Stigma, social context, and mental health: Lesbian and gay couples across the transition to adoptive parenthood.

This is the first study to examine change in depression and anxiety across the first year of adoptive parenthood in same-sex couples (90 couples: 52 lesbian, 38 gay male). Given that sexual minorities uniquely contend with sexual orientation-related stigma, this study examined how both internalized and enacted forms of stigma affect the mental health of lesbians and gay men during the transition to parenthood. In addition, the role of contextual support was examined. Higher perceived workplace support, family support, and relationship quality were related to lower depressive and anxious symptoms at the time of the adoption, and higher perceived friend support was related to lower anxiety symptoms. Lower internalized homophobia and higher perceived neighborhood gay-friendliness were related to lower depressive symptoms. Finally, individuals with high internalized homophobia who lived in states with unfavorable legal climates regarding gay adoption experienced the steepest increases in depressive and anxious symptoms. Findings have important implications for counselors working with sexual minorities, especially those experiencing the transition to parenthood. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measuring perceptions of stigmatization by others for seeking psychological help: Reliability and validity of a new stigma scale with college students.

Fear of being stigmatized is the most cited reason why individuals avoid psychotherapy. Conceptually, this fear should be strongest when individuals consider the reactions of those they interact with. Across 5 samples, the authors developed the Perceptions of Stigmatization by Others for Seeking Help (PSOSH) scale. In Sample 1 (N = 985), the 5 items of the PSOSH were selected (α = .91). In Sample 2 (N = 842), the unidimensional factor structure of the scale was examined across a diverse sample. In Sample 3 (N = 506), concurrent validity was supported through moderate associations with 3 different stigma measures (i.e., public stigma toward counseling, r = .31; public stigma toward mental illness, r = .20; and self-stigma, r = .37). In Sample 4 (N = 144), test–retest reliability across a 3-week period was calculated (.82). Finally, in Sample 5 (N = 130), reliability (α = .78) and validity were explored with a sample experiencing symptoms of psychological distress. Relationships between variables (i.e., public stigma toward counseling, r = .31, and self-stigma, r = .40) were similar to those in previous samples. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Toward an affirmative lesbian, gay, bisexual, and transgender leadership paradigm.

This article presents an affirmative paradigm for understanding the leadership of sexual minorities—that is, lesbian, gay, bisexual, and transgender (LGBT) people. Although research on LGBT issues in leadership to date is almost nonexistent, there are several bodies of literature that can contribute to an understanding of the unique leadership challenges faced by sexual minority people. These include the literatures on stigma and marginalization, leadership in particular status groups (e.g., college students, women), and LGBT vocational issues (especially workplace climate and identity disclosure). We propose a new, multidimensional model of LGBT leadership enactment that incorporates sexual orientation (particularly regarding identity disclosure), gender orientation (including leader gender), and the situation (conceptualized here as group composition); the model also is embedded in context, the most relevant factors that affect the enactment of leadership being stigma and marginalization. We explicate this model with findings and concepts from relevant literatures, and we conclude the article with recommendations for building a scholarly literature in LGBT leadership. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How does sexual minority stigma “get under the skin”? A psychological mediation framework.

Sexual minorities are at increased risk for multiple mental health burdens compared with heterosexuals. The field has identified 2 distinct determinants of this risk, including group-specific minority stressors and general psychological processes that are common across sexual orientations. The goal of the present article is to develop a theoretical framework that integrates the important insights from these literatures. The framework postulates that (a) sexual minorities confront increased stress exposure resulting from stigma; (b) this stigma-related stress creates elevations in general emotion dysregulation, social/interpersonal problems, and cognitive processes conferring risk for psychopathology; and (c) these processes in turn mediate the relationship between stigma-related stress and psychopathology. It is argued that this framework can, theoretically, illuminate how stigma adversely affects mental health and, practically, inform clinical interventions. Evidence for the predictive validity of this framework is reviewed, with particular attention paid to illustrative examples from research on depression, anxiety, and alcohol-use disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Threat and guilt aspects of internalized antilesbian and gay prejudice: An application of personal construct theory.

