Mechanisms conferring risk for psychopathology in stigmatized groups

描述(由申请人提供)：污名是几个群体中不利心理健康结果的风险因素，包括同性恋者和双性恋者(LGB)、非裔美国人和超重/肥胖者。然而，导致这一风险的机制仍然没有得到充分的了解，阻碍了为这些脆弱人口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，本研究试图了解污名如何在精神病理学中起作用。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，这些因素为精神病理学提供了风险。这一模型的预测实用性和普适性将在一项纵向的前瞻性研究中进行检验，该研究以社区为基础，对大约2100名青少年(5-12年级)进行研究。与污名相关的压力源在LGB、非裔美国人和肥胖/超重的年轻人中尤其普遍，但对这一年龄段的研究一直很缺乏。因此，本提案将促进我们对耻辱在这一重要的发展时期导致精神病理学的方式的理解。这项拟议工作的具体目标是：(1)将污名相关应激作为青少年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污名相关应激的后遗症；(3)确定这些过程是否在污名和内化症状之间的关系中起中介作用；以及(4)通过对三个污名化群体的检查，评估所提出的病因学模型的普适性。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：由于改善对受耻辱个人的态度的努力涉及随着时间的推移而长期变化，因此需要对那些目前因耻辱而经历心理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方法来改变。因此，这一结果将为制定以理论为基础的预防性干预措施奠定基础，以期减少各种受歧视群体成员中的精神疾病发病率。

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.