5.1 Social Determinants of Mental Health in LGBT societies

Question 1

What was Bieber and Socaride’s idea surrounding homosexuality?

Answer 1

There is a pathological family that gives rise to homosexual men made up of a distant, cold father and an over-dominating mother

Question 2

What was homosexuality previously thought to be inherent to?

Answer 2

Homosexuality was thought to be inherent to psychological dis-functioning
Thought there was a cure for it = conversion therapies

Question 3

What did Hooker aim to do?

Answer 3

Test the notion of homosexuality as a form of psychopathology

Question 4

How did Hooker conduct her study and what did she find?

Answer 4

Found a group of healthy homosexuals
Compared 30 gay active men in the LA society and tested them on a battery of psychological adjustment tests

No diff between gay men v heterosexual controls

Question 5

As a result of Hooker’s study, what changed?

Answer 5

Started to change the idea that being gay was a psychological dysfunction
Homosexuality removed as a disorder from DSM-II in 1973
Partly a political push but also science helped to do this

Question 6

What do you see when looking at mental health prevalence in LGBTQ people compared to straight people?

Answer 6

On most mental health outcomes, LGBTQ people experience a higher incidence rate - this is a cause for concern

Need to make sense of this disparity

Question 7

What was the alternative hypothesis put forward by the psychoanalysts?

Answer 7

Shouldn’t be assuming the cause is inherent to LGBT

The effect of living in a hostile and social environment for LGBT people is causing their mental health problems

It would be surprising if they didn’t suffer some mental health problems as a result of their stigmatised status

Question 8

What does the minority stress model and hypothesis attempt to explain?

Answer 8

Used the concept of stress to explain how exposure to hostile social environments can cause increased mental health instability

Question 9

What are the 3 major categories for proximal minority stress

Answer 9

Internalised homophobia
Stigma consciousness
Concealment

Question 10

What is internalised homophobia?

Answer 10

Feeling bad about being gay

Learning that being gay in the culture is bad and causes conflict within themselves

Question 11

What is stigma consciousness?

Answer 11

Expectation of abuse from others
Hypervigilant to threat - people may become aware of their sexuality and attack them
This can persist even in safe environments - internalised -ve beliefs cause them to stress

Question 12

What is concealment?

Answer 12

The stress involved in concealing one’s sexual identity from other people
Trying to hide their label to not risk rejection from society - this causes stress

Question 13

What are objective incidences of stress?

Answer 13

Hate crimes, bullying etc

Question 14

What leads to an increase in mental health problems according to minority stress hypothesis?

Answer 14

Objective and proximal stressors

Question 15

What can buffer LGBT people from poor mental health outcomes?

Answer 15

Group based coping strategies - when people can associate with others like them, this can moderate their stress and act as a buffer

Question 16

Do stressors exist on a continuum?

Answer 16

Yes - a continuum of severity

Question 17

Discuss how stressors are formal/structural and informal/interpersonal

Answer 17

Formal:
Laws being made, employment discrimination
Higher level structural and legal forms of discrimination

Informal:
Exclusion from other people
Experience -ve interactions with others as a result of their sexuality

Question 18

What did Burton 2013 study investigate

Answer 18

High school students - measured the sexual identity of them, experiences of sexual minority-specific victimization, assessed their psychological wellbeing and other demographic characteristics

Measured at time 1 and time 2 (6 months later)

Using a longitudinal design can control for pre-existing mental health problems when trying to look at how discrimination had impacted wellbeing in the last 6 months

Question 19

What did Burton’s study find?

Answer 19

Found an indirect effect:
Sexual minority status at time 1 did not predict depression at time 2 directly
Only predicted it through instances of sexual minority-specific victimization
Sexual minority people who did not experience victimisation did not show increase in depression
Victimisation has a mediating effect that is driving the mental health problems in this population

Question 20

Discuss the constitutional amendment natural study looking at LGBT people and stigma

Answer 20

Red states - constitutional amendment placed on the ballot, blue - no constitutional amendment

In the red states, much more negativity towards anti-gay
Increase in anti-gay stigma

Question 21

What does the MS hypothesis predict about mental health states regarding red and blue states?

Answer 21

Minority stress hypothesis predicts that increase in anti-gay stigma in red states should have worse mental health than the blue states

Question 22

What did the natural (red or blue state) study find regarding wellbeing in LGBT people?