Building on G. A. Kelly's (1991a, 1991b) personal construct theory, this study introduced concepts of threat and guilt as different manifestations of internalized antilesbian and gay prejudice. Results with 102 lesbian and gay participants indicated that internalized threat and guilt each accounted for unique variance in global internalized antilesbian and gay prejudice. Also, as expected, internalized threat was associated uniquely with lower preference for lesbian or gay sexual orientation, whereas internalized guilt was associated uniquely with lesbian and gay identity denigration. Finally, threat partially mediated the relations of internalized antilesbian and gay prejudice with intrapersonal identity stresses (i.e., identity confusion, difficulty of identity formation process), whereas guilt partially mediated the relations of internalized antilesbian and gay prejudice with interpersonal identity stresses (i.e., maintaining privacy, discomfort with disclosure). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The influence of general identity disturbance on reports of lifetime substance use disorders and related outcomes among sexual minority adults with a history of substance use.

Previous research has shown that sexual minority (i.e., nonheterosexual) individuals report increased problematic substance use involvement, compared with their sexual majority counterparts. We hypothesize that feelings of an unstable sense of self (i.e., identity disturbance) may potentially drive problematic substance use. The purpose of the current study is to examine identity disturbance among sexual minorities as a potential explanatory mechanism of increased sexual minority lifetime rates of substance dependence. Measures of identity disturbance and three indicators of sexual orientation from lifetime female (n = 16,629) and male (n = 13,553) alcohol/illicit drug users in Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were examined. Findings generally showed that the increased prevalence of alcohol dependence, illicit drug dependence, and combined alcohol/illicit drug dependence as well as a younger age of alcohol use initiation among sexual minority women was associated with elevated levels of identity disturbance. The results were consistent with a mediational role for identity disturbance in explaining the association between sexual minority status and substance dependence and were generally replicated among male sexual minority respondents. The current research suggests that identity disturbance, a predictor of substance use, may contribute to heightened risk for substance dependence among certain subgroups of sexual minority individuals. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The impact of minority stress on mental health and substance use among sexual minority women.

Objective: We examined the direct and indirect impact of minority stress on mental health and substance use among sexual minority women. Method: A combination of snowball and targeted sampling strategies was used to recruit lesbian and bisexual women (N = 1,381) for a cross-sectional, online survey. Participants (M age = 33.54 years; 74% White) completed a questionnaire assessing gender expression, minority stressors (i.e., victimization, internalized homophobia, and concealment), social–psychological resources (i.e., social support, spirituality), and health-related outcomes. We used structural equation modeling to test associations among these factors, with gender expression as an antecedent and social–psychological resources as a mediator between minority stress and health. Results: The final model demonstrated acceptable fit, χ2(79) = 414.00, p confirmatory fit index = .93, Tucker–Lewis index = .91, standardized root-mean-square residual = .05, root-mean-square error of approximation = .06, accounting for significant portions of the variance in mental health problems (56%) and substance use (14%), as well as the mediator social–psychological resources (24%). Beyond indirect effects of minority stress on health outcomes, direct links emerged between victimization and substance use and between internalized homophobia and substance use. Conclusions: Findings indicate a significant impact of minority stressors and social–psychological resources on mental health and substance use among sexual minority women. The results improve understanding of the distinct role of various minority stressors and their mechanisms on health outcomes. Health care professionals should assess for minority stress and coping resources and refer for evidence-based psychosocial treatments. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Mental health and substance use disorders among Latino and Asian American lesbian, gay, and bisexual adults.

Growing evidence suggests that lesbian, gay, and bisexual adults may be at elevated risk for mental health and substance use disorders, possibly due to anti-gay stigma. Little of this work has examined putative excess morbidity among ethnic/racial minorities resulting from the experience of multiple sources of discrimination. The authors report findings from the National Latino and Asian American Survey (NLAAS), a national household probability psychiatric survey of 4,488 Latino and Asian American adults. Approximately 4.8% of persons interviewed identified as lesbian, gay, bisexual, and/or reported recent same-gender sexual experiences. Although few sexual orientation-related differences were observed, among men, gay/bisexual men were more likely than heterosexual men to report a recent suicide attempt. Among women, lesbian/bisexual women were more likely than heterosexual women to evidence positive 1-year and lifetime histories of depressive disorders. These findings suggest a small elevation in psychiatric morbidity risk among Latino and Asian American individuals with a minority sexual orientation. However, the level of morbidity among sexual orientation minorities in the NLAAS appears similar to or lower than that observed in population-based studies of lesbian, gay, and bisexual adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The “model minority myth”: Internalized racialism of positive stereotypes as correlates of psychological distress, and attitudes toward help-seeking.

