Discrimination and sexual minority mental health: Mediation and moderation effects of coping.

Abstract

Stigma and discrimination related to sexual minority status are unique stressors associated with mental and physical health concerns among sexual minority individuals. Although some theoretical models propose that the strategies sexual minorities apply to cope with these particular stressors can mediate and/or moderate their impact on mental health outcomes, only a few studies have examined this proposition empirically, typically using measures of broad coping strategies that are not discriminationspecific. A nonprobability sample of 354 self-identified lesbian, gay, and bisexual (LGB) individuals completed self-report measures of perceived discrimination experiences, psychological distress, and discrimination-specific coping strategies used, including education/advocacy, internalization, drug and alcohol use, resistance, and detachment strategies. Perceived discrimination explained levels of depression, anxiety, and stress after controlling for income, education, and race. Drug and alcohol use mediated the relationship between discrimination and depression, anxiety, and stress symptoms. Internalization mediated the relationship between discrimination and anxiety symptoms and moderated the relationship between discrimination and depression and anxiety. The education/advocacy, resistance, and detachment strategies played no clear mediator or moderator roles in the relationship between discrimination and psychological distress. Psychological interventions that assist sexual minority clients in the development of effective coping skills, such as avoidance of drug and alcohol use for coping and internalization may reduce the harm associated with the experience of stigma and discrimination.

Coping with discrimination: The insidious effects of gender minority stigma on depression and anxiety in transgender individuals

“…We specifically examined indirect effects because we assessed coping in response to discrimination and thus were exploring what types of reactions to discrimination may help explain its links with anxiety and depression. This is in line with others’ conceptualizations of coping in other marginalized groups as mediators of the association between marginalization and mental health (e.g., racial minorities: Alvarez & Juang, ; sexual minorities: Ngamake et al, ). In the second approach, we examined whether the various coping responses moderated the association between discrimination and mental health to assess whether the coping strategies may buffer or exacerbate the effects of discrimination.…”

“…Although much of the prior research has focused on coping broadly with gender minority stress, as discussed by Ngamake, Walch, and Raveepatarakul (), there are advantages to using measures of coping that are specific to a given stressor (in this case, discrimination). Widely used, broad scales may only capture the ways people cope with stress generally and may not provide the most accurate information for how individuals cope in response to gender minority stressors.…”

“We Are Powerful People”: Health-Promoting Strengths of LGBTQ Communities of Color

“…Positive psychological and psycho-cognitive processes, such as problem solving and active coping, may mediate the effects of stressors, both general and minority specific, on health (Hatzenbuehler, 2009). Ngamake, Walch, and Raveepatarakul (2016) tested various coping strategies among sexual minority participants as the main mechanism of the relationship between perceived discrimination and psychological distress. Although results only indicated that participants who employed disengagement coping strategies (i.e., substance use) to deal with discriminatory experiences were more likely to report depression, anxiety, and stress symptoms, adaptive coping strategies were also examined, including education, advocacy, and resistance.…”

The Influence of Stress on Depression and Substance Use Problems Among Young Male Same-Sex Couples: Relationship Functioning as an Underlying Mechanism

“…Numerous studies have demonstrated that discrimination and victimization are associated with depression (Feinstein, Goldfried, & Davila, 2012; Mays & Cochran, 2001; Mustanski et al, 2016; Ngamake, Walch, & Raveepatarakul, 2016; Swann, Minshew, Newcomb, & Mustanski, 2016) and substance use among sexual minority individuals (Bontempo & D’Augelli, 2002; Darwich, Hymel, & Waterhouse, 2012; Espelage, Aragon, Birkett, & Koenig, 2008; Goldbach et al, 2014; Phillips et al, 2017; Wong, Weiss, Ayala, & Kipke, 2010). Research has also demonstrated that the internalization of negative attitudes toward sexual minorities is associated with depression (see Newcomb & Mustanski, 2010), but findings have been mixed for substance use (see Brubaker, Garrett, & Dew, 2009).…”