The Effects of Intersecting Stigma: A Longitudinal Examination of Minority Stress, Mental Health, and Substance Use Among Black, Latino, and Multiracial Gay and Bisexual Men
The Effects of Intersecting Stigma: A Longitudinal Examination of Minority Stress, Mental Health, and Substance Use Among Black, Latino, and Multiracial Gay and Bisexual Men
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DOI：
10.1037/vio0000218
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发表时间：
2018-11-01
影响因子：
2.8
通讯作者：
Parsons, Jeffrey T.
中科院分区：
文献类型：
--
作者：
English, Devin;Rendina, H. Jonathon;Parsons, Jeffrey T.
目的：尽管黑人、拉丁裔和多种族同性恋和双性恋男性（GBM）在美国更广泛地受到GBM面临的心理和行为健康不平等的不成比例的影响（疾病控制与预防中心，2017年），但缺乏关于他们的交叉耻辱经历如何促成这些趋势的研究。本研究以少数族群压力和交叉性理论为基础，探讨种族歧视和同性恋拒绝敏感性对情绪调节困难、抑郁和焦虑症状以及后来的吸毒和酗酒的主要和交叉影响。方法：我们收集了170名黑人、拉丁裔或多种族后裔的GBM的纵向数据。测量包括基线种族歧视，同性恋拒绝敏感性，情绪调节困难，6个月抑郁和焦虑症状，基线至12个月酗酒和吸毒。我们使用纵向结构方程模型分析数据。结果：我们的研究结果表明，种族歧视及其与同性恋拒绝敏感性的相互作用与更高水平的情绪调节困难显著相关，这预示着6个月时更高水平的抑郁和焦虑症状，而抑郁和焦虑症状反过来又预示着12个月时更高水平的酗酒，而不是吸毒。此外，柱头变量对重度饮酒的总间接影响具有统计学意义。结论：这些发现表明，在黑人、拉丁裔和多种族GBM患者持续存在心理和行为健康不平等的情况下，研究人员和临床医生有必要考虑种族和性少数耻辱感对情绪调节的影响。
Objective: Although Black, Latino, and multiracial gay and bisexual men (GBM) are disproportionately affected by psychological and behavioral health inequities facing GBM more broadly in the United States (Centers for Disease Control & Prevention, 2017), there is a dearth of research examining how their experiences of intersectional stigma contribute to these trends. Based in minority stress and intersectionality theories, this study examined the main and intersectional effects of racial discrimination and gay rejection sensitivity on emotion regulation difficulties, depressive and anxiety symptoms, and later drug use and heavy drinking. Method: We collected longitudinal data from 170 GBM of Black, Latino, or multiracial descent. Measurements included baseline racial discrimination, gay rejection sensitivity, and emotion regulation difficulties, 6-month depressive and anxiety symptoms, and baseline to 12-month heavy drinking and drug use. We analyzed data using longitudinal structural equation models. Results: Our results indicated that racial discrimination and its interaction with gay rejection sensitivity were significantly associated with higher levels of emotion regulation difficulties, which predicted higher levels of depressive and anxiety symptoms at 6 months, which, in turn, predicted higher levels of heavy drinking, but not drug use, at 12 months. Moreover, the total indirect effect from the stigma variables to heavy drinking was statistically significant. Conclusions: These findings indicate that it is critical for researchers and clinicians to consider the effects of intersecting racial and sexual minority stigma on emotion regulation in the persistence of psychological and behavioral health inequities facing Black, Latino, and multiracial GBM.