Date of Award

2020

Degree Type

Dissertation

Degree Name

Doctor of Philosophy in Psychology

Specialization

Clinical Psychology

Department

Psychology

First Advisor

Joseph Rossi

Abstract

Introduction: It is well-documented that, compared to their heterosexual counterparts, sexual minority women (SMW) are at an increased risk for a variety of negative mental health outcomes, including depression, non-suicidal self-injury (NSSI), suicidal ideation, and suicide attempts. According to the minority stress model, lesbian, gay, and bisexual individuals are at an increased risk for adverse health outcomes because they experience excess stress as a result of belonging to a stigmatized group. In particular, sexual minority stress may be mediated by LGB-specific stressors including discrimination and victimization as a result of one’s sexual orientation, internalized homophobia, and concealment. The majority of studies examining mental health outcomes among SMW have utilized a negative lens, focusing on risk rather than protective factors in the population. Accordingly, the proposed study aimed to replicate and extend prior research on SMW by providing a comprehensive examination of how minority stressors impact NSSI and suicidality. Moreover, the current study investigated potential protective factors in the context of this model, including family processes (i.e., family support and number of family supports), peer processes (i.e., peer support and number of peer supports), and individual processes (i.e., resilience and adaptive coping). Methods: Participants were 271 self-identified, sexual minority women aged 18 and older, from the general population. The majority of participants identified as lesbian (n = 143), White (83.4%; n = 226), and had a mean age of 29 (SD = 7.64). Participants were recruited using various LGB electronic mailing lists and LGB-focused social media platforms. Study participants anonymously completed several measures related to minority stressors, social supports, resiliency and coping style, and mental health symptoms. Results: Structural equation modeling (SEM) was used to examine if the proposed protective factors of family, peer, and individual processes mediated the relationship between minority stressors (i.e., internalized homophobia, discrimination, victimization, and concealment) and suicidality/NSSI. Preliminary results did not find NSSI to be significantly related to the latent mediational factors (i.e., family, peer, and individual processes), and therefore subsequent structural equation models for NSSI were not conducted. Structural equation model results for suicidality revealed individual processes significantly mediated the relationship between internalized homophobia and suicidality. Conclusions: Overall findings of the present study highlight the unique role of risk and protective factors related to suicidality in SMW. The current study underscores the critical need for continued research focused on identifying the underlying mechanisms contributing to higher rates of suicidality among SMW, specifically the unique contributions of risk factors such as internalized homophobia, as well as the role of individual processes as a protective factor against suicidality. Future research should be conducted with the goal of designing more culturally sensitive suicide risk assessments and tailoring individual treatment to address risk and protective factors specific to SMW and suicidality.

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