Health Psychology: Minority Stressors (PDF)

Health Psychology Health of minority groups = relative to the individuals who belong to the minority People of Color (ethnic minority groups) Many studies show poorer well-being for ethnic minority groups -> structural racism, lower socioeconomic backgr...

Health Psychology Health of minority groups = relative to the individuals who belong to the minority People of Color (ethnic minority groups) Many studies show poorer well-being for ethnic minority groups -> structural racism, lower socioeconomic background as well as access to health care are related to different health indicators Trans individuals (gender minority groups) Higher suicide rates for gender diverse individuals relative to “general population”, 10-to20 time higher rates in US-samples LGB + individuals (sexual minority groups ): Sexual minorities are 2,5 times more likely to have a life-time history of mental disorder compared to heterosexual  Diverging lived experiences between (individually and structurally) more privileged vs more marginalized people A little ABC - Female, male, intersex conditions Recent finding show that there is much more variance that one would assume with a dichotomous category / binary conceptualization of sex (female vs. male) Woman, man, trans, non-binary, genderqueer, genderfluid, agender Approx.. 0,6% of the population identify with a gender minority identity Recent studies indicate higher prevalence of non-binary gender identity  Gender expression : the way in which person acts to communicate gender in a given culture ( in a given society and given time) (ex. Clothing, communication patterns, interest) A trait-like predisposition to experience sexual attraction for one sex or other, akin to an erotic compass Markers of erotic interest : sexual attractions, fantasies, behaviors, but also romantic and emotional attraction 1 to 6 % of the population belong to a sexual minority group if one considers self-identified sexual orientation such as lesbian, gay male, bisexual or other identities Numbers increase if one considers sexual experiences with same-sex partners (up to 8%) or same-sex sexual attraction (up to 11%) -> prevalence depends on questions used in a survey  Self-identification as gay, lesbian, bisexual depends on cultural context including stigmatization of same-sex attraction Prevalence of psychological symptoms and mental disorders Sexual minority are 2,5 times more likely to have a life-time history of mental disorder compared to heterosexual - Internalizing outcomes including depression and anxiety disorders - Externalizing behaviors including tobacco use, alcohol and polysubstance use Greater prevalence of multiple forms of victimization including physical abuse and sexual assault : difference between LGB individual and their heterosexual sibling(s) Poorer well-being and increased stress for LGB+ people compared to heterosexual people also in Switzerland : suicidal attempts, self-harming behavior Swiss study - Up to five-time higher risk for suicide attempt in young gay and bisexual men (compared to heterosexual men)  Psychological burden Swiss LGBT panel Minority stress model (Meyer, 2003) 1) People with a minority status (ex. Gender, sexual orientation, ethnicity) are confronted with additional stressors (additive effect of stress) -> more stress to cope with 2) Minority stress is chronic and unique (to individuals with minority status) 3) Minority stress is socially based Minority stressors are on a continuum : distal to proximal stressors German study (Sattler, WAGNER, & Christiansen, 2016) - Confirmation of (parts of) minority stress model  - N= 1188 self-identified gay men who participated in an online study (Age: M=38, SD=11), data collected in 2014 - Social support : less mental health problem for those who are rejected How does sexual minority stigma get “Under the skin” a psychological mediation Framework Sexual minorities confront increased stress exposure resulting from stigma Stigma-related stress creates elevations in general coping/emotion regulation, social/interpersonal, and cognitive conferring risk for psychopathology -> such processes mediate the relationship between stigma-related stress and psychopathology Biopsychosocial model of health Internalized stigma : for ex. Internalized homonegativity Internalized homonegativity refers to the internalization of socioculturally imposed negative attitudes and images by people with same-sex feelings. The negative attitudes are maintained by : Heteronormativity as a chronic minority stressor Heteronormativity : a concept developed in queer theory that describes the social privileging of heterosexuality and the assumption that heterosexuality is the only natural and normal sexuality Fear/concerns before the first coming out Coming out : a process Internal vs external coming out The process is not necessarily linear -> for ex. Initial negative experiences can delay further coming out  Large individual differences in timing and length of the process (external) coming out is never complete : repeated decisions “to come out or not”, especially in new setting -> possible chronic stress  Coming out is influenced by heteronormativity and gender binarity : more fluid identities are gaining importance among young generations today - Sexual identity : queer, pansexual, sexual fluid - Gender identity : nonbinary, genderfluid, genderqueer Coming out : timing - People tend to come out earlier nowadays Coming out : a dilemma Dilemma : dealing openly with one’s own LGBT Identity is associates with better psychological well-being, higher self-esteem and fewer depressive  symptoms, less identity stress (ex. Concealment motivation), but also, more perceived harassment and victimization - Controversial : negative reactions can increase anxiety, psychological problems and dysfunctional coping behavior (alcohol, substance use) - Resilience must be considered in the context of the individual  Coming out might not always be recommended Intersectionality Identities intersect with one another -> Different social identities overlap and are combined with specific structures of oppression / stressors Term goes back to Kimberle Crenshaw : she described how she and other black women are not represented by (typically white privileged) feminism and black liberation movements (typically represented by black men)  Intersectionality theory plays an important role in different disciplines such as psychology and public health Intersecting identities : sexual and ethnic identity : sexual and ethnic identity Resources Minority identity is not only a source of stress but can also be a source of coping and social support Social support from friends sometimes even more important than family support - Specific to sexual and gender minority individuals : usually a minority within the family of origin - Contact with/ support from other LGBT young people very important for building a positive identity Friends of sexual minority youth Social support from friends is related to : - Less depressive symptomatology - Less suicidality - Less hopelessness - Greater self-esteem and self-acceptance - Greater life satisfaction - Fewer school problems - Less sexual risk behaviors Support a/access to other sexual minority youth may be particularly important - > additional support for sexual identity integration Swiss study with trans individuals Online study with 90 participants Minority stress Minority stress is an important concept to better understand the development and maintenance of mental health problems in people with a minority status - Of course, minority stress is not the only possible reason for psychological problems and/or seeking psychotherapy in people with minority status ! Opportunities to reduce minority stress - Legal /societal level : protection against discrimination, reduction of institutional discrimination, addressing norms - Psychological level : building a positive identity, promoting access to social support, improving stress management skills /emotion regulation - Healthcare system : supportive actors /professionals can significantly reduce minority stress