, NC,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter D R","family":"Higgins","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Michigan , Ann Arbor, MI,","place":["United 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