Effect of perceived public stigma on internalized homophobia,anticipated stigma,shame, and guilt: Outness as a moderator

Although previous studies found that distal minority stress contributes to proximal minority stress and shame/guilt among the lesbian, gay, and bisexual (LGB) population, it is unclear whether the extent to which LGB individuals' open display and discussion their sexual orientation moderates these relationships. A total of 1,452 Chinese LGB adults provided demographic information and completed measures of outness, perceived public stigma, internalized homophobia, anticipated stigma, shame, and guilt. Structural equation modelling was conducted to test the hypothesized moderation analyses. Perceived public stigma had positive associations with internalized homophobia, anticipated stigma, shame, and guilt. Outness played a moderating role in the associations of perceived public stigma with internalized homophobia, anticipated stigma, shame, and guilt. Specifically, when LGB individuals had higher levels of outness, the effects of perceived public stigma on internalized homophobia, anticipated stigma, shame, and guilt were lower. Moreover, such moderating effect did not differ by sexual orientation. The degree to which sexual minority individuals' sexual orientation is known by and openly discussed with others may lower the extent to which LGB individuals internalize sexual stigma, expect rejection after coming out, and develop shame and guilt as a result of perceived social prejudice and discrimination.     

Social Media as Social Capital of LGB Individuals in Hong Kong: Its Relations with Group Membership,Stigma, and Mental Well‐Being

Social media are found to facilitate social information exchange among lesbian, gay, and bisexual (LGB) individuals who are subjected to social stigma. This study tested the protective role of LGB‐tailored social media uses and gratifications in promoting LGB group membership, which we hypothesized to reduce LGB stigma and enhance mental health among LGB individuals in Hong Kong. Based on a sample of 233 Chinese LGB individuals in Hong Kong, structural equation modeling showed evidence for our hypotheses, χ_(df=62)² = 88.20, GFI = 0.95, CFI = 0.98, NNFI = 0.98, SRMR = 0.07, RMSEA = 0.04. Community surveillance, identity expression, and emotional support on social media may promote mental health by instilling a sense of group membership and reducing stigma. Social media may build camaraderie and bolster resilience among LGB individuals that may otherwise be difficult in conservative regions.     

How Does Stigma "Get Under the Skin"?: The Mediating Role of Emotion Regulation

ABSTRACT— Stigma is a risk factor for mental health problems, but few studies have considered how stigma leads to psychological distress. The present research examined whether specific emotion-regulation strategies account for the stigma-distress association. In an experience-sampling study, rumination and suppression occurred more on days when stigma-related stressors were reported than on days when these stressors were not reported, and rumination mediated the relationship between stigma-related stress and psychological distress. The effect of social support on distress was moderated by the concealability of the stigma: Lesbian, gay, and bisexual (LGB) respondents reported more isolation and less social support than African American respondents subsequent to experiencing stigma-related stressors, whereas African Americans reported greater social support than LGB participants. Social isolation mediated the stigma-distress association among LGB respondents. In a second experimental study, participants who ruminated following the recall of an autobiographical discrimination event exhibited prolonged distress on both implicit and explicit measures relative to participants who distracted themselves; this finding provides support for a causal role of rumination in the stigma-distress relationship.     

Minority stress and health: Implications for lesbian,gay, bisexual,transgender, and questioning (LGBTQ) young people

Historically, the pathologization of lesbian, gay, bisexual, transgender, and questioning (LGBTQ) orientations shaped research and professional practice, while the impact of stigma was not considered. Within a minority stress conceptualization however, stigma-related prejudice and discrimination experienced by LGBTQ people constitute chronically stressful events that can lead to negative health outcomes. Minority stress has been linked to psychological distress among gay men and lesbians and may contribute to elevated rates of distress frequently observed among LGBTQ youth. This study explored the impact of minority stress on psychological distress among LGBTQ youth in Ireland. Measures assessing three components of minority stress (sexual identity distress, stigma consciousness, and heterosexist experiences) were administered online to LGBTQ youth aged 16–24 years (N = 301). Each minority stressor had a significant independent association with distress. Stepwise regression analyses identified the linear combination of minority stressors as significantly predictive of distress [F(3,201) = 30.80, p ≤ 0.001]. Results suggest that the oppressive social environment created through sexual/transgender identity-related stigma negatively impacts on the well-being of LGBTQ youth. These findings have implications for health professionals and policy makers interested in the concerns of LGBTQ youth experiencing difficulties related to minority status and will facilitate the development and tailoring of interventions aimed at reaching those most at risk.     

