Mechanisms linking distal minority stress and depressive symptoms in a longitudinal, population-based study of gay and bisexual men: A test and extension of the psychological mediation framework.
Mechanisms linking distal minority stress and depressive symptoms in a longitudinal, population-based study of gay and bisexual men: A test and extension of the psychological mediation framework.
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DOI：
10.1037/ccp0000749
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发表时间：
2022-08
影响因子：
5.9
通讯作者：
Hatzenbuehler, Mark L
中科院分区：
文献类型：
--
作者：
Lattanner, Micah R;Pachankis, John E;Hatzenbuehler, Mark L
同性恋和双性恋男性患抑郁症的比例明显高于异性恋男性。少数民族压力理论提出，远端少数民族压力源，如人际歧视，促成了这种差异。心理调解框架提出了一些社会心理机制，通过这些机制，远端少数群体压力会导致性少数群体抑郁程度的升高。尽管这一框架得到了越来越多的支持，但现有研究仍存在一些局限性，包括主要依赖于横截面设计；专注于机制和版主的一小部分；使用非概率样本。我们从美国成年人的人口数据集中招募了男同性恋和双性恋男性样本（N = 502）。参与者在基线、6个月随访和1年随访时完成了远端少数民族压力（即人际歧视）、心理社会机制（即反刍、情绪清晰度和社会支持）、身份相关调节因子（即身份中心性、污名意识和性取向认同）和抑郁症状的有效测量。反刍（b=0.38, 95% CI[0.13, 0.84]）、缺乏情绪清晰度（b=0.43, 95% CI[0.11, 0.83]）和缺乏社会支持（b=0.21, 95% CI[0.04, 0.45]）分别介导了人际歧视与抑郁症状之间的潜在关系，控制了初始症状、年龄和教育程度。这些间接影响不受身份相关特征或性别认同的影响。我们的研究为迄今为止的心理调解框架提供了一些最有力的经验证据，并提出了专注于减少少数群体压力对性少数群体男性心理健康后果的干预目标。
Gay and bisexual men have significantly higher rates of depression than heterosexual men. The minority stress theory proposed that distal minority stressors, like interpersonal discrimination, contribute to this disparity. The psychological mediation framework posited several psychosocial mechanisms through which distal minority stress creates elevations in depression among sexual minorities. Despite accumulating support for this framework, there are a number of limitations to existing research, including largely relying on cross-sectional designs; focusing on a small subset of mechanisms and moderators; and using non-probability samples. We recruited a sample of gay and bisexual men (N = 502) obtained from a population-based dataset of U.S. adults. Participants completed validated measures of distal minority stress (i.e., interpersonal discrimination), psychosocial mechanisms (i.e., rumination, emotional clarity, and social support), identity-related moderators (i.e., identity centrality, stigma consciousness, and sexual orientation identity), and depressive symptoms at baseline, six-month follow-up, and 1-year follow-up. Rumination (b=0.38, 95% CI [0.13, 0.84]), lack of emotional clarity (b=0.43, 95% CI [0.11, 0.83]), and lack of social support (b=0.21, 95% CI [0.04, 0.45]) each individually mediated the prospective relationship between interpersonal discrimination and depressive symptoms, controlling for initial symptoms, age, and education. These indirect effects were not moderated by identity-related characteristics or sexual identity. Our study provides some of the strongest empirical evidence for the psychological mediation framework to date and suggests targets for interventions focused on reducing the mental health consequences of minority stress for sexual minority men.