The impact of internalized homophobia on HIV preventive interventions

A growing body of research implicates internalized homophobia—the internalization of society's antihomosexual sentiments by gay and lesbian people—as a factor contributing to HIV-related sexual risk behavior in gay and bisexual men. Although accumulating evidence links internalized homophobia and sexual risk behavior, no study has explored the impact of internalized homophobia on efforts to prevent these behaviors. This paper examines the effect of internalized homophobia on gay and bisexual men's awareness of, participation in, and perceptions of programs offered by a community-based HIV prevention organization. In Study 1, 595 gay and bisexual men reported their levels of awareness of and participation in HIV prevention programming offered by one community organization. Internalized homophobia was negatively related to men's awareness of the services offered by the organization. However, among the men who were aware of at least one service, internalized homophobia did not further predict service utilization. Study 2 examined 89 gay and bisexual men who participated for a single session in a group-structured, community-based HIV preventive intervention. Pre- to immediate postintervention change in perceptions of condom use self-efficacy was inversely related to internalized homophobia. Internalized homophobia was also a significant negative predictor of the extent to which participants felt similar to and related well with other members of the group. Together, these findings suggest that internalized homophobia may pose multiple barriers to community-based HIV prevention efforts.     

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。     

Psychotherapy, classism, and the poor: conspicuous by their absence

Four decades of research have delineated the need for improved psychotherapeutic opportunities for poor clients, yet psychotherapists remain contradictory in their stance regarding service to the poor. Despite periodic calls within the field to address the needs of poor people, evidence from the psychotherapeutic literature suggests that the poor are still largely absent from consideration. What barriers prevent psychotherapists from enacting their professional principles more consistently on behalf of poor clients? The author suggests that unexamined classist assumptions constitute a significant obstacle for practitioners and presents the experience of confronting her own classism to illustrate the operation of these attitudinal barriers.     

Depressive symptoms, cortisol, and cognition during human aging: the role of negative aging perceptions

Depressive symptoms and memory impairments are associated with heightened stress hormone levels during aging. A factor that is related to memory deficits during aging is internalized negative aging stereotypes; the idea people have about the process of aging. In this study, we assessed the associations between internalized negative aging stereotypes, depressive symptoms, subjective and objective memory assessments, and cortisol concentration among older adults. Forty older adults aged between 58 and 85 years (18 females and 22 males; mean age?±?SD: 71.25?±?8.80 years) were assessed in this study. Measures of internalized negative aging stereotypes, depressive symptoms, and both subjective and objective memory performance were assessed. Salivary samples were obtained for measurement of cortisol concentration. Stepwise linear regressions were executed in our main analyses. Internalized negative aging stereotypes were associated with increased depressive symptoms and subjective memory complaints. No significant differences were observed for objective memory performance, or cortisol concentration. Internalized negative aging stereotypes are associated with increased depressive symptomatology and subjective complaints of memory; however, they do not predict increased cortisol concentration nor objective memory performance during aging. These results indicate that the mechanism underlying the association between internalized negative aging stereotypes and cognitive impairments may not be related to dysregulations of cortisol secretion among older adults.     

Shame,attachment, and addictions: Implications for family therapists

Research based on attachment theory is reviewed for its relevance to the development of later addictions. The problem of internalized shame as an attachment related issue is discussed. Some original research into internalized shame using the Internalized Shame Scale is summarized. The relevance of this research and theory for family of origin based treatment of addictions is explored.     

Distress and Internalized Homophobia Among Lesbian Women Treated for Early Stage Breast Cancer

A convenience sample of 57 lesbian women who had been recruited for a study of adjustment to breast cancer completed measures of internalized homophobia, degree of disclosure of sexual orientation, social support, self-esteem, and distress. Consistent with our prediction, internalized homophobia related to greater distress. Contrary to our prediction, disclosure did not relate to lower distress. Path models were consistent with the position that internalized homophobia promotes distress through lower self-esteem and perceived unavailability of social support. However, the data were also consistent with a model in which low self-esteem leads to internalized homophobia by way of elevated distress. Internalized homophobia also related inversely to utilization of health care resources. Our discussion centers on the need for more information regarding this understudied population.     

Narrative enhancement and cognitive therapy: a new group-based treatment for internalized stigma among persons with severe mental illness

Internalized stigma has been suggested to play a major role in negative changes in identity in severe mental illness. Evidence suggests that roughly one-third of people with severe mental illness show elevated internalized stigma and that it is linked to compromised outcomes in both subjective and objective aspects of recovery. Despite substantial evidence for the impact of internalized stigma, few efforts have been made to develop professionally led treatment to address this issue. In this article, we discuss our development of a new group-based approach to the treatment of internalized stigma which we have termed "narrative enhancement and cognitive therapy (NECT)". We describe the treatment approach and offer an illustration of it by way of a case vignette.     

Therapeutische Teams: Theorie—Empirie—Klinik (Therapeutic Teams: Theory—Research—Clinic)

Abstract

Internalized stigma has been suggested to play a major role in negative changes in identity in severe mental illness. Evidence suggests that roughly one-third of people with severe mental illness show elevated internalized stigma and that it is linked to compromised outcomes in both subjective and objective aspects of recovery. Despite substantial evidence for the impact of internalized stigma, few efforts have been made to develop professionally led treatment to address this issue. In this article, we discuss our development of a new group-based approach to the treatment of internalized stigma which we have termed “narrative enhancement and cognitive therapy (NECT)”. We describe the treatment approach and offer an illustration of it by way of a case vignette.     

People with physical disability in Serbia: Relationship between internalized stigma,experienced and anticipated discrimination,and empowerment

The aim of present study was to explore relationships between experienced and anticipated discrimination, internalized stigma, and empowerment among people with physical disabilities in Serbia. The convenience sample consisted of persons with different types of physical disabilities. The following scales were administrated: The Discrimination and Stigma Scale, the Internalized Stigma of Mental Illness Scale, and the Boston University Empowerment Scale. An analysis showed that internalized stigma was correlated with experienced and anticipated discrimination and empowerment, while no correlation was found between empowerment and discrimination. People with physical disabilities who experienced and anticipated discrimination are at higher risk of reporting internalized stigma.     

Healing internalized racism: the role of a within-group sanctuary among people of African descent

This article addresses the role of a "within-group" sanctuary for healing internalized racism among people of African descent. Internalized racism is distinguished from racism, juxtaposing the different experience of those who are oppressed and those who are privileged by racism. It is suggested that a context consisting exclusively of persons of African descent can provide an optimally safe space for initial stages of healing from internalized racism. The anxiety that a collective of African descendants can generate among whites, and subsequently among those of African descent, is examined by raising questions as to its possible meanings. Whites are encouraged to use their privilege to support such self-determined sanctuaries, rather than to obstruct them. People of African descent are encouraged to tolerate the anxiety that can be generated without "changing back," and to examine whether internalized racism is also implicated.     

Cognitive and behavioral distancing from the poor

The author argues that distancing is the dominant response to poor people on the part of those who are not poor and that distancing, separation, exclusion, and devaluing operationally define discrimination. Such responses, together with stereotypes and prejudice, define classism. The article focuses on classism in the United States. Classism is examined in the context of theoretical propositions about the moral exclusion of stigmatized others and is illustrated by cognitive distancing, institutional distancing (in education, housing, health care, legal assistance, politics, and public policy), and interpersonal distancing. The adoption of the Resolution on Poverty and Socioeconomic Status by the American Psychological Association Council of Representatives in August 2000 is cited as an important step in the direction of eliminating the invisibility of low-income persons in psychological research and theory.     