Infant feeding and internalized stigma: The role of guilt and shame

Globally the rates of breastfeeding duration are extremely low and postnatal mental health issues are common. As a result, it is important to examine the emotions that underlie these matters. Across two studies (one correlational study N = 160 and one experimental study N = 118), we examined participants’ experiences of shame and guilt when feeding their baby, and the relationship between these emotions with breastfeeding behaviors and internalized stigma. We also examined the psychosocial factors that predict internalized stigma, and whether shame and guilt mediate these relationships. We focused on three factors that have been shown to be associated with internalized stigma in other domains: self-esteem and social support (Study 1), as well as self-efficacy (Study 2). Multiple regression revealed that experienced guilt uniquely predicted a shorter duration of exclusive breastfeeding (Study 1). Higher self-efficacy (Study 2), self-esteem, and perceived social support (Study 1) predicted lower internalized stigma of feeding choice. We found that shame was a mediator for the self-esteem and internalized stigma relationship (Study 1), while guilt was a mediator for the self-efficacy and internalized stigma relationship (Study 2). Our findings highlight the importance of experienced shame and guilt in mothers’ infant feeding experiences. The current results can inform future research and the design of interventions to improve breastfeeding rates and reduce feelings of stigma.     

Comparing Education,Employment, Social Support and Well-being among Youth with Disabilities and Their Peers in South Africa

Youth with disabilities face many challenges in life which are thought to have a negative impact on their well-being. Evidence, however, suggests that individuals differ in their resilience to deal with adverse life-events and protect their well-being. These differences may be explained by an individual’s resources such as education, employment, and social support. Studies on how youth with disabilities perceive their well-being and resources important to their well-being are, however, lacking. In this study we therefore compared education, employment, social support, and well-being between youth with disabilities (n?=?120) and their peers (n?=?117) in South Africa. In addition, we investigated the relationship between background characteristics, having a disability, access to resources, and well-being. The unemployment rate among youth with disabilities is higher, they are less educated, receive less social support and report poorer states of well-being. Our study showed that having a disability, social support, and employment were associated with the well-being of youth in South Africa. While having a disability predicted well-being in youth, the effect was mediated by employment and social support, indicating that those two resources influence wellbeing through both a direct and buffer effect. Therefore, employment and social support may mitigate the negative consequences of a disability and have a substantial role in improving or maintaining well-being.     

Depression is not an inevitable outcome of disclosure avoidance: HIV stigma and mental health in a cohort of HIV-infected individuals from Southern India

Previous research has shown that HIV stigma in India can be characterized by a framework dividing manifestations into enacted (discrimination), vicarious (hearing stories of discrimination), felt normative (perceptions of stigma's prevalence), and internalized stigma (personal endorsement of stigma beliefs). We examined whether this framework could explain associations among stigma, efforts to avoid HIV serostatus disclosure, and depression symptoms in a cohort of 198 HIV-infected individuals from Southern India who were followed up for one year as part of a study of antiretroviral adherence. Prior studies had suggested that disclosure avoidance was a primary outcome of stigma and that impaired well-being was a primary outcome of disclosure avoidance. Analyses from our longitudinal research revealed that the pattern of associations among stigma, disclosure avoidance, and depression symptoms remained consistent over time. Enacted and vicarious stigmas were correlated with felt normative stigma beliefs. In turn, felt normative stigma was correlated with disclosure avoidance. And, enacted stigma, internalized stigma, and disclosure avoidance were all associated with depression symptoms. However, even though the overall framework held together, internalized stigma and depression symptoms dropped significantly over time while other components remained unchanged. These findings suggest that, although HIV stigma may limit disclosure, it does not invariably lead to psychological maladjustment. Amidst ongoing perceptions and experiences of stigma, HIV-positive individuals can achieve significant improvements in their acceptance of the disease and in mental well-being.     

