A longitudinal and experience sampling investigation of rejection sensitivity and its role in sexual minority adolescents' mental health

项目总结 性少数群体青少年(SMA)受到心理健康问题的影响不成比例，例如 相对于他们的异性恋同龄人而言，抑郁和自杀倾向。这些差距是最大的 青春期和持续到成年，通常归因于独特的人际压力， 他们面临着(比如性取向相关的拒绝)。鉴于拒绝是心理健康的一个强有力的风险因素 问题，尤其是青春期的问题，历来是对SM个体研究的重点 心理健康。然而，除了被拒绝的经历，被拒绝的期望和情绪 陪伴他们在心理健康方面也起着重要作用。拒绝敏感性(RS)理论提出 早期被拒绝的经历会导致焦虑、容易察觉和强烈的倾向。 对拒绝做出反应，这可能会损害一个人的心理健康。尽管有证据表明RS与 随着SM成人中一系列心理健康问题的出现，我们对其发展和作用的理解 SMA的心理健康在几个重要方面受到限制(例如，几乎所有先前的研究都是交叉的 对成年人的部分研究，缺乏对可能伴随的不同情绪的关注 拒绝的预期以及潜在的机制和保护因素)。 鉴于这些差距，拟议的R01的目标是确定与性取向相关的角色 不同类型RS发展中的拒绝反应及其心理健康后果 SMA，以确定RS影响该人群心理健康的机制，并确定 RS发生发展中的保护因素。我们将招募500名SMA(14-17岁)参加 使用我们团队先前工作中建立的方法进行的纵向和经验抽样研究。数据将是 在四次半年期评估(基线、6个月、12个月、18个月)中收集，以确定纵向关系 在与性取向有关的拒绝、RS(焦虑和愤怒)和精神健康(抑郁症状)中 以及临床提升、自杀意念和反应性攻击)。此外，参与者还将完成6- 一周体验-抽样研究(每天4次评估，分两次为期3周)进行检查 RS发生在日常生活中的前因后果。这些数据将用于实现以下三个目标 具体目标：(1)确定性取向相关拒绝之间的纵向和日常关系 (2)认同感；(2)确定 机制(社交退缩、对拒绝的自责和他人的责备，以及性取向 隐瞒)精神障碍与心理健康问题之间的纵向和日常关系；以及(3) 检验性取向相关的社会支持和接受作为发展中的保护性因素 RS。拟议的R01将加深我们对RS的发展、其后果、 基本机制和保护因素，这些因素将为改善SMA精神健康的干预措施提供信息。

PROJECT SUMMARY Sexual minority adolescents (SMA) are disproportionately affected by mental health problems such as depression and suicidality relative to their heterosexual peers. These disparities are greatest during adolescence and persist into adulthood, and are generally attributed to the unique interpersonal stressors that they face (e.g., sexual orientation-related rejection). Given that rejection is a robust risk factor for mental health problems, especially during adolescence, it has historically been the focus of research on SM individuals' mental health. However, in addition to experiences of rejection, expectations of rejection and the emotions that accompany them also play important roles in mental health. The rejection sensitivity (RS) theory proposes that early experiences of rejection can lead to a disposition to anxiously expect, readily perceive, and intensely react to rejection, which can then compromise one's mental health. Despite evidence that RS is associated with a range of mental health problems among SM adults, our understanding of its development and role in SMA's mental health is limited in several important ways (e.g., nearly all prior studies have been cross- sectional studies of adults, and there has been a lack of attention to different emotions that can accompany expectations of rejection as well as underlying mechanisms and protective factors). Given these gaps, the goals of the proposed R01 are to determine the role of sexual orientation-related rejection in the development of different types of RS and their respective mental health consequences among SMA, to identify the mechanisms through which RS influences mental health in this population, and to identify protective factors in the development of RS. We will recruit a cohort of 500 SMA (ages 14-17) to participate in a longitudinal and experience-sampling study using methods established in our team's prior work. Data will be collected at four biannual assessments (baseline, 6-, 12-, 18-months) to determine the longitudinal relations among sexual orientation-related rejection, RS (anxious and angry), and mental health (depression symptoms and clinical elevations, suicidal ideation, and reactive aggression). In addition, participants will complete a 6- week experience-sampling study (4 assessments per day, administered in two 3-week bursts) to examine antecedents and consequences of RS as they occur in daily life. These data will be used to accomplish three specific aims: (1) Determine the longitudinal and daily relations among sexual orientation-related rejection, RS (anxious and angry), and mental health (depression, suicidal ideation, and reactive aggression); (2) Identify mechanisms (social withdrawal, self- and other-blame in response to rejection, and sexual orientation concealment) underlying the longitudinal and daily relations between RS and mental health problems; and (3) Examine sexual orientation-related social support and acceptance as protective factors in the development of RS. The proposed R01 will advance our understanding of the development of RS, its consequences, the underlying mechanisms, and protective factors, which will inform interventions to improve SMA's mental health.