Sexual orientation concealment and mental health: A conceptual and meta-analytic review

Identity concealment affects all sexual minority individuals, with potentially complex mental health implications. Concealing a sexual minority identity can simultaneously generate the stress of hiding, protect against the stress of discrimination, and keep one apart from sexual minority communities...

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Vydané v:Psychological bulletin Ročník 146; číslo 10; s. 831
Hlavní autori: Pachankis, John E, Mahon, Conor P, Jackson, Skyler D, Fetzner, Benjamin K, Bränström, Richard
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: United States 01.10.2020
Predmet:
Adult
Anxiety - psychology
Anxiety Disorders - psychology
Bisexuality - psychology
Comorbidity
Confidentiality
Cross-Sectional Studies
Defense Mechanisms
Female
Humans
Male
Mental Disorders - epidemiology
Mental Disorders - etiology
Mental Disorders - psychology
Risk Factors
Sexual and Gender Minorities - psychology
Sexual and Gender Minorities - statistics & numerical data
Sexual Behavior - psychology
Social Stigma
Substance-Related Disorders - epidemiology
Substance-Related Disorders - psychology
ISSN:1939-1455, 1939-1455
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Shrnutí:Identity concealment affects all sexual minority individuals, with potentially complex mental health implications. Concealing a sexual minority identity can simultaneously generate the stress of hiding, protect against the stress of discrimination, and keep one apart from sexual minority communities and their norms and supports. Not surprisingly, existing studies of the association between sexual orientation concealment and mental health problems show contradictory associations-from positive to negative to null. This meta-analysis attempts to resolve these contradictions. Across 193 studies ( = 92,236) we find a small positive association between sexual orientation concealment and internalizing mental health problems (i.e., depression, anxiety, distress, problematic eating; ESr = 0.126; 95% CI [0.102, 0.151]) and a small negative association between concealment and substance use problems (ESr = -0.061; 95% CI [-0.096, -0.026]). The association between concealment and internalizing mental health problems was larger for those studies that assessed concealment as lack of open behavior, those conducted recently, and those with younger samples; it was smaller in exclusively bisexual samples. Year of data collection, study location, and sample gender, education, and racial/ethnic composition did not explain between-study heterogeneity. Results extend existing theories of stigma and sexual minority mental health, suggesting potentially distinct stress processes for internalizing problems versus substance use problems, life course fluctuations in the experience of concealment, distinct experiences of concealment for bisexual individuals, and measurement recommendations for future studies. Small overall effects, heavy reliance on cross-sectional designs, relatively few effects for substance use problems, and the necessarily coarse classification of effect moderators in this meta-analysis suggest future needed methodological advances to further understand the mental health of this still-increasingly visible population. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:1939-1455
1939-1455
DOI:10.1037/bul0000271