Stigma modifies the association between social support and mental health among sexual violence survivors in the Democratic Republic of Congo: implications for practice

Background and Objectives: The aim of this study was to further understanding of the relationship between social support, internalized and perceived stigma, and mental health among women who experienced sexual violence in the eastern Democratic Republic of Congo (DRC).

Methods: Drawing from baseline survey data collected in eastern DRC, researchers conducted a secondary cross-sectional analysis using data from 744 participants. Regression and moderation analyses were conducted to examine associations between social support variables, felt stigma, and depression, anxiety and posttraumatic stress disorder (PTSD).

Results: Emotional support seeking and felt stigma were positively associated with increased symptom severity across all three mental health variables. Stigma modified associations between emotional support seeking and depression (t?=??2.49, p?=?.013), anxiety (t?=??3.08, p?=?.002), and PTSD (t?=??2.94, p?=?.003). Increased frequency of emotional support seeking was associated with higher mental health symptoms of anxiety and PTSD among women experiencing all levels of stigma.

Conclusions: Enhancing understanding of social support and stigma may inform research and intervention among Congolese forced migrant populations across circumstances and geographic locations. Implications for practice and research are discussed.     

What We Know and Where We Go from here: A Review of Lesbian,Gay, and Bisexual Youth Hookup Literature

In this paper, we acknowledge and critique the absence of lesbian, gay, and bisexual (LGB) experiences in the recent proliferation of scholarship on “hooking up” among youth (aged 16 to 24). Although previous research has documented that LGB youth hookup at high rates (up to three-quarters of LGB youth), and oftentimes more than heterosexuals, the most basic aspects of hookups (e.g., motivations, experiences, and outcomes) have not been comprehensively explored. This is pertinent because young adulthood, in particular, is a time when young people explore their sexuality. Most scholarship on hooking up has focused on White heterosexual college students, mostly due to sampling constraints and impediments, and so we are left with a critical gap in our knowledge about LGB youth—a population that is typically at higher risk for sexual, mental, and emotional health issues. We begin by reviewing the literature on hooking up among heterosexual young adults as organized by four themes: hookup definitions/frequencies, contexts, motivations, and outcomes. We do this to explicitly highlight and contrast what little is known about LGB youth hookups. We then provide a research agenda that projects how future researchers can advance this area of scholarship and begin to fill its gaps, while considering the hookup experiences of diverse LGB youth.     

Self-esteem among lesbian,gay, bisexual and same-sex-attracted Mormons and ex-Mormons

Lesbian, gay, bisexual and same-sex-attracted (LGB/SSA) individuals in conservative religions often experience stigma, shame, and psychological distress in reconciling their religious and sexual identities, yet religion can also provide existential comfort and social support. We investigated relationships among self-esteem, participation in the Mormon Church, and sexual identity acceptance among 348 LGB/SSA Mormons and ex-Mormons in 2013–2014 and found that the two groups reported similar self-esteem. By testing plausible mediators (family support, gay/SSA identity acceptance, and agreement with Mormon Church policy prohibiting same-sex behaviour) through a path model, results revealed different pathways to self-esteem. Practicing LGB/SSA Mormons reported higher family support and lower gay/SSA identity acceptance than ex-Mormons, while those self-identifying as SSA but not gay reported lower gay/SSA identity acceptance. We suggest that religiously active Mormons demonstrate low self-acceptance of their gay/SSA identity while ex-Mormons suffer loss of familial and social support, resulting in equal self-esteem across church status groups.     

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.     

Discrimination,Internalized Homonegativity,and Attitudes Toward Children of Same‐Sex Parents: Can Secure Attachment Buffer Against Stigma Internalization?

