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      Minority Stressors, Rumination, and Psychological Distress in Lesbian, Gay, and Bisexual Individuals

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          Abstract

          This study tested the mechanisms by which social stigma contributes to psychological distress in lesbian, gay, and bisexual individuals. A large community sample ( N = 4248, M age = 29.9 years, 42.9% female, 57.1% male, 35.7% bisexual, 64.3% lesbian/gay, 9.9% non-white) was recruited using targeted and general advertisements for an online cross-sectional survey. Participants completed measures of childhood gender nonconformity, prejudice events, victimization, microaggressions, sexual orientation concealment, sexual orientation disclosure, expectations of rejection, self-stigma, rumination, and distress. Structural equation modeling was used to test the relationships between these variables in a model based upon minority stress theory and the integrative mediation framework with childhood gender nonconformity as the initial independent variable and distress (depression, anxiety, and well-being) as the final dependent variable. The results broadly support the hypothesized model. The final model had good fit χ 2(37) = 440.99, p < .001, TLI = .96, CFI = .98, RMSEA = .05 [.05, .06] and explained 50.2% of the variance in psychological distress and 24.8% in rumination. Sexual orientation and gender had moderating effects on some individual paths. Results should be considered in the context of the cross-sectional nature of the data, which prevented tests of causality, and self-report measures used, which are vulnerable to bias. Findings indicate strong relationships between minority stressors and psychological distress in lesbian, gay, and bisexual individuals, which are partially accounted for by rumination. These results may inform the development of interventions that address the added burden of minority stress among lesbian, gay, and bisexual individuals.

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          The online version of this article (10.1007/s10508-019-01502-2) contains supplementary material, which is available to authorized users.

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          Most cited references72

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          Reporting practices in confirmatory factor analysis: an overview and some recommendations.

          Reporting practices in 194 confirmatory factor analysis studies (1,409 factor models) published in American Psychological Association journals from 1998 to 2006 were reviewed and compared with established reporting guidelines. Three research questions were addressed: (a) how do actual reporting practices compare with published guidelines? (b) how do researchers report model fit in light of divergent perspectives on the use of ancillary fit indices (e.g., L.-T. Hu & P. M. Bentler, 1999; H. W. Marsh, K.-T., Hau, & Z. Wen, 2004)? and (c) are fit measures that support hypothesized models reported more often than fit measures that are less favorable? Results indicate some positive findings with respect to reporting practices including proposing multiple models a priori and near universal reporting of the chi-square significance test. However, many deficiencies were found such as lack of information regarding missing data and assessment of normality. Additionally, the authors found increases in reported values of some incremental fit statistics and no statistically significant evidence that researchers selectively report measures of fit that support their preferred model. Recommendations for reporting are summarized and a checklist is provided to help editors, reviewers, and authors improve reporting practices.
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            Validity of the Brief Patient Health Questionnaire Mood Scale (PHQ-9) in the general population.

            The aim of this study was to assess the validity of the Patient Health Questionnaire depression module (PHQ-9). It has been subject to studies in medical settings, but its validity as a screening for depression in the general population is unknown. A representative population sample (2,066 subjects, 14-93 years) filled in the PHQ-9 for diagnosis [major depressive disorder, other depressive disorder, depression screen-positive (DS+) and depression screen-negative (DS-)] and other measures for distress (GHQ-12), depression (Brief-BDI) and subjective health perception (EuroQOL; SF-36). A prevalence rate of 9.2% of a current PHQ depressive disorder (major depression 3.8%, subthreshold other depressive disorder 5.4%) was identified. The two depression groups had higher Brief-BDI and GHQ-12 scores, and reported lower health status (EuroQOL) and health-related quality of life (SF-36) than did the DS- group (P's < .001). Strong associations between PHQ-9 depression severity and convergent variables were found (with BDI r = .73, with GHQ-12 r = .59). The results support the construct validity of the PHQ depression scale, which seems to be a useful tool to recognize not only major depression but also subthreshold depressive disorder in the general population.
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              The psychological implications of concealing a stigma: a cognitive-affective-behavioral model.

              Many assume that individuals with a hidden stigma escape the difficulties faced by individuals with a visible stigma. However, recent research has shown that individuals with a concealable stigma also face considerable stressors and psychological challenges. The ambiguity of social situations combined with the threat of potential discovery makes possessing a concealable stigma a difficult predicament for many individuals. The increasing amount of research on concealable stigmas necessitates a cohesive model for integrating relevant findings. This article offers a cognitive-affective-behavioral process model for understanding the psychological implications of concealing a stigma. It ends with discussion of potential points of intervention in the model as well as potential future routes for investigation of the model.
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                Author and article information

                Contributors
                liadh.timmins@kcl.ac.uk
                Journal
                Arch Sex Behav
                Arch Sex Behav
                Archives of Sexual Behavior
                Springer US (New York )
                0004-0002
                1573-2800
                22 July 2019
                22 July 2019
                2020
                : 49
                : 2
                : 661-680
                Affiliations
                [1 ]GRID grid.13097.3c, ISNI 0000 0001 2322 6764, Department of Psychology, Institute of Psychiatry, , King’s College London, ; 5th Floor, Bermondsey Wing, Guy’s Hospital Campus, London, SE1 9RT UK
                [2 ]GRID grid.13097.3c, ISNI 0000 0001 2322 6764, Department of Psychology, Institute of Psychiatry, , King’s College London, ; Denmark Hill, London, UK
                Author information
                http://orcid.org/0000-0001-7984-4748
                Article
                1502
                10.1007/s10508-019-01502-2
                7031186
                31332645
                b6ab352b-df6d-4895-a186-b1c8fab4e781
                © The Author(s) 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 13 February 2017
                : 16 June 2019
                : 17 June 2019
                Categories
                Original Paper
                Custom metadata
                © Springer Science+Business Media, LLC, part of Springer Nature 2020

                Sexual medicine
                minority stress,gender nonconformity,rumination,prejudice,sexual orientation
                Sexual medicine
                minority stress, gender nonconformity, rumination, prejudice, sexual orientation

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