Implicit Internalized Stigma: Measuring and Examining a Determinant of Mental Health Disparities for Sexual Minorities

项目总结/摘要 性少数群体继续面临心理健康差距-最近的国家数据显示，37%的性少数群体 少数成年人有精神疾病。当性少数群体内化时， 对自己的负面态度通过普遍的社会同性恋恐惧症。内化的耻辱感是一个关键的决定因素 性少数群体的心理健康差异;然而， 在研究和临床实践中，内化的污名几乎完全被忽视，也许是因为 没有有效和可靠的工具来衡量这一现象。为了弥补这方面的差距， 项目有三个目标：（1）使用情感工具创建一个内隐内化的性少数污名工具 （2）信度评价（内部一致性和重测 信度）和效度（收敛效度，判别效度和预测效度）的内隐内化性 AMP的少数污名版本;和（3）检查之间的并发和预测关系 内隐内化的性少数耻辱和抑郁症状和焦虑症状的结果。 开发测量将涉及混合方法方法：为测量生成视觉刺激（即， 异性恋和同性伴侣的形象），评估夫妇形象，以平衡各组，采访 专家确定效价反应选项，为在线管理制定措施，试点测试 初步措施与100名性少数成年人的样本，并放弃不可靠的反应， 基于预测试的尺寸。评估最终措施的心理测量学将涉及在线数据 收集400名性少数成年人的两波和管理措施的内隐和 明确的内在耻辱感。内隐污名化与心理健康关系的研究 结果将使用400名性少数成年人的样本进行两次评估， 抑郁症状、焦虑症状和相关协变量，以隔离内隐内化的影响 心理健康的耻辱。分析，将涉及可靠性分析，成对相关性和交叉滞后 面板建模该项目具有创新性和重要性，因为它有可能改变研究， 临床实践，这几乎完全集中在明确的内在耻辱。该工具 用于流行病学研究，以了解内隐内化的耻辱作为心理健康的决定因素 差距。它也可以作为一种靶向机制用于干预研究和临床实践，以改善 性少数群体的心理健康。

Project Summary/Abstract Sexual minorities continue to face mental health disparities – recent national data show that 37% of sexual minority adults had a mental illness. Stigma can exist internally among sexual minorities when they internalize negative attitudes about themselves via pervasive societal homophobia. Internalized stigma is a key determinant of mental health disparities for sexual minorities; however, the implicit or subconscious dimension of internalized stigma has been almost completely overlooked in research and clinical practice, perhaps because there is not a valid and reliable instrument to measure this phenomenon. To address gaps in this area, this project has three aims: (1) Creating an implicit internalized sexual minority stigma instrument using an Affect Misattribution Procedure (AMP) approach; (2) Evaluating the reliability (internal consistency and test-retest reliability) and validity (convergent, discriminant, and predictive validity) of the implicit internalized sexual minority stigma version of the AMP; and (3) Examining concurrent and predictive relationships between implicit internalized sexual minority stigma and outcomes of depressive symptoms and anxiety symptoms. Developing the measure will involve a mixed-methods approach: generating visual stimuli for the measure (i.e., images of heterosexual and same-sex couples), evaluating couple images to balance across groups, interviewing experts to identify valence response options, programming the measure for online administration, pilot-testing the preliminary measure with a sample of 100 sexual minority adults, and dropping unreliable response dimensions based on pre-testing. Evaluating the psychometrics of the final measure will involve online data collection from 400 sexual minority adults across two waves and administration of measures of implicit and explicit internalized stigma. Examining relations between implicit internalized stigma and mental health outcomes will use the sample of 400 sexual minority adults assessed at two waves, and data collection on depressive symptoms, anxiety symptoms, and relevant covariates to isolate the effect of implicit internalized stigma on mental health. Analyses, will involve reliability analysis, pairwise correlations, and cross-lagged panel modeling. This project is innovative and significant because it has the potential to shift research and clinical practice, which has almost exclusively focused on explicit internalized stigma. The instrument could be used in epidemiological research to understand implicit internalized stigma as a determinant of mental health disparities. It could also be used in intervention research and clinical practice as a target mechanism to improve mental health among sexual minorities.