With increasing numbers of same‐sex couples raising children in the United States, discriminatory attitudes toward children of same‐sex parents (ACSSP) are of increasing concern. As with other forms of stigma and discrimination, lesbian, gay, and bisexual (LGB) individuals are at risk for internalizing these societal attitudes, which can negatively affect parenting‐related decisions and behaviors and the mental and physical health of their children. Secure attachment is characterized by positive views of the self as loveable and worthy of care that are understood to develop in early relationships with caregivers. Secure attachment has been associated with positive mental and physical health, including among LGB individuals and couples. This study aimed to test the potential buffering role of secure attachment against stigma internalization by examining associations among secure attachment, discrimination, internalized homonegativity (IH), and ACSSP in an online survey study of 209 U.S. adults in same‐sex relationships. Bootstrap analyses supported our hypothesized moderated mediation model, with secure attachment being a buffer. Greater discrimination was indirectly associated with more negative ACSSP through greater IH for individuals with mean or lower levels, but not for individuals with higher than average levels of secure attachment, specifically because among those with higher levels of secure attachment, discrimination was not associated with IH. These findings build on and extend past research, with important implications for future research and clinical work with LGB individuals, same‐sex couples, and their families, including potential implementation of interventions targeting attachment security.     

In the Wake of Don't Ask Don't Tell: Suicide Prevention and Outreach for LGB Service Members

It is estimated that lesbian, gay, and bisexual (LGB) individuals are three to five times more likely to attempt suicide than their heterosexual counterparts. Factors linked to increased LGB suicide risk are overt and covert discrimination, internalized oppression, nondisclosure of sexual orientation, and lack of adequate social support. As the U.S. military adjusts to the repeal of Don't Ask Don't Tell (DADT), it will be imperative to understand and support service people who are struggling with many of these same issues. This article explores factors linked to suicidality and provides education for professionals working with LGB service people. Emphasis is placed on strategies for the provision of support and suicide prevention for members of this population.     

The effect of personal and group discrimination on the subjective well-being of people with mental illness: the role of internalized stigma and collective action intention

The goal of this study is to test a model in which personal discrimination predicts internalized stigma, while group discrimination predicts a greater willingness to engage in collective action. Internalized stigma and collective action, in turn, are associated to positive and negative affect. A cross-sectional study with 213 people with mental illness was conducted. The model was tested using path analysis. Although the data supported the model, its fit was not sufficiently good. A respecified model, in which a direct path from collective action to internalized stigma was added, showed a good fit. Personal and group discrimination appear to impact subjective well-being through two different paths: the internalization of stigma and collective action intentions, respectively. These two paths, however, are not completely independent, as collective action predicts a lower internalization of stigma. Thus, collective action appears as an important tool to reduce internalized stigma and improve subjective well-being. Future interventions to reduce the impact of stigma should fight the internalization of stigma and promote collective action are suggested.     

年轻男同性恋者内化同性恋嫌恶与主观幸福感的关系：自尊与孤独感的中介效应

通过网络抽样法,采用内化同性恋嫌恶量表、自尊量表、孤独感量表、主观幸福感量表对249名年轻男同性恋者进行调查,考察当代国内年轻男同性恋者内化同性恋嫌恶的现状,并探讨内化同性恋嫌恶与主观幸福感的关系及自尊与孤独感在其间的中介效应。结果表明：（1）总体上,国内年轻男同性恋者内化同性恋嫌恶处于中等偏低水平,且有较大比例年轻男同性恋者不存在内化同性恋嫌恶。（2）内化同性恋嫌恶与积极情感、生活满意度显著负相关,与消极情感显著正相关。（3）自尊与孤独感在内化同性恋嫌恶与主观幸福感间起完全中介作用。（4）内化同性恋嫌恶通过影响自尊间接影响孤独感,又通过影响孤独感作用于主观幸福感。     

