5.1 Social Determinants of Mental Health in LGBT societies Flashcards
What was Bieber and Socaride’s idea surrounding homosexuality?
There is a pathological family that gives rise to homosexual men made up of a distant, cold father and an over-dominating mother
What was homosexuality previously thought to be inherent to?
Homosexuality was thought to be inherent to psychological dis-functioning
Thought there was a cure for it = conversion therapies
What did Hooker aim to do?
Test the notion of homosexuality as a form of psychopathology
How did Hooker conduct her study and what did she find?
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
As a result of Hooker’s study, what changed?
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
What do you see when looking at mental health prevalence in LGBTQ people compared to straight people?
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
What was the alternative hypothesis put forward by the psychoanalysts?
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
What does the minority stress model and hypothesis attempt to explain?
Used the concept of stress to explain how exposure to hostile social environments can cause increased mental health instability
What are the 3 major categories for proximal minority stress
Internalised homophobia
Stigma consciousness
Concealment
What is internalised homophobia?
Feeling bad about being gay
Learning that being gay in the culture is bad and causes conflict within themselves
What is stigma consciousness?
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
What is concealment?
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
What are objective incidences of stress?
Hate crimes, bullying etc
What leads to an increase in mental health problems according to minority stress hypothesis?
Objective and proximal stressors
What can buffer LGBT people from poor mental health outcomes?
Group based coping strategies - when people can associate with others like them, this can moderate their stress and act as a buffer
Do stressors exist on a continuum?
Yes - a continuum of severity
Discuss how stressors are formal/structural and informal/interpersonal
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
What did Burton 2013 study investigate
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
What did Burton’s study find?
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
Discuss the constitutional amendment natural study looking at LGBT people and stigma
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
What does the MS hypothesis predict about mental health states regarding red and blue states?
Minority stress hypothesis predicts that increase in anti-gay stigma in red states should have worse mental health than the blue states
What did the natural (red or blue state) study find regarding wellbeing in LGBT people?
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
What are traits that develop due to victimisation called?
Persecution induced traits
Discuss how internalised homophobia can be a developmental challenge
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
How can internalised homophobia affect your life?
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
What did Newcomb & Mustanski’s meta-analysis investigate?
Looked at relationship between internalised homophobia and mental health outcomes
What did Newcomb & Mustanski’s meta-analysis find?
Modest +ve association between internalised homophobia and psychological distress and depression across studies
No gender differences
Overall = supported the minority stress hypothesis
How was Newcomb & Mustanski’s meta-analysis limited?
It is correlation - only looking at associations between variables
There are other potential explanations for the effect
Most undertaken in non-random samples
What did Ross et al investigate?
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
Where did Ross’s data come from and how did he code it?
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
What did Ross’s study find?
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
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?
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
What is more strongly predictive of psychological distress than objective instances of victimisation?
Stigma consciousness
How is concealment of sexual orientation dependent on context? Give an example.
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
What is a practical implication of concealment of sexual orientation dependent on context?
Deciding the best time to “come out” - ensuring they are in a safe environment
How do group based coping factors act as a buffer?
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
What are the current issues with the data?
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
Are mental health discrepancies among male sexual orientation groups illusory due to inappropriate group comparisons?
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
