“…According to the psychological mediation framework, stress comes first in the causal chain leading to physiological and psychological health outcomes (i.e., stress → psychological mediators → psychopathology). Furthermore, Hatzenbuehler et al (2009a, b) argue that distal stigma-related stressors affect psychopathology through cognitive, social/interpersonal, and emotional channels. In particular, he and his colleagues have shown through a series of experimental and longitudinal studies that stigma-related stress increases emotion dysregulation (e.g., increased rumination, engagement in impulsive behaviors), which in turn can lead to risk for depression, anxiety, and substance abuse problems among sexual minority individuals (e.g., Hatzenbuehler et al 2009a, b).…”