Stereotypes associated with Asian Americans (model minority group) are, at times, positive. Endorsement of these stereotypes (i.e., internalized racialism) might contribute to Asian's distress and their attitudes toward seeking services. The purpose of this study was to use the theory of “status-based rejection sensitivity” as a way to examine the relationship between internalized racialism (i.e., endorsement and/or internalization of positive Asian stereotypes) and psychological distress, and attitudes toward help-seeking among 291 Asian Americans. Results indicated that higher levels of endorsement of positive Asian stereotypes were related to higher levels of psychological distress and more negative attitudes toward help-seeking. No evidence was found for the moderating roles of internalized racialism in the endorsement of positive Asian stereotypes–distress/help-seeking links. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The link between alcohol use and aggression toward sexual minorities: An event-based analysis.

The current study used an event-based assessment approach to examine the day-to-day relationship between heterosexual men's alcohol consumption and perpetration of aggression toward sexual minorities. Participants were 199 heterosexual drinking men between the ages of 18–30 who completed (1) separate timeline followback interviews to assess alcohol use and aggression toward sexual minorities during the past year, and (2) written self-report measures of risk factors for aggression toward sexual minorities. Results indicated that aggression toward sexual minorities was twice as likely on a day when drinking was reported than on nondrinking days, with over 80% of alcohol-related aggressive acts perpetrated within the group context. Patterns of alcohol use (i.e., number of drinking days, mean drinks per drinking day, number of heavy drinking days) were not associated with perpetration after controlling for demographic variables and pertinent risk factors. Results suggest that it is the acute effects of alcohol, and not men's patterns of alcohol consumption, that facilitate aggression toward sexual minorities. More importantly, these data are the first to support an event-based link between alcohol use and aggression toward sexual minorities (or any minority group), and provide the impetus for future research to examine risk factors and mechanisms for intoxicated aggression toward sexual minorities and other stigmatized groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Organizational efforts to affirm sexual diversity: A cross-level examination.

A growing number of organizations have enacted policies intended to recognize and affirm sexual diversity in the workforce. This research demonstrates that the more prevalent these policies, the less likely sexual minority members are to experience treatment discrimination. Further, as expected, more equitable treatment was associated with higher levels of satisfaction and commitment among lesbian and gay employees. Treatment discrimination was also systematically related to the use of 3 identity management strategies (i.e., counterfeiting, avoiding, integrating). Findings also illustrate the importance of considering individual attributes in diversity research. In particular, group identity attitudes were associated with work-related attitudes and identity management. Overall, the research demonstrates the importance of organizational efforts to affirm sexual diversity and highlights the need for future research in this area. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived public stigma and the willingness to seek counseling: The mediating roles of self-stigma and attitudes toward counseling.

This study examined the mediating effects of the self-stigma associated with seeking counseling and attitudes toward seeking counseling on the link between perceived public stigma and willingness to seek counseling for psychological and interpersonal concerns. Structural equation modeling of data from 676 undergraduates indicated that the link between perceived public stigma and willingness to seek counseling was fully mediated by self-stigma and attitudes. Perceptions of public stigma contributed to the experience of self-stigma, which, in turn, influenced help-seeking attitudes and eventually help-seeking willingness. Furthermore, 57% of the variance in attitudes toward counseling and 34% of the variance in willingness to seek counseling for psychological and interpersonal concerns were accounted for in the proposed model. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of disengagement coping with HIV risk on unprotected sex among HIV-negative gay men in New York City.

