Katie Wang1, Sara E Burke2, Julia M Przedworski3, Natalie M Wittlin4, Ivuoma N Onyeador4, John F Dovidio4, Liselotte N Dyrbye5, Jeph Herrin6, Michelle van Ryn3. 1. Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA. 2. Department of Psychology, Syracuse University, Syracuse, New York, USA. 3. School of Nursing, Oregon Health & Science University, Portland, Oregon, USA. 4. Department of Psychology, Yale University, New Haven, Connecticut, USA. 5. Division of Community Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA. 6. Division of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
Abstract
Purpose: The pervasiveness of sexual minority stressors in the U.S. medical training environment is well documented, yet little is known about the mental health impact of such stressors on sexual minority medical residents. We compared depression and anxiety symptoms between sexual minority and heterosexual third-year medical residents, adjusting for depression and anxiety before residency, and examined the role of perceived residency belonging during the second year of residency as a predictor of subsequent sexual identity-based differences in depression and anxiety. Methods: In 2010-2011, first-year medical students enrolled in the Cognitive Habits and Growth Evaluation Study and completed surveys in the last year of medical school (MS4; 2014), as well as second (R2; 2016) and third (R3; 2017) year of residency. The surveys contained measures of sexual identity, residency belonging, depression, and anxiety. Results: Of the 2890 residents who provided information about their sexual identity, 291 (10.07%) identified as sexual minority individuals. Sexual minority residents reported significantly higher levels of depression (p = 0.009) and anxiety (p = 0.021) than their heterosexual peers at R3, even after adjusting for depression and anxiety at MS4. Sexual minority residents also reported a lower sense of belonging at R2 than did heterosexual residents (p = 0.006), which was in turn associated with higher levels of depression and anxiety at R3 (ps < 0.001). Conclusion: Sexual minority residents experienced higher levels of depression and anxiety than their heterosexual counterparts, and these mental health disparities were associated with lower perceived belonging in residency. Residency programs should prioritize evidence-based, targeted interventions for sexual minority mental health.
Purpose: The pervasiveness of sexual minority stressors in the U.S. medical training environment is well documented, yet little is known about the mental health impact of such stressors on sexual minority medical residents. We compared depression and anxiety symptoms between sexual minority and heterosexual third-year medical residents, adjusting for depression and anxiety before residency, and examined the role of perceived residency belonging during the second year of residency as a predictor of subsequent sexual identity-based differences in depression and anxiety. Methods: In 2010-2011, first-year medical students enrolled in the Cognitive Habits and Growth Evaluation Study and completed surveys in the last year of medical school (MS4; 2014), as well as second (R2; 2016) and third (R3; 2017) year of residency. The surveys contained measures of sexual identity, residency belonging, depression, and anxiety. Results: Of the 2890 residents who provided information about their sexual identity, 291 (10.07%) identified as sexual minority individuals. Sexual minority residents reported significantly higher levels of depression (p = 0.009) and anxiety (p = 0.021) than their heterosexual peers at R3, even after adjusting for depression and anxiety at MS4. Sexual minority residents also reported a lower sense of belonging at R2 than did heterosexual residents (p = 0.006), which was in turn associated with higher levels of depression and anxiety at R3 (ps < 0.001). Conclusion: Sexual minority residents experienced higher levels of depression and anxiety than their heterosexual counterparts, and these mental health disparities were associated with lower perceived belonging in residency. Residency programs should prioritize evidence-based, targeted interventions for sexual minority mental health.
Entities:
Keywords:
belonging; medical residency; mental health; minority stress; sexual identity
Authors: Liselotte N Dyrbye; Sara E Burke; Rachel R Hardeman; Jeph Herrin; Natalie M Wittlin; Mark Yeazel; John F Dovidio; Brooke Cunningham; Richard O White; Sean M Phelan; Daniel V Satele; Tait D Shanafelt; Michelle van Ryn Journal: JAMA Date: 2018-09-18 Impact factor: 56.272
Authors: Natalie M Wittlin; John F Dovidio; Sara E Burke; Julia M Przedworski; Jeph Herrin; Liselotte Dyrbye; Ivuoma N Onyeador; Sean M Phelan; Michelle van Ryn Journal: Soc Sci Med Date: 2019-08-04 Impact factor: 4.634
Authors: Sylvia P Perry; Rachel Hardeman; Sara E Burke; Brooke Cunningham; Diana J Burgess; Michelle van Ryn Journal: J Racial Ethn Health Disparities Date: 2015-10-20
Authors: Michelle van Ryn; Rachel Hardeman; Sean M Phelan; Diana J Burgess; John F Dovidio; Jeph Herrin; Sara E Burke; David B Nelson; Sylvia Perry; Mark Yeazel; Julia M Przedworski Journal: J Gen Intern Med Date: 2015-07-01 Impact factor: 5.128