期刊
SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY
卷 51, 期 8, 页码 1181-1192出版社
SPRINGER HEIDELBERG
DOI: 10.1007/s00127-016-1236-1
关键词
Sexual minority populations; Gay, lesbian, and bisexual health; Stress; Community belonging; Mental health
类别
资金
- CIHR Doctoral Research Award (Frederick Banting and Charles Best Canada Graduate Scholarship)
- CIHR Institute of Gender and Health, Skills Development Award
- Killam Doctoral Scholarship
- Canadian Institutes of Health Research, New Investigator Award
To examine the extent to which sexual identity disparities in mental health outcomes (anxiety disorder, mood disorder, anxiety-mood disorder, and co-occurring anxiety or mood disorder and heavy drinking) are mediated by life stress or moderated by a sense of community belonging. This study pooled data from a large, national, multi-year sample of Canadians aged 18-59 years, who self-identified as lesbian, gay, bisexual, or heterosexual (N = 222,548). A series of stratified binary mediation models were fitted. Significance of the indirect effect was determined by using bootstrapping to obtain standard errors and confidence intervals. Sexual minority (versus heterosexual) respondents were significantly more likely to describe their lives as stressful, their sense of community belonging as weak, and had significantly greater odds of the negative mental health outcomes. Perceived life stress partially mediated the effects of sexual identity on the mental health outcomes. The differences between the mediated effects for the gay/lesbian and bisexual subgroups were statistically significant (all p < 0.05). When stratified by sense of community belonging, life stress mediated the relationship with mood disorders for the gay/lesbian group, where a strong sense of community belonging was associated with greater odds of mood disorders for gay/lesbian versus heterosexual respondents. These mediation and moderated mediation models provide further evidence for a social patterning of the mental health disparities experienced by sexual minorities in Canada.
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