I describe minority stress processes along a continuum from distal stressors, which are typically defined as objective events and conditions, to proximal personal processes, which are by definition subjective because they rely on individual perceptions and appraisals.
The notion that stress is related to social structures and conditions is at once intuitively appealing and conceptually difficult. Evidence from this research suggests that compared with their heterosexual counterparts, gay men and lesbians suffer from more mental health problems including substance use disorders, affective disorders, and suicide Cochran, ; Gilman et al.
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A distinction between personal and group resources is often not addressed in the coping literature. One elaboration of social stress theory may be referred to as minority stress to distinguish the excess stress to which individuals from stigmatized social are exposed as a result of their social, often a minority, position.
Free a society like ours where homosexuals are uniformly treated with disparagement or contempt—to say nothing about outright hostility—it would be surprising indeed if substantial s straight them Washington not suffer from an impaired self-image and men degree of unhappiness with their stigmatized status.
In its most general form, recent stress discourse has been concerned with external events or conditions that are taxing to individuals and exceed their capacity to endure, therefore having potential to induce mental or somatic illness Dohrenwend, Some have used an engineering analogy, explaining that stress can be assessed as a load relative to a supportive surface Wheaton, Stress researchers have identified both individual and social stressors.
Anomie, a sense of normlessness, lack of social control, and alienation can lead to suicide because basic social needs are not met. The study of mental health of lesbian, gay, and bisexual LGB populations has been complicated by the debate on the classification of homosexuality as a mental disorder during the s and early s.
In this article the author reviews research evidence on the prevalence of mental disorders in lesbians, gay men, and bisexuals LGBs and shows, using meta-analyses, that LGBs have a higher prevalence of mental disorders than heterosexuals. I suggest a distal—proximal distinction because it relies on stress conceptualizations that seem most relevant to minority stress and because of its concern with the impact of external social conditions and structures on individuals.
Recently, researchers have returned to the study of mental health of LGB populations. The question of whether homosexuality should be considered a mental disorder is a question about classification. Crocker et al. Through reappraisal, the in-group validates deviant experiences and feelings of minority persons Thoits, The distinction between personal and group-level coping may be somewhat complicated because even group-level resources e.
Such identities vary in the social and personal meanings that are attached to them and in the subjective stress they entail. The minority person is likely to be subject to such conflicts because dominant culture, social structures, and norms do not typically reflect those of the minority group.
Empirical evidence supports these contentions. Social theorists have been concerned with the alienation from social structures, norms, and institutions. American history is rife with narratives recounting the ill effects of prejudice toward members of minority groups and of their struggles to gain freedom and acceptance. It can be answered by debating which behaviors, cognitions, or emotions should be considered indicators of a mental disorder American Psychiatric Association, To use postmodernist understanding of scientific knowledge, such a debate on classification concerns the social construction of mental disorder—what we as a society and as scientists agree are abnormal behaviors, cognitions, and emotions.
As early asAllport suggested that minority members respond to prejudice with coping and resilience. This heritage has tainted discussion on mental health of lesbians and gay men by associating—even equating—claims that LGB people have higher prevalences of mental disorders than heterosexual people with the historical antigay stance and the stigmatization of LGB persons Bailey, However, a fresh look at the issues should make it clear that whether LGB populations have higher prevalences of mental disorders is unrelated to the classification of homosexuality as a mental disorder.
This conceptual framework is the basis for the review of research evidence, suggestions for future research directions, and exploration of public policy implications.
As objective stressors, distal stressors can be seen as independent of personal identification with the ased minority status Diamond, Nevertheless, if she is perceived as a straight by others, she may suffer from stressors associated with prejudice toward LGB people e.
The importance of coping with stigma has also been asserted in LGB populations. In contrast, the more proximal stress processes are more subjective and are therefore related to self-identity as lesbian, gay, or bisexual. The relative silence of psychiatric epidemiological literature regarding the mental health of LGB populations may have aimed to remove stigma, but it has been misguided, leading to the neglect of this important issue. The foundation for a model of minority stress is not found in one theory, nor is the term minority stress commonly used.
Like other individuals who cope with general stress, LGB people use a range of personal coping mechanisms, resilience, and men to withstand stressful experiences Antonovsky, ; Masten, ; Ouellette, Jones et al. There has been increased interest in the minority stress model, for example, as it applies to the social environment of Blacks in the United States and their experience of stress related to racism Allison, ; Clark et al.
Similarly, Allport described prejudice as a noxious environment for the minority person and suggested that it le to adverse effects. Social identity and self-categorization theories extend psychological understanding of intergroup relations and free impact on the self. Beyond theoretical variations, a unifying concept may emerge from stress theory. Modern writers have agreed that positive coping is common and beneficial to members of minority groups Clark Washington al.
The concept of social stress extends stress theory by suggesting that conditions in the social environment, not only personal events, are sources of stress that may lead to mental and physical ill effects. I discuss other theoretical orientations that help explain minority stress below in reviewing specific minority stress processes. Nevertheless, it is important to distinguish between group-level and personal resources because when group-level resources are absent, even otherwise-resourceful individuals have deficient coping.
This hypothesis can be described in terms of minority stress Brooks, ; Meyer, In this article I review research evidence on prevalences of mental disorders and show, using meta-analyses, that LGB people have higher prevalences of mental disorders than heterosexual people.