Objective: This study examined how disengagement coping with HIV risk mediated the association between internalized homophobia and unprotected anal intercourse (UAI) and how sexual encounters in public venues (public sex) and drug use moderated the association between disengagement coping and UAI among HIV-negative gay men. Disengagement coping included fatalistic beliefs about maintaining HIV-negative seronegative serostatus (fatalism), optimistic attitudes toward medical seriousness of HIV infection and reduced concern about HIV risk due to highly active anti-retroviral therapies (optimism), and negative affective states associated with sexual risk (anxiety). Design: A survey was conducted among 285 HIV-negative gay men at an HIV prevention counseling program in New York City. Main Outcome Measures: Sexual risk was defined as having had UAI with nonprimary partners in the past 6 months. Results: In addition to the positive association between internalized homophobia, disengagement coping, and UAI, fatalism mediated the association between internalized homophobia and UAI; and optimism mediated the association between anxiety and UAI. A significant moderation effect of public sex was found between fatalism and UAI. Conclusions: The findings highlight the importance of understanding disengagement coping as it affects sexual risk practices among HIV-negative gay men in the continuing epidemic. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adaptation to sexual orientation stigma: A comparison of bisexual and lesbian/gay adults.

This study extends research on dimensions of sexual minority experience by examining differences between bisexual and lesbian/gay adults in adaptation to sexual orientation stigma. The authors investigated sexual orientation self-disclosure, connection to community, and 4 identity-related variables (internalized homonegativity, stigma sensitivity, identity confusion, and identity superiority) in a community sample of 613 lesbian, gay, and bisexual adults. Sexual orientation effects were found on 3 of these 6 variables: Bisexual participants reported higher levels of identity confusion and lower levels of both self-disclosure and community connection relative to their lesbian/gay peers. Taken together, the 6 variables predicted indicators of psychosocial functioning. Associations among the 6 dimensions of sexual minority experience and psychosocial functioning did not differ for bisexual and lesbian/gay participants. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Science, public policy, and legal recognition of same-sex relationships.

In their comments on my article discussing the social science data relevant to societal recognition of same-sex committed relationships (see record 2006-11202-004), Rosik and Byrd (see record 2007-14606-024) and Schiller (see record 2007-14606-025) criticized aspects of my analysis and raised questions about the role of psychology in policy debates concerning sexual orientation. In the limited space available here, I first respond to their specific criticisms and then briefly consider the broader policy question. Both comments raised questions about whether and how psychologists should address policy issues related to sexual orientation. Rosik and Byrd advocated what they called a "measured approach" that "would distinguish the social scientist from the social activist" (p. 712). In practice, however, their measured approach apparently allows for vague constructs (e.g., men's "uncivilized" sexual nature), accepts conservative social activists' assumptions (e.g., about the necessity of marital "gender complementarity"), and ignores data that contradict their predictions (e.g., Badgett, 2004). Thus, it clearly is inadequate as a source for guidance. As for Tyler's fourth criterion (see record 200714606-026), it is difficult to know if and how psychologists' efforts in this arena will be effective. Regardless of the ultimate policy outcome, however, to the extent that we successfully communicate accurate information about the current state of scientific knowledge on sexual orientation and same-sex relationships, we will have remained true to our commitment to take a leading role in removing the stigma associated with homosexuality. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived experiences of anti-bisexual prejudice: Instrument development and evaluation.

This research describes the development and psychometric evaluation of the Anti-Bisexual Experiences Scale (ABES). Items were developed on the basis of prior literature, revised on the basis of expert feedback, and submitted to psychometric evaluation. Exploratory factor analysis of data from 350 bisexual participants yielded 3 factors of reported experiences of prejudicial treatment reflecting (a) Sexual Orientation Instability, (b) Sexual Irresponsibility, and (c) Interpersonal Hostility. This structure emerged with bisexual persons' reported experiences of prejudice from heterosexual people as well as from lesbian and gay people. Confirmatory factor analysis of data from a separate sample of 349 bisexual individuals supported the stability of this 3-factor structure. The data offered evidence of acceptable reliability (i.e., Cronbach's alphas of .81 to .94), convergent validity (i.e., with stigma consciousness, r = .37 to .54; with awareness of public devaluation, r = .28 to .41), and discriminant validity (i.e., for impression management, r = –.00 to .09). Relative levels of the various types of perceived experiences of anti-bisexual prejudice and the role of such experiences within the minority stress framework were also explored. With a separate sample of 176 bisexual individuals, data on the final 17-item version of the ABES yielded 2-week test–retest reliability coefficients of .77 to .89 and Cronbach's alphas of .86 to .96 across subscales. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors of HIV-related stigma among young people living with HIV.