Answer 22

The data showed that there was no change in the wellbeing on any indices who resided in the blue states before and after the constitutional amendment debate

In the red states, there was worse wellbeing on 4 indices after the ballot
Increase mood disorder, anxiety disorder, alcohol disorder, comorbid disorder

No increases for heterosexuals living in states with proposed constitutional amendments
Was specific to the LGBT people in the red states

Question 23

What are traits that develop due to victimisation called?

Answer 23

Persecution induced traits

Question 24

Discuss how internalised homophobia can be a developmental challenge

Answer 24

Not aware of it when they are kids, internalise the stigma

Experience is distressing when they realise they are a member of this group that has a -ve status in society

Question 25

How can internalised homophobia affect your life?

Answer 25

Discomfort telling people you’re gay
Avoiding same sex behaviour and relationships and connecting with LGBT community
Attempts to try and “change” their sexuality = Conversion therapies etc
Conflict can result in poor mental health: lower self-esteem etc

Question 26

What did Newcomb & Mustanski’s meta-analysis investigate?

Answer 26

Looked at relationship between internalised homophobia and mental health outcomes

Question 27

What did Newcomb & Mustanski’s meta-analysis find?

Answer 27

Modest +ve association between internalised homophobia and psychological distress and depression across studies

No gender differences

Overall = supported the minority stress hypothesis

Question 28

How was Newcomb & Mustanski’s meta-analysis limited?

Answer 28

It is correlation - only looking at associations between variables
There are other potential explanations for the effect
Most undertaken in non-random samples

Question 29

What did Ross et al investigate?

Answer 29

Looking at internalised homophobia and HIV risk in MSM

Looking at whether the societal level of how homosexuals are accepted had an effect on how the gay individual felt about themselves

Question 30

Where did Ross’s data come from and how did he code it?

Answer 30

Huge amount of data coming from sexual health clinics - n=180,000 (huge sample in social psych!)
Coded parts of Europe from where the samples came from in regard to anti-gay laws and stigma in those countries

Question 31

What did Ross’s study find?

Answer 31

Most conservative countries (Russia) had the highest internalised homophobia levels
Societal is impacting individual wellbeing

Men who are higher in IH are less likely to use safe sex during sex with a stranger in the past 12 months

Question 32

Why do Men who are higher in IH are less likely to use safe sex during sex with a stranger in the past 12 months?

Answer 32

Men higher in IH were less “out” about being gay
Therefore, less likely to have had an HIV test in the past

More likely to engage in impulsive relationships with other men

Question 33

What is more strongly predictive of psychological distress than objective instances of victimisation?

Answer 33

Stigma consciousness

Question 34

How is concealment of sexual orientation dependent on context? Give an example.

Answer 34

Living in a hostile social environment being open about being gay can open you up to additional forms of prejudice
May only work for the best when the environment you are in is a safe one in the first place
Is moderated by the environment you are in

e.g. Dutch man being “out” didn’t predict worse wellbeing
Dutch women being “out” didn’t predict worse wellbeing
There was larger stigma at the time to be a gay man than a lesbian

Question 35

What is a practical implication of concealment of sexual orientation dependent on context?

Answer 35

Deciding the best time to “come out” - ensuring they are in a safe environment

Question 36

How do group based coping factors act as a buffer?

Answer 36

Gives them experience in environments where they are not being stigmatised
Supports against stigma and discrimination - buffers the -ve impact
Disconfirms -ve stereotypes about LGBTs

Question 37

What are the current issues with the data?

Answer 37

Correlational data = cannot imply causation

Non-representative sampling = usually when we sample we throw out a big advert in gay press and get biased sample of highly affiliated gay people and v politically involved etc

Question 38

Are mental health discrepancies among male sexual orientation groups illusory due to inappropriate group comparisons?

Answer 38

Asking whether there is a real difference in mental health between male straight and gay men
Gay men tend to show more female patterns of mental health outcomes
Perhaps we are using the wrong comparison group by comparing them to straight men

When compared gay men and straight women, there were no diffs found
○ Therefore should we expect gay men to have the same mental health outcomes as straight men?

Doesn’t explain this diff for lesbian women and straight men tho
Lesbian women have worse mental health than straight women