Causes and Impact of Minority Stress on Health and Development in Youth

描述（由申请人提供）：在几个关键的健康领域中，性取向群体的差异现已得到充分记录，性少数群体报告的心理困扰、物质使用和依赖以及饮食失调症状更多。与异性恋者相比，性少数群体的高风险行为背后的原因鲜为人知。在此，我们建议通过测试我们的性少数压力理论（SMST）来解释这些性取向差异。SMST是基于社会对同性恋的污名化。与同性恋相关的压力，指的是性少数群体对社会污名化的体验，包括由已知个体（如亲属、异性恋朋友）和社区中的陌生人施加的外部压力源（如偏见、歧视、言语虐待、身体暴力）。与同性恋相关的压力还包括内部压力，性少数个体将社会的污名内化，比如对同性恋持有负面态度。我们提出的研究将探讨同性恋相关压力对性取向亚群体之间在心理困扰、生理困扰（皮质醇、脱氢表雄酮）、健康行为、慢性疼痛、适应和适应方面的差异的影响，并研究调节因素。例如亲子关系对性取向与同性恋压力关系的影响，以及应对方式对同性恋压力与心理和生理困扰关系的影响。与同性恋有关的压力在影响性少数青年的发展和成年初期的心理社会适应方面可能特别重要。我们的研究将对同性恋相关压力的重要前兆敏感，比如性别不一致。它还将研究性别、经历与同性恋有关的压力的年龄、性少数群体地位和地位的转变、性少数群体中和谐与不和谐的取向模式以及性认同发展如何随着与同性恋有关的压力、健康、适应和调整结果而变化。我们将收集新的自我报告调查和生物学数据来调查这些关键问题的成长今天的研究（GUTS），纵向队列研究16,882美国青少年和初成成人从1996年开始，并正在进行中。具体来说，我们将在从GUTS收集的超过10年的数据中增加3个数据收集阶段，并将青少年的数据与他们的母亲的数据联系起来，这些母亲组成了护士健康研究II。我们将研究儿童和青少年时期暴力受害的差异，以及其他形式的与同性恋有关的压力，以及随着时间的推移，这些压力对随后的心理和生理困扰、物质使用和饮食失调行为、慢性疼痛、适应和成年初期的调整的影响。

DESCRIPTION (provided by applicant): Sexual orientation group disparities in several critical health domains are now well documented, with sexual minorities reporting more psychological distress, substance use and dependence, and eating disorders symptoms. Little is known about the reasons underlying higher risk behaviors among sexual minorities relative to heterosexuals. Herein, we propose to explain these sexual orientation disparities by testing our Sexual Minority Stress Theory (SMST). SMST is based on society's stigmatization of homosexuality. Gay-related stress, the experience by a sexual-minority individual of society's stigmatization, consists of external stressors (such as prejudice, discrimination, verbal abuse, physical violence) perpetrated by known individuals (such as kin, heterosexual friends) and strangers in the community. Gay-related stress also consists of internal stress, in which the sexual-minority individual internalizes society's stigmatization, such as possessing negative attitudes toward homosexuality. Our proposed research will address the impact of gay-related stress on disparities between and among sexual orientation subgroups in psychological distress, physiological distress (cortisol, DHEA), health behaviors, chronic pain, adaptation, and adjustment in emerging adulthood, and examine moderators, such as the effect of parent-child relationships on the relations between sexual orientation and gay-related stress and the effect of coping on the relations between gay-related stress and both psychological and physiological distress. Gay-related stress may be particularly important in influencing a sexual minority youth's development and psychosocial adjustment in emerging adulthood. Our research will be sensitive to important precursors of gay-related stress, such as gender nonconformity. It will also examine how sex, age at experiencing gay-related stress, sexual minority status and transitions in status, concordant vs. nonconcordant orientation patterns among sexual minorities, and sexual identity development vary with gay-related stress, health, adaptation, and adjustment outcomes. We will collect new self-report survey and biological data to investigate these critical issues in the Growing Up Today Study (GUTS), a longitudinal cohort study of 16,882 U.S. adolescents and emerging adults begun in 1996 and ongoing. Specifically, we will add 3 data collection phases to more than 10 years of data collected from GUTS and link the youths' data with those of their mothers, who comprise the Nurses' Health Study II. We will examine disparities in violence victimization in childhood and adolescence and other forms of gay-related stress and the impact of these over time on subsequent psychological and physiological distress, substance use and eating disordered behaviors, chronic pain, adaptation, and adjustment in emerging adulthood.