Mechanisms conferring risk for psychopathology in stigmatized groups

描述（由申请人提供）：在一些群体中，耻辱感是不良心理健康结果的风险因素，包括男同性恋、女同性恋和双性恋（LGB）、非裔美国人和超重/肥胖人群。然而，造成这种风险的机制仍然没有得到充分的了解，阻碍了为这些弱势群体制定有效的干预措施。通过整合临床心理学和社会心理学的研究、理论和方法，本研究旨在了解耻辱感如何影响精神病理学。作者提出了一个理论模型，假设耻辱的经历使个人更容易受到既定的心理和社会风险因素的影响，这些因素赋予了精神病理学的风险。该模型的预测效用和概括性将在一项纵向前瞻性研究中进行检验，该研究在社区队列中约有2,100名青少年（5-12年级）。与耻辱感相关的压力源在LGB、非裔美国人和肥胖/超重青年中尤为普遍，但针对这一年龄组的研究一直缺乏。因此，目前的建议将推进我们的方式耻辱导致精神病理在这一重要的发展时期的理解。提出的工作的具体目的是：(1)在青少年纵向样本中证明耻辱相关压力是内化症状发展的风险因素；(2)建立特定的认知、情绪调节和社会过程作为耻辱感相关应激的后遗症；(3)确定这些过程是否介导了耻辱感与内化症状之间的关系；(4)通过对三个被污名化群体的检查来评估所提出的病因学模型的普遍性。这项研究的结果有可能为一个重要的公共卫生问题提供新的见解。公共卫生相关性：由于努力改善对被污名化个体的态度需要长期的改变，因此需要对那些目前因污名化而出现精神健康问题的人进行临床干预。这项研究强调了几个过程，包括认知、情绪调节和耻辱的社会后遗症，这些都可以通过现有的治疗来改变。因此，研究结果将为以理论为基础的预防干预措施的发展奠定基础，这些干预措施旨在减少各种被污名化群体成员中精神病发病率的流行。

DESCRIPTION (provided by applicant): Stigma is a risk factor for adverse mental health outcomes among several groups, including gays, lesbians and bisexuals (LGB), African-Americans, and the overweight/obese. The mechanisms conferring this risk, however, remain inadequately understood, hindering the development of effective interventions for these vulnerable populations. Through integrating research, theory and methods from clinical and social psychology, the present investigation seeks to understand how stigma contributes to psychopathology. The author proposes a theoretical model hypothesizing that experiences of stigma render individuals more vulnerable to established psychological and social risk factors that confer risk for psychopathology. The predictive utility and generalizability of this model will be examined in a longitudinal, prospective study among a community-based cohort of approximately 2,100 adolescents (grades 5-12). Stigma-related stressors are particularly pervasive among LGB, African-American and obese/overweight youth, but research with this age group has been lacking. Thus, the present proposal will advance our understanding of the ways in which stigma leads to psychopathology during this significant developmental period. Specific aims of the proposed work are to: (1) document stigma-related stress as a risk factor for the development of internalizing symptoms in a longitudinal sample of adolescents; (2) establish specific cognitive, emotion regulation, and social processes as sequelae of stigma-related stress; (3) determine whether these processes mediate the relationship between stigma and internalizing symptoms; and (4) evaluate the generalizability of the proposed etiologic model through the examination of three stigmatized groups. The results of the study have the potential to provide new insights into an important public health problem. PUBLIC HEALTH RELEVANCE: Because efforts to improve attitudes towards stigmatized individuals involve protracted changes over time, clinical interventions are needed for those currently experiencing mental health problems that result from stigma. This study highlights several processes including cognitive, emotion regulation and social sequelae of stigma that are modifiable through existing treatments. The results will therefore set the stage for the development of theory-based preventive interventions that seek to reduce the prevalence of psychiatric morbidity among members of various stigmatized groups.