Stigma is a risk factor for adverse mental health outcomes among several groups, including gays, lesbians and bisexuals (LGB), African-Americans, and the overweight/obese. The mechanisms conferring this risk, however, remain inadequately understood, hindering the development of effective interventions for these vulnerable populations. Through integrating research, theory and methods from clinical and social psychology, the present investigation seeks to understand how stigma contributes to psychopathology. The author proposes a theoretical model hypothesizing that experiences of stigma render individuals more vulnerable to established psychological and social risk factors that confer risk for psychopathology. The predictive utility and generalizability of this model will be examined in a longitudinal, prospective study among a community-based cohort of approximately 2,100 adolescents (grades 5-12). Stigma-related stressors are particularly pervasive among LGB, African-American and obese/overweight youth, but research with this age group has been lacking. Thus, the present proposal will advance our understanding of the ways in which stigma leads to psychopathology during this significant developmental period.
Specific aims of the proposed work are to: (1) document stigma-related stress as a risk factor for the development of internalizing symptoms in a longitudinal sample of adolescents;(2) establish specific cognitive, emotion regulation, and social processes as sequelae of stigma-related stress;(3) determine whether these processes mediate the relationship between stigma and internalizing symptoms;and (4) evaluate the generalizability of the proposed etiologic model through the examination of three stigmatized groups. The results of the study have the potential to provide new insights into an important public health problem.

Public Health Relevance

Because efforts to improve attitudes towards stigmatized individuals involve protracted changes over time, clinical interventions are needed for those currently experiencing mental health problems that result from stigma. This study highlights several processes including cognitive, emotion regulation and social sequelae of stigma that are modifiable through existing treatments. The results will therefore set the stage for the development of theory-based preventive interventions that seek to reduce the prevalence of psychiatric morbidity among members of various stigmatized groups.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Predoctoral Individual National Research Service Award (F31)
Project #
5F31MH083401-02
Application #
7623035
Study Section
Special Emphasis Panel (ZRG1-F11-K (20))
Program Officer
Hill, Lauren D
Project Start
2008-05-01
Project End
2009-08-31
Budget Start
2009-05-01
Budget End
2009-08-31
Support Year
2
Fiscal Year
2009
Total Cost
$19,123
Indirect Cost
Name
Yale University
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
043207562
City
New Haven
State
CT
Country
United States
Zip Code
06520
Keyes, K M; Martins, S S; Hatzenbuehler, M L et al. (2012) Mental health service utilization for psychiatric disorders among Latinos living in the United States: the role of ethnic subgroup, ethnic identity, and language/social preferences. Soc Psychiatry Psychiatr Epidemiol 47:383-94
Hatzenbuehler, Mark L; Keyes, Katherine M; McLaughlin, Katie A (2011) The protective effects of social/contextual factors on psychiatric morbidity in LGB populations. Int J Epidemiol 40:1071-80
Hatzenbuehler, Mark L; Corbin, William R; Fromme, Kim (2011) Discrimination and alcohol-related problems among college students: a prospective examination of mediating effects. Drug Alcohol Depend 115:213-20
McLaughlin, Katie A; Hatzenbuehler, Mark L; Keyes, Katherine M (2010) Responses to discrimination and psychiatric disorders among Black, Hispanic, female, and lesbian, gay, and bisexual individuals. Am J Public Health 100:1477-84
Hatzenbuehler, Mark L; McLaughlin, Katie A; Keyes, Katherine M et al. (2010) The impact of institutional discrimination on psychiatric disorders in lesbian, gay, and bisexual populations: a prospective study. Am J Public Health 100:452-9
Hatzenbuehler, Mark L; Nolen-Hoeksema, Susan; Dovidio, John (2009) How does stigma ""get under the skin""?: the mediating role of emotion regulation. Psychol Sci 20:1282-9
Hatzenbuehler, Mark L; Keyes, Katherine M; Hasin, Deborah S (2009) State-level policies and psychiatric morbidity in lesbian, gay, and bisexual populations. Am J Public Health 99:2275-81
Hatzenbuehler, Mark L; Dovidio, John F; Nolen-Hoeksema, Susan et al. (2009) An Implicit Measure of Anti-Gay Attitudes: Prospective Associations with Emotion Regulation Strategies and Psychological Distress. J Exp Soc Psychol 45:1316-1320
Hatzenbuehler, Mark L (2009) How does sexual minority stigma ""get under the skin""? A psychological mediation framework. Psychol Bull 135:707-30
Hatzenbuehler, Mark L; Keyes, Katherine M; Hasin, Deborah S (2009) Associations between perceived weight discrimination and the prevalence of psychiatric disorders in the general population. Obesity (Silver Spring) 17:2033-9