Enacted and perceived HIV stigma was examined among substance-using young people living with HIV (YPLH) in Los Angeles, San Francisco, and New York City (N = 147). Almost all YPLH (89%) reported perceived stigma, and 31% reported enacted experiences in the past 3 months; 64% reported experiences during their lifetime. The HIV stigma questions were characterized by factors of avoidance, social rejection, abuse, and shame. In multivariate models, enacted stigma was associated with gay or bisexual identity, symptomatic HIV or AIDS, and bartering sex. Perceived stigma was associated with female gender, symptomatic HIV or AIDS, bartering sex, lower injection drug use, and fewer friends and family knowing serostatus. Gay or bisexual YPLH who were also HIV symptomatic or AIDS diagnosed experienced more HIV stigma than their heterosexual peers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Two Forms of Racism and Their Related Outcomes: The Bad and the Ugly.

Two experiments investigated the related outcomes of two forms of racism among college students (413 in the first and 374 in the second experiment) enrolled in a program leading to careers in law enforcement such as police officers. The two forms of racism were the overt, traditional type whereby visible minorities are denigrated the basis of innate characteristics, and the subtle type called neoracism, which incorporates egalitarian values and negative beliefs in the blame of visible minorities for undeserved gains and overall social problems. The design of the experiments allowed for a reality check that they pertained to racial issues relevant to training and work in law enforcement. Experiment 1 showed, as hypothesized, that although both forms of racism are linked, only neoracism is associated with covert attitudes (i.e., unfavourable reactions to employment equity), and traditional racism is related to overt discriminatory behavioural intentions. Experiment 2 investigated the impact of priming a negative reaction to a visible minority on the pattern of these links. Under such conditions the observed links strongly suggest that respondents regress to old norms as neoracism is then associated with both covert negative attitudes and overt discriminatory behavioural intentions. The theoretical and practical implications of these findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Justice, citizenship, and role definition effects.

A limitation of the organizational citizenship behavior (OCB) literature is that theory and empirical evidence suggest that some employees define OCBs as part of their job. A theoretical framework that addresses this problem is tested in this article. The framework focuses on 2 effects: a role enlargement effect (i.e., employees with more favorable attitudes define OCB as inrole behavior, which, in turn, results in greater citizenship) and a role discretion effect (i.e., the relationship between employees' attitudes and their citizenship will be stronger among employees who define OCB as extrarole behavior). In tests of this framework with 2 independent samples of supervisor–subordinate dyads, role definition were found to moderate several relationships between procedural justice and OCB, providing support for the role discretion effect. Implications for OCB theory and research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stigma consciousness: the psychological legacy of social stereotypes

Whereas past researchers have treated targets of stereotypes as though they have uniform reactions to their stereotyped status (e.g., J. Crocker & B. Major, 1989; C. M. Steele & J. Aronson, 1995), it is proposed here that targets differ in the extent to which they expect to be stereotyped by others (i.e., stigma consciousness). Six studies, 5 of which validate the stigma-consciousness questionnaire (SCQ), are presented. The results suggest that the SCQ is a reliable and valid instrument for detecting differences in stigma consciousness. In addition, scores on the SCQ predict perceptions of discrimination and the ability to generate convincing examples of such discrimination. The final study highlights a behavioral consequence of stigma consciousness: the tendency for people high in stigma consciousness to forgo opportunities to invalidate stereotypes about their group. The relation of stigma consciousness to past research on targets of stereotypes is considered as is the issue of how stigma consciousness may encourage continued stereotyping.