It is appealing because it recalls the commonplace experience that environmental and social conditions can be stressful.
These theories posit that the process of categorization e. From the distal to the proximal they are a external, objective stressful events and conditions chronic and acuteb expectations of such events and the vigilance this expectation requires, and c the internalization of negative societal attitudes.
The operationalized research question that pervaded the debate was, Do homosexuals have high prevalences of mental disorders? The author offers a conceptual framework for understanding this excess in prevalence of disorder in terms of minority stress —explaining that stigma, prejudice, and discrimination create a hostile and stressful social environment that causes mental health problems. Symbolic interaction theories thus suggest that negative regard from others le to negative self-regard.
Rather, a minority stress model is inferred from several sociological and social psychological theories. Interactions with others are therefore crucial for the development of a sense of self and well-being. According to Durkheim, people need moral regulation from society to manage their own needs and aspirations.
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Try out PMC Labs and tell us what you think. Whether individuals can access and use group-level resources depends on many factors, including personality variables. But the research did not accurately operationalize the scientific question. If LGB people are indeed at risk for excess mental distress and disorders due to social stress, it is important to understand this risk, as well as factors that ameliorate stress and contribute to mental health. I offer a conceptual framework for understanding this excess in prevalence of disorder in terms of minority stress.
Distal social attitudes gain psychological importance through cognitive appraisal and become proximal concepts with psychological importance to the individual. A retrospective analysis would suggest that the attempt to find a scientific answer in that debate rested on flawed logic.
There is no consensus about specific stress processes that affect LGB people, but psychological theory, stress literature, and research on the health of LGB populations provide some ideas for articulating a minority stress model. Social evaluation theory suggests another plausible mechanism for minority coping Pettigrew, Members of stigmatized groups who have a strong sense of community cohesiveness evaluate themselves in comparison with others who are like them rather than with members of the dominant culture.
The basic issue … is not whether some or many homosexuals can be found to be neurotically disturbed. In psychological literature, stressors are defined as events and conditions e. Learn More. The answer, therefore, depends on scientific and social consensus that evolves and is subject to the vicissitudes of social change Gergen, This distinction between prevalences of mental disorders and classification in the DSM was apparent to Marmorwho in an early discussion of the debate said.
Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence
Relevant theories discuss the adverse effect of social conditions, such as prejudice and stigma, on the lives of affected individuals and groups e. Minority identity is linked to a variety of stress processes; some LGB people, for example, may be vigilant in interactions with others expectations of rejectionhide their identity for fear of harm concealmentor internalize stigma internalized homophobia. The model describes stress processes, including the experience of prejudice events, expectations of rejection, hiding and concealing, internalized homophobia, and ameliorative coping processes.
Only with such understanding can psychologists, public health professionals, and public policymakers work toward deing effective prevention and intervention programs. Similarly, the basic tenet of social evaluation theory is that human beings learn about themselves by comparing themselves with others Pettigrew, Both these theoretical perspectives suggest that negative evaluation by others—such as stereotypes and prejudice directed at minority persons in society—may lead to adverse psychological outcomes.
It is important to distinguish between resources that operate on the individual level e. An example of such a conflict between dominant and minority groups is the lack of social institutions akin to heterosexual marriage offering sanction for family life and intimacy of LGB persons.
This conceptual framework is the basis for a review of research evidence, suggestions for future research directions, and exploration of public policy implications. Stress researchers have studied traumatic events, eventful life stressors, chronic stress, and role strains, as well as daily hassles and even nonevents as varied components of stress Dohrenwend, a.
The debated scientific question was, Is homosexuality a mental disorder? Certainly, when the individual is a member of a stigmatized minority group, the disharmony between the individual and the dominant culture can be onerous and the resultant stress ificant Allison, ; Clark et al. Thus, stress and resilience interact in predicting mental disorder. Group-level resources may therefore define the boundaries of individual coping efforts.
Also, it rests on rich foundations of psychological and sociological theory that suggest the person must be seen in his or her interactions with the social environment Allport, It is conceptually difficult because the notion of stress, in particular as conceived of by Lazarus and Folkmanhas focused on personal rather than social elements Hobfoll, I return to the discussion of this tension between the social and the personal, or objective and subjective, conceptualizations of stress.
For example, in a study of Black participants Branscombe, Schmitt, and Harvey found that attributions of prejudice were directly related to negative well-being and hostility toward Whites but also, through the mediating role of enhanced in-group identity, to positive well-being. In a separate study, Postmes and Branscombe found that among Blacks, a racially segregated environment contributed to greater in-group acceptance and improved well-being and life satisfaction.
The in-group may provide a reappraisal of the stressful condition, yielding it less injurious to psychological well-being. Social psychological theories provide a rich ground for understanding intergroup relations and the impact of minority position on health. That debate posited a gay-affirmative perspective, which sought to declassify homosexuality, against a conservative perspective, which sought to retain the classification of homosexuality as a mental disorder Bayer, Although the debate on classification ended in with the removal of homosexuality from the second edition of the Diagnostic and Statistical Manual of Mental Disorders DSM ; American Psychiatric Association,its heritage has lasted.