Concealment Versus Disclosure: A Cross-Sectional Study Examining Psychological Well-Being and Secrecy Management

Background: Most people keep secrets about themselves to manage stigmatization. The tendency to actively conceal distressing personal information from others is known as self concealment. Accumulating evidence has shown that self concealment is detrimental to well-being, due to dysfunctional emotional regulation, ruminative thoughts of the secret, and negative help-seeking attitudes. The conflict between strong motives to conceal and disclose, or ambivalence towards self concealment, is believed to be another underlying reason for the negative impact of self concealment on well-being. This online survey study aims to examine the relationship between self concealment, distress disclosure, ambivalence towards self concealment, and well-being.

Methods: Four hundred and forty-eight Hong Kong Chinese were recruited through local community, advertisements, social media, and institutional mass mailing, to complete an online survey. The mean age was 31.08 years (ranging from 18 to 71, SD = 10.61). The majority were female (74.1%), single (37.1%), and received tertiary education (86.1%).

Results: Self concealment was positively correlated with depression and anxiety (rs > .27, p < .001), but negatively correlated with life satisfaction, self compassion, and self acceptance (rs > -.26, p < .001). In contrast, distress disclosure was negatively correlated with depression and anxiety (rs > -.14, p < .01), but positively correlated with life satisfaction, self compassion, and self acceptance (rs > .22, p < .001). To examine the relationship between ambivalence towards self concealment and well-being, participants were divided into four groups using median split. The median self concealment and distress disclosure score was 3.4 and 3.04, respectively. Participants whose self concealment and distress disclosure score were below the median were classified as “Indifferent” (n = 60). Those whose self concealment and distress disclosure score were equal to or above the median were classified as “Ambivalent” (n = 72). Participants whose self concealment was below the median but distress disclosure score was equal to or above the median were classified as “Disclosure-Oriented” (n = 110). Participants whose self concealment was equal to or above the median but distress disclosure score was below the median were classified as “Concealment-Oriented” (n = 122). One-way ANOVA results showed significant overall group differences in all five well-being variables. Post-hoc Turkey test results showed that, compared to “Disclosure-Oriented” participants, “Concealment-Oriented” participants reported significantly greater depression and anxiety, but lower life satisfaction, self compassion, and self acceptance. But there were no significant differences in all five well-being variables between “Ambivalent” and “Concealment-Oriented” participants.

Implications: The present findings support the relative benefits of distress disclosure over self concealment. Helping professionals are recommended to seek out opportunities to offer psycho-education regarding the psychological costs of self concealment, in addition to the psychological benefits of distress disclosure. Moreover, the present study found that people who were ambivalent towards self concealment had equally poor well-being as did those who were oriented towards self concealment. Such finding enhances our understanding of the distressing lived experience of people with concealable stigmatized identities, such as infectious disease (COVID-19), infertility, sexual orientation, being incarcerated, suicidal loss, or victimization.