Navigating Social Class Roles in Community Research

This paper describes the first author's attempt to collect data in a homeless shelter without attending to her role in the social class hierarchy of the organization. The author's egalitarian approach towards the homeless clients, and her lack of involvement in "staff-only" activities, transgress the social class norms within the organizational structure. While the author is successful in gaining the trust of the homeless clients, her approach alienates shelter staff, especially those in the higher echelons of the social hierarchy. The concepts of classism, world views, and Social Identity Theory, are utilized to discuss the dilemma faced by researchers who want to challenge, or work outside, a setting's status quo.     

Ambivalent Classism: The Importance of Assessing Hostile and Benevolent Ideologies about Poor People

Abstract

We present a model of ambivalent classism in which hostile (overtly negative and insulting) and benevolent (subjectively positive but condescending) attitudes about poor people co-exist and independently predict endorsement of restrictive and poverty-perpetuating welfare policies. Whereas existing classism scales predominantly measure antipathy toward poor people, we developed and validated the Ambivalent Classism Inventory (ACI), a 20-item scale that captures both hostile and benevolent attitudes toward poor people. The ACI has one hostile factor (hostile classism) and two benevolent factors (protective paternalism and complementary class differentiation). Data from four samples (total n?=?1,543) indicate that the ACI has good reliability and validity. Findings underscore the role of benevolent beliefs in classist attitudes. Item generation, analytical methods, and implications are discussed.     

Marital Breakdown,Shame, and Suicidality in Men: A Direct Link?

The influence of feelings of shame originating from marital breakdown on suicidality is examined. The role of mental health problems as probable mediating factors is also considered. Internalized shame, state (related to separation) shame, and mental health problems were significantly correlated with the score for suicidality during separation in both genders. Tested structural equation model indicated that internalized shame was not directly linked to suicidality, but was mediated either by state shame or mental health problems in males in the context of separation. Our findings seem to indicate that separated males are more vulnerable to the experience of state shame in the context of separation, which might lead to the development of suicidality.     

Predictors of anxiety and depression among newly diagnosed people living with HIV: A longitudinal study

This longitudinal study examined whether past resilience and internalized stigma predicted anxiety and depression among newly diagnosed Spanish-speaking people living with HIV (PLWH). We also analyzed whether coping strategies mediated this relationship. Data were collected at two time points from 119 PLWH. Approximately a third of participants had scores indicative of anxiety symptoms, the same result was found for depressive symptoms. Structural equations modeling revealed that 61% of the variance of anxiety and 48% of the variance of depression 8 months after diagnosis was explained by the proposed model, which yielded a good fit to data. Anxiety and depressive symptoms were significantly and negatively predicted by positive thinking, thinking avoidance, and past resilience, and positively predicted by self-blame. Additionally, anxiety was positively predicted by internalized stigma. Past resilience negatively predicted internalized stigma, self-blame, and thinking avoidance and it positively predicted positive thinking. Internalized stigma positively predicted self-blame. Moreover, internalized stigma had a significant indirect effect on anxiety symptoms through self-blame, and past resilience had significant indirect effects on anxiety symptoms and depressive symptoms through internalized stigma and coping. The results point to the need for clinicians and policy makers to conduct systematic assessments and implement interventions to reduce internalized stigma and train people living with HIV to identify and use certain coping behaviors.     

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.     

Roman Catholic Gay Priests: Internalized Homophobia, Sexual Identity, and Psychological Well-Being

Using convenience sampling, a national sample of 156 actively ministering or retired Roman Catholic priests was obtained. One hundred and five (105) of these priests identified as gay/homosexual (67.3 %), 42 identified as heterosexual (26.9 %), and 9 identified as bisexual (5.8 %). Due to the small number of bisexual participants, the bisexual priests’ responses were excluded, and the whole sample was divided into a gay/homosexual group and a heterosexual comparison group. This confidential study yielded a response rate of 78 %. The priests were mailed self-report survey instruments, including the Scales of Psychological Well-Being, the Internalized Homonegativity Inventory, the Gay Identity Questionnaire, the Depression-Happiness Scale, and the Marlowe-Crowne Social Desirability Scale, as well as a demographics questionnaire. Results demonstrated that internalized homophobia was negatively correlated with psychological well-being and associated with depression. Internalized homophobia was also found to be related to less integration of sexual identity. There was no significant difference between the gay/homosexual and the heterosexual group in their psychological well-being and depression scores, and both groups emerged as high scorers on the measures of psychological well-being and depression-happiness (high scores on this bipolar instrument indicate happiness). Implications and limitations of the study are reviewed and discussed.     

