Nicholas A Livingston1,2, Annesa Flentje3, James Brennan4, Ethan H Mereish5, Oakleigh Reed4, Bryan N Cochran4. 1. National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA. 2. Department of Psychiatry, Boston University School of Medicine, Boston, MA. 3. Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, CA. 4. Department of Psychology, University of Montana, Missoula, MT. 5. Department of Health Studies, American University, Washington, D.C.
Abstract
BACKGROUND: Sexual and gender minorities (SGM) experience higher rates of depression and anxiety, which are linked to higher rates of discrimination and victimization. SGM individuals may conceal their SGM identities to decrease discrimination and victimization exposure; however, these experiences still occur, and concealment itself is often associated with greater anxiety and depression. However, it remains unclear whether lifetime victimization and identity concealment moderate the effect of day-to-day discrimination, which we evaluated in the current study using ecological momentary assessment (EMA). METHODS: Fifty SGM participants (Mage=21.82, SD=4.70; 84% White) completed baseline assessment (e.g., concealment and lifetime victimization) followed by EMA of daily discrimination and anxious and depressed mood for 14 days. RESULTS: As hypothesized, daily discrimination predicted momentary increases in anxious and depressed mood, b = .34, p < .001. Notably, these effects were more pronounced among individuals who reported higher levels of identity concealment, b = .25, p < .001, and previous SGM-based victimization experiences (marginally), b = .18, p = .05. Main effects of cumulative lifetime victimization and identity concealment, measured at baseline, were associated with higher ratings of anxious and depressed mood over the two-week study. DISCUSSION: While identity concealment may reduce exposure to discrimination and victimization, we found that concealment and prior victimization predict heightened reactivity to daily discrimination experiences. Additional research is needed to further explicate real-time effects of minority stress exposure, and to develop interventions that may mitigate risk among SGM individuals with prior victimization exposure and higher levels of identity concealment in particular.
BACKGROUND: Sexual and gender minorities (SGM) experience higher rates of depression and anxiety, which are linked to higher rates of discrimination and victimization. SGM individuals may conceal their SGM identities to decrease discrimination and victimization exposure; however, these experiences still occur, and concealment itself is often associated with greater anxiety and depression. However, it remains unclear whether lifetime victimization and identity concealment moderate the effect of day-to-day discrimination, which we evaluated in the current study using ecological momentary assessment (EMA). METHODS: Fifty SGM participants (Mage=21.82, SD=4.70; 84% White) completed baseline assessment (e.g., concealment and lifetime victimization) followed by EMA of daily discrimination and anxious and depressed mood for 14 days. RESULTS: As hypothesized, daily discrimination predicted momentary increases in anxious and depressed mood, b = .34, p < .001. Notably, these effects were more pronounced among individuals who reported higher levels of identity concealment, b = .25, p < .001, and previous SGM-based victimization experiences (marginally), b = .18, p = .05. Main effects of cumulative lifetime victimization and identity concealment, measured at baseline, were associated with higher ratings of anxious and depressed mood over the two-week study. DISCUSSION: While identity concealment may reduce exposure to discrimination and victimization, we found that concealment and prior victimization predict heightened reactivity to daily discrimination experiences. Additional research is needed to further explicate real-time effects of minority stress exposure, and to develop interventions that may mitigate risk among SGM individuals with prior victimization exposure and higher levels of identity concealment in particular.
Authors: John E Pachankis; Mark L Hatzenbuehler; H Jonathon Rendina; Steven A Safren; Jeffrey T Parsons Journal: J Consult Clin Psychol Date: 2015-07-06
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