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

项目摘要/摘要 性少数群体继续面临心理健康差距-最近的全国数据显示，37%的性少数群体 少数族裔成年人患有精神疾病。当性少数群体内化时，他们可能会在内部存在耻辱 通过社会上普遍存在的同性恋恐惧症对自己持负面态度。内在化污名是一个关键的决定因素 性少数群体的心理健康差距；然而，隐含或潜意识的层面 内在化污名在研究和临床实践中几乎完全被忽视，可能是因为 目前还没有一种有效可靠的工具来衡量这一现象。为了解决这一领域的差距，这 该项目有三个目标：(1)利用情感创建一种隐性的内在性少数族裔污名工具 错误归因程序(AMP)方法；(2)信度评估(内部一致性和重测 信度)和效度(收敛、判别和预测效度) 少数族裔污名版本的AMP；以及(3)检查AMP之间的并发和预测关系 内隐内在性少数人污名与抑郁症状和焦虑症状的结果。 开发该测量将涉及混合方法方法：为该测量生成视觉刺激(即， 异性恋和同性伴侣的照片)，评估夫妇的照片以平衡不同群体，采访 专家识别价格响应选项，规划在线管理的措施，试点测试 初步测量了100名性少数成年人的样本，并删除了不可靠的回答 基于预试的尺寸。评估最终测量的心理测量学将涉及在线数据 通过两次调查收集了400名少数性行为成年人的资料，并对其进行了测量 明显的内在化污名。内隐内化污名与心理健康关系的研究 结果将使用在两次浪潮中评估的400名性少数族裔成年人的样本，并收集关于 抑郁症状、焦虑症状及相关协变量对内隐内化隔离效应的影响 对心理健康的污名。分析，将涉及可靠性分析、成对相关和交叉滞后 面板建模。这个项目具有创新性和重大意义，因为它有可能改变研究和 临床实践，这几乎完全集中在外在的内在化污名。仪器可能是 在流行病学研究中用于理解内在化污名是心理健康的决定因素 差距。它也可以用于干预研究和临床实践，作为一种靶向机制来改善 性少数群体的心理健康状况。

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.