Depression Among Transgender Older Adults: General and Minority Stress

This study aims to (a) examine the direct and indirect effects internalized heterosexism, disclosure of gender identity, and perceived general stress in association with depression among transgender older adults; and (b) to assess the relative contribution of each relationship. Secondary analyses of data from a large community‐based study of older sexual and gender minorities were conducted utilizing structural equation modeling with a subsample (n = 174) of transgender adults aged 50 to 86‐years old. Disclosure of gender identity had no significant direct or indirect effects on either perceived general stress or depression. Internalized heterosexism did not have a direct effect on depression, but did have a significant indirect effect through perceived general stress. Finally, perceived general stress had an additional significant direct effect on depression, over and above internalized heterosexism. Total effect sizes appear to be considerable with standardized betas greater than 5.0. Perceived general stress and internalized heterosexism independently and cumulatively have significant direct and indirect effects on depression among transgender older adults. Implications for depression among transgender older adults and the role of community psychology are discussed.     

Minority Stress and the Risk of Unwanted Sexual Experiences in LGBQ Undergraduates

Sexual assault is prevalent among lesbian, gay, bisexual, and queer (LGBQ) college students, but its relationship to anti-LGBQ stigma has not been established. The goal of the present study was to determine whether minority stress, specifically internalized homophobia, predicted unwanted sexual experiences among LGBQ undergraduates (N = 763), whether routine behaviors (number of consensual sexual partners and alcohol use) mediated this relationship, and whether sense of LGBTQ community was a protective factor. Significant proportions of sexual minority men (10 %), women (18 %), and non-binary or transitioning students (19 %) reported an unwanted sexual experience since entering college. Internalized homophobia was associated with greater risk of unwanted sexual experiences. It also had a negative indirect effect on unwanted sexual experience risk through a negative association with number of sexual partners. Alcohol use did not mediate the relationship between internalized homophobia and unwanted sexual experiences. Sense of LGBTQ community was associated with lower risk, mediated by lower levels of internalized homophobia. The relationships between internalized homophobia and unwanted sexual experience risk were similar for women and men. These findings demonstrate that minority stress increases LGBQ students’ risk of sexual victimization and that in-group social relationships can mitigate this risk. We argue that minority stress is an important risk factor for sexual violence. Violence prevention interventions should attempt to reduce internalized homophobia, and colleges and high schools should establish LGBQ-affirming social climates and provide resources for LGBQ students, including targeted violence prevention efforts and programs that foster a sense of supportive community.     

Elaborating the Connection between Social Class and Classism in College

Scholarship has documented the challenges that face college students of marginalized economic backgrounds, an issue that is relevant for Community Psychology because of the field's commitment to social justice. Community psychologists are concerned with facilitating access to social resources such as education across the full range of social identities. The current study builds on recent research that has identified the key role of classism in students' struggles. We developed a new measure of college student financial stress in order to investigate the relationship between indices of social class (financial stress, subjective social status, and parental education) and indices of classism (institutional, interpersonal, and citational). We also explored whether race or immigration status moderated these relationships in a sample of diverse students (N = 278). Findings show that students' current financial stress has the strongest relationship with classism, and immigration status moderates the exposure to citational classism. Specifically, we found evidence for perpetuation of classism among U.S. born students higher on the social class ladder. Implications for future research include the importance of considering multiple domains of social class, studying social class in a context‐specific way, and differentiating dimensions of classism. Findings also suggest that financial stress is an important focus in the work to support marginalized students, and that classist narratives need to be addressed among students of higher social class.