As with other marginalized groups who have gained legal protection under the law in the United States, prejudice and discrimination against members of the disability community,c1 did not disappear with the passage of the Americans with Disabilities Act in 1990. Indeed, modern discrimination against many marginalized groups has taken on less overt and more subtle forms, often referred to as microaggressions.2,3 Microaggressions broadly, are behaviors that can be unintended, unrecognized, or even well intentioned that implicitly reinforce marginalization through subtle slights, insults, or discrimination of members of nondominant groups.3, 4, 5 Microaggressions are specific to each marginalized community, and have been described as “death by a thousand paper cuts,"6 implying it is the cumulative effect of the subtle slights, insults, and discrimination that cause harm.7 Prior studies have found higher experiences of microaggressions are positively correlated with negative mental health outcomes in people of color,8 sexual minorities,9,10 and individuals with a variety of disabilities.11,12 Given that well-being is not the absence of mental health distress, but rather about effective functioning across multiple domains, it is important to examine the relationship between ableist microaggressions and well-being.13 Furthermore, because microaggressions are a unique type of stress it is necessary to investigate coping strategies.

From an ecological systems theory perspective, well-being within the context of disability is influenced through complex person-environment interactions.14 Microaggressions are part of the person-environment interactions and prior research using the two different ableist microaggression scales reported that ableist microaggression scores positively correlated with more depressive symptoms11,12 and higher anxiety symptoms.12 People with congenital disabilities, people with more visible disabilities, and people with more severe disabilities, have reported experiencing more ableist microaggressions and stigma.11,12,15,16 These research studies are consistent with critical disabilities studies theory, which recognized that as with other minority groups, people with disabilities are viewed and defined in relation to the non-disabled majority, with cultural messages that perpetuate a hierarchical dualistic belief that disability is inferior to non-disabled.17,18 The consequence of ongoing social devaluation is further supported by research using the minority stress model, which has found that for non-dominant group members the social stigma and discrimination they experience leads to health disparities, including those affecting mental health and well-being.19, 20, 21

Research on coping among different samples of the disability community suggests that active problem-focused coping has more positive health outcomes than people who use avoidant coping.22,23 However, other research has pointed out that problem-focused coping strategies are useful when the stressor is controllable and emotion-focused coping is more suitable if the stressor is uncontrollable.24 Given that ableist microaggressions are a distinctive form of uncontrollable stress it is important to examine coping strategies as they relate to ableist microaggressions and well-being.

The objective of this study was to evaluate the relationship between ableist microaggressions and well-being and if coping strategies moderate the relationship in a sample of adults with varied disabilities in the United States. It was hypothesized that ableist microaggressions would be associated with lower well-being. We further hypothesized that coping would moderate the relationship, specifically that socially supported coping would buffer the effects, and that avoidant coping would exacerbate the effects of ableist microaggressions on well-being. Given prior research planned exploratory post-hoc analyses, significant differences were expected in people with more visible disabilities will experience more ableist microaggressions and will have lower well-being.