Perfectionism, Coping, Social Support, and Depression in Maltreated Adolescents

The current study examined the associations among dimensions of perfectionism, coping, social support, and depression in 58 adolescents with a history of maltreatment. Participants completed the Child-Adolescent Perfectionism, multidimensional measures of coping and social support, and the CES-D Depression Scale. Correlational analyses showed that depression was associated with socially prescribed perfectionism, internalized emotion-oriented coping, avoidant-oriented distancing, and low family support and peer support. Analyses of coping responses and perfectionism established links between self-oriented perfectionism and internalized emotion-oriented coping responses and self-reliant problem-solving. Socially prescribed perfectionism was associated with avoidance-oriented coping (i.e., distancing). While self-oriented perfectionism and social support were unrelated, socially prescribed perfectionism was associated with reduced levels of family support. Collectively, the findings highlight the roles of poor coping and social support as contributors to the emotional distress experienced by maltreated adolescents. Moreover, it is suggested that the distress experienced by perfectionistic youth with a history of maltreatment reflects, in part, the role of maladaptive coping styles and coping resource deficits. Our findings support further consideration of personality dimensions such as perfectionism as contributors to poor functioning among maltreated youth.     

Coping,social support,stigma, and gender difference among people living with HIV in Guangxi,China

The current study examined whether gender, HIV-related stigma, social support, and the interaction between gender and social support are associated with coping responses among people living with HIV and AIDS (PLWHA) in Guangxi, China. A total of 2987 PLWHA in Guangxi participated from October 2012 to August 2013. Multivariate analysis of covariance was conducted with gender and social support as main factors in the model, and stigma and other variables as covariates. After controlling for demographic variables and stigma, there were significant main effects of emotional social support (F = 1.61, p < .001), functional social support (F = 1.67, p < .001), and informational social support (F = 3.67, p < .001) on various coping strategies. The interaction between gender and informational social support (F = 1.33, p < .05), internalized stigma (F = 37.03, p < .001) and perceived stigma (F = 9.16, p < .001) were associated with various coping strategies. Findings signify the importance of HIV-related stigma and social support differences in the coping strategies among PLWHA in Guangxi, China.     

The Mediating Role of Self-Discrepancies in the Relationship Between Media Exposure and Well-Being Among Lesbian,Gay, and Bisexual Adolescents

Extant research suggests that exposure to depictions of sexuality in the media may influence the well-being of lesbian, gay, and bisexual (LGB) adolescents. Far less is known about the underlying processes that may explain this relationship. Self-discrepancy theory was utilized to predict that relationships between media exposure and well-being among LGB adolescents would be mediated by self-discrepancies in identity. A national survey of 573 LGB adolescents revealed that exposure to gay- and lesbian-oriented media was positively related to the well-being of LGB teens. The relationship between gay- and lesbian-oriented media exposure and well-being was mediated by self-discrepancies in identity for LGB adolescents low in sexual identity commitment. This finding suggests that increased exposure to gay- and lesbian-oriented media could decrease uncommitted LGB teens' perceived differences between their actual selves and their ideal selves, which, in turn, could increase their well-being. A positive relationship between mainstream media exposure and well-being was not mediated by self-discrepancies. The discussion focuses on the role of media in the identity development and sexual socialization of LGB adolescents.     

Psychological distance reduces the effect of internalized stigma on mental health treatment decisions

Although stigma is a major barrier to treatment for those with mental health concerns, it is poorly understood when stigma is more or less influential in mental health treatment decisions. In the current work, we examined whether psychological distance—the removal of an event from direct experience—reduced the influence of internalized stigma on willingness to seek treatment. Specifically, we tested the hypothesis that psychological distance versus proximity (e.g., seeking treatment in three months vs. in two days, respectively) decreases the negative influence of stigma on willingness to seek treatment. We focused on a population for whom mental health treatment decisions are personally-relevant: individuals who had previously sought mental health treatment. Experiment 1 showed that the extent to which these individuals internalized (i.e., personally endorsed) stigma about mental illness predicted lower intentions to make an appointment with a mental health care provider for themselves (but not another person). Experiment 2 replicated this result using a different measure of psychological distance (temporal distance) and extended this finding to behavior (time spent reading mental health resources). Overall, this research demonstrated that internalized stigma disrupts mental health treatment-seeking intentions and behaviors when they are psychologically proximal, but not when they are distant. Potential applications of these results are discussed.