title: Perceived distress tolerance accounts for the covariance between discrimination experiences and anxiety symptoms among sexual minority adults.
abstract: Sexual orientation-related discrimination experiences have been implicated in elevated rates of anxiety symptoms within sexual minority groups. Theory suggests that chronic discrimination experiences may dampen the ability to tolerate distress, increasing vulnerability for anxiety. This study examined the role of distress tolerance, or the capacity to withstand negative emotions, as a construct underlying associations between discriminatory experiences and anxiety among sexual minority adults. Participants (N=119;Mage=36.4±14.8; 50% cisgender male, 31% cisgender female, 19% transgender; 37% non-Latino white) were recruited from Houston, Texas. Measures administered included the Heterosexist Harassment, Rejection, and Discrimination Scale (discrimination experiences), Distress Tolerance Scale (distress tolerance), and the State-Trait Inventory for Cognitive and Somatic Anