Hypervigilance: An Understudied Mediator of the Longitudinal Relationship Between Stigma and Internalizing Psychopathology Among Sexual Minority Young Adults

Abstract

Hypervigilance is often theoretically invoked as a psychological mechanism linking stigma to sexual minority young adults’ elevated risk for internalizing psychopathology. Yet, within sexual minority mental health research, hypervigilance is rarely explicitly assessed but instead commonly conflated with putatively related constructs, such as sexual orientation-related rejection sensitivity and rumination. This lack of measurement consistency and construct clarity has stymied the empirical study of hypervigilance among sexual minorities, hindering conceptual and mechanistic understandings of this psychological process. To clarify this construct, we embedded a recently developed hypervigilance measure within a longitudinal, population-based study of N=811 Swedish sexual minority young adults (ages 17–34). Relatively small correlations of hypervigilance with sexual orientation-related rejection sensitivity (r=0.23) and rumination (r=0.24) suggested that hypervigilance represents a largely discrete construct. In parallel meditation models, hypervigilance—but not sexual orientation-related rejection sensitivity or rumination—mediated prospective associations between perceived discrimination and anxiety and depression symptoms two years later, explaining up to 40% of these effects when controlling for demographics and initial symptoms. Serial mediation models demonstrated that sexual orientation-related rejection sensitivity and rumination prospectively predicted hypervigilance on these longitudinal paths. Supplemental models using an alternative stigma measure, sexual orientation-related victimization, provided converging support for these mediation patterns. Findings indicate that hypervigilance may represent a distinct transdiagnostic mechanism through which stigma-related experiences and processes undermine sexual minority mental health. We discuss implications for enhancing psychological interventions by explicitly addressing hypervigilance among sexual minority young adults.

The role of internalized transphobia and negative expectations in the relationship between identity-specific intimate partner violence and mental health outcomes in transgender and gender nonconforming young adults.

“…Interestingly, the current study also found that negative expectations played a larger role in the associations of identity-specific IPV with anxiety and PTSD than in those with depression. This may reflect an underlying hypervigilance that has been shown to be characteristic of both negative expectations for future events (Hendricks & Testa, 2012; Hollinsaid et al, 2022) and anxiety- and trauma-related disorders (American Psychiatric Association, 2022; Grillon, 2008; Grupe & Nitschke, 2013; Riggle et al, 2021). The possible role of hypervigilance in these relationships should be explored in future research.…”

Associations Between Structural Stigma and Allostatic Load Among Sexual Minorities: Results From a Population-Based Study

“…This finding suggests that these factors may partially mediate this observed relationship. Additional psychosocial mechanisms-including hypervigilance (94), emotion regulation (95), concealment (96), and social isolation (97), which collectively influence allostatic processes by recalibrating stress responses that can contribute to AL over time (85)-warrant investigation in future work.…”

Promoting Resilience to Improve Disordered Eating (PRIDE): A case series of an eating disorder treatment for sexual minority individuals

“…Structural stigma leads to both chronic distal minority stressors (e.g., victimization, discrimination, lack of social safety) and subsequent minority stress reactions, or internal processes within the SM person (Feldman & Meyer, 2007; Meyer, 1995). These reactions include internalized stigma (i.e., negative attitudes towards, and/or nonacceptance of, one's own SM identity), sexual orientation concealment, and SM‐related hypervigilance (chronic anxious expectations of rejection due to sexual orientation; Hollinsaid et al, 2023; Pachankis et al, 2023). Minority stressors increase vulnerability to ED behaviors through resultant negative emotions and maladaptive coping (Calzo et al, 2020; Gordon et al, 2016; Gordon et al, 2019; Katz‐Wise et al, 2015).…”