Mental health disparities in LGB populations: Moving from markers of risk to mediating pathways

Lesbian, gay, and bisexual (LGB) populations are at increased risk for multiple mental health burdens compared to heterosexuals. My dissertation examined the mechanisms that can account for these mental health disparities using a variety of methods and samples, including epidemiology, community-based, experimental, and experience sampling studies.;In the first study, I demonstrated that living in states with policies that did not confer protection to LGB individuals led to a stronger association between LGB status and mental disorders. Having established that institutional forms of discrimination confer risk for psychopathology, the remainder of my dissertation examined the psychological mechanisms linking discrimination and psychopathology. In a series of four studies, my colleagues and I provided evidence that universal psychological processes (e.g., emotion regulation, social support) account for the relationship between stigma-related stress and adverse mental health outcomes.;In a prospective, community-based study, sexual minority adolescents had greater difficulties than their heterosexual peers in regulating their emotions, which in turn led to greater symptoms of depression and anxiety relative to their heterosexual peers. Using an experience sampling methodology, it was shown that on days in which stigma-related stressors occurred, LGB respondents reported greater emotion regulation difficulties, including rumination, suppression, and social isolation, which in turn led to greater psychological distress over the course of the 10-day study. In a follow-up experimental study, when respondents were experimentally induced to ruminate (versus distract) following the recall of an idiographic discrimination event, they experienced lower mood according to both explicit and implicit ratings, providing further evidence that rumination subsequent to experiencing stigma-related stressors can exacerbate psychological distress. In the final study, we provided support for the generalizability of these results to a different health outcome (alcohol-related problems) across several groups that experience discrimination (e.g., race/ethnicity, overweight/obesity).;These results therefore point to both social- and individual-level determinants of mental health disparities in LGB populations. Collectively, these papers offer a potentially fertile theoretical paradigm for future inquiry on LGB mental health disparities. Ultimately, this information can be used in the development of prevention interventions that seek to decrease the prevalence of psychopathology within this vulnerable population.