Minority stress among sexual minority women

描述(由申请人提供)： 困扰女性的最普遍的精神障碍是焦虑和情感障碍，而常见的健康危险行为包括酗酒和吸毒、吸烟和肥胖相关行为。据估计，占美国女性人口4%-5%的性少数群体女性(SMW；女同性恋者、双性恋者和其他与女性合作的女性)尤其容易出现这些不良后果。例如，与异性恋同龄人相比，SMW患抑郁症的可能性高出三倍，吸烟的可能性高出两倍，超重的可能性高出三倍。事实上，这一人群已被确认为2010年健康人中存在健康差距的风险。研究人员假设，SMW中精神障碍和健康危险行为的发生率上升与这一人群经历的个人和文化压迫有关。然而，这一“少数群体压力”假说在对妇女的实证研究中没有得到充分的检验，部分原因是缺乏对性别问题敏感的模型和工具来评估妇女地位妇女的具体关切。迫切需要研究少数民族应激源在这一人群中的影响和性质，以便设计预防干预措施。为此，拟议的混合方法研究将检查少数群体压力与SMW健康结果之间的关系。具体地说，定性阶段将使用24名法定最低工资妇女的三个重点小组来描述“性别表达”这一新类别，并探讨其与健康结果的关系以及谁可能面临最大的风险。定量阶段将调查性别表达和少数族裔应激源对心理健康(即抑郁、焦虑)和健康危险行为(如酗酒和吸毒、吸烟、肥胖相关行为)结果的影响的理论模型。我们将研究的少数民族应激源包括与偏见相关的受害、耻辱意识、掩饰、内在化的同性恋恐惧症和内在化的性别歧视。量化数据将通过对200名不同种族的SMW进行的基于网络的全国性调查来收集。申请者是一个排名很高的临床心理学项目的尖子生，他概述了该项目广泛而详细的研究计划。此外，她还组建了一支这一领域的专家团队，他们能够很好地指导她并帮助实现项目目标。

DESCRIPTION (provided by applicant): The most prevalent mental disorders afflicting women are anxiety and affective disorders, while common health risk behaviors include alcohol and drug use, smoking, and obesity-related behaviors. Sexual minority women (SMW; lesbians, bisexual women, and other women who partner with women), who constitute an estimated 4-5% of the U.S. population of women, are at particular risk for these adverse outcomes. For example, SMW are up to three times more likely to experience depression, up to two times more likely to smoke, and up to three times more likely to be overweight compared to their heterosexual counterparts. Indeed, this population has been acknowledged as at risk for health disparities in Healthy People 2010. Researchers have hypothesized that the elevated rates of mental disorders and health risk behaviors among SMW are linked to the individual and cultural oppression experienced by this population. However, this "minority stress" hypothesis has not been adequately examined in empirical studies of women, in part due to the lack of a gender-sensitive model and instrument to assess SMW's specific concerns. Research on the impact and nature of minority stressors in this population is desperately needed in order to design prevention interventions. To this end, the proposed mixed-methods study will examine associations among minority stress and health outcomes of SMW. Specifically, the qualitative phase will use three focus groups of 24 SMW to provide a description of the novel category "gender expression" and explore its relation to health outcomes and who may be at greatest risk. The quantitative phase will investigate a theoretical model of the effects of gender expression and minority stressors on the outcomes of mental health (i.e., depression, anxiety) and health risk behaviors (i.e., alcohol and drug use, smoking, obesity-related behaviors). Minority stressors we will study include bias-related victimization, stigma consciousness, concealment, internalized homophobia, and internalized sexism. Quantitative data will be collected in a national web-based survey of 200 ethnically diverse SMW. The applicant, who is a top student at a highly ranked clinical psychology program, has outlined an extensive and detailed research plan for the project. Moreover, she has assembled a team of experts in this area who are well situated to mentor her and assist in achieving the project goals.