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The Mediating Roles of Rejection Sensitivity and Proximal Stress in the Association Between Discrimination and Internalizing Symptoms Among Sexual Minority Women

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Abstract

The negative impact of discrimination on mental health among lesbian, gay, and bisexual populations has been well documented. However, the possible mediating roles of sexual orientation rejection sensitivity and rejection-based proximal stress in the association between discrimination and internalizing symptoms remain unclear. Rejection-based proximal stress is a subset of proximal stressors that are theorized to arise from concerns about and expectations of sexual orientation-based rejection and discrimination. Drawing on minority stress theory, we tested potential mediating effects using indirect effects structural equation modeling in a sample of 300 sexual minority women. Results indicated that the indirect effect of discrimination on internalizing symptoms (a latent variable indicated by depression and anxiety symptoms) through sexual orientation rejection sensitivity and rejection-based proximal stress (a latent variable indicated by preoccupation with stigma, concealment motivation, and difficulty developing a positive sexual identity) was significant. Additionally, the indirect effects of discrimination on rejection-based proximal stress through sexual orientation rejection sensitivity and of sexual orientation rejection sensitivity on internalizing symptoms through rejection-based proximal stress were also significant. These findings indicate that sexual orientation rejection sensitivity plays an important role in contributing to rejection-based proximal stress and internalizing symptoms among sexual minority women.

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Notes

  1. Of note, stigma consciousness and rejection sensitivity are often used interchangeably with one another. However, these concepts are distinct in important ways. Stigma consciousness focuses on perceptions of others’ views of one’s identity (Pinel, 1999), while rejection sensitivity reflects the interaction of anxiety concerning potential stigmatization and perceived probability of the potential stigmatization (London et al., 2012).

  2. Stigma consciousness has also been linked with more frequent experiences of discrimination and greater psychological distress (e.g., Lewis, Derlega, Griffin, & Krowinski, 2003; Lewis, Milletich, Mason, & Derlega, 2014). While this construct is related to preoccupation with stigma, there are important conceptual differences. Preoccupation with stigma is specific to an individual’s perceptions of and concern about how others perceive their identity (e.g., Mohr & Kendra, 2011), while stigma consciousness also captures one’s general understanding that stigma toward one’s group exists (Pinel, 1999).

  3. Gender differences in preoccupation with stigma and internalized homonegativity have been found, with SMW reporting lower levels of both, but no gender differences in concealment, concealment motivation, or difficulty developing a positive sexual identity have been documented (e.g., Balsam & Mohr, 2007; Mohr & Fassinger, 2000).

  4. In a just-identified model, all observed information is used to produce parameter estimates, meaning that the number of unknown values to be estimated (parameters) is equal to the number of known values (observed associations among variables; Brown, 2015). This results in a unique set of model parameters, which perfectly reproduces the observed associations among variables.

  5. An alternative model was tested in which sexual orientation RS was considered an indicator of the latent proximal stress variable rather than an antecedent to it. This alternative model did not fit the data well, χ 2(16) = 72.86, p < .001; CFI = .91; TLI = .85; RMSEA = .11. A comparison of BIC and AIC values indicated that the original model [without controls; χ 2(13) = 27.15, p = .01; CFI = .98; TLI = .95; RMSEA = .06] was substantially preferred over the alternative model, as indicated by a difference of greater than 10 points (ΔBIC = 39.71; ΔAIC = 28.61), with lower values for the original model (BIC = 9630.35; AIC = 9737.75) compared to the alternative model (BIC = 9670.06; AIC = 9766.36; Raferty, 1995).

  6. Due to issues with convergence for the multigroup models, multigroup models were run with a single binary race/ethnicity variable, with White coded as 0 and non-White and multiracial coded as 1.

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Authors and Affiliations

  1. Department of Psychology, Stony Brook University, 100 Nichols Road, Stony Brook, NY, 11794-2500, USA

    Christina Dyar, Nicholas R. Eaton & Bonita London

  2. Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Brian A. Feinstein

  3. Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL, USA

    Brian A. Feinstein

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  1. Christina Dyar
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Correspondence to Christina Dyar.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Dyar, C., Feinstein, B.A., Eaton, N.R. et al. The Mediating Roles of Rejection Sensitivity and Proximal Stress in the Association Between Discrimination and Internalizing Symptoms Among Sexual Minority Women. Arch Sex Behav 47, 205–218 (2018). https://doi.org/10.1007/s10508-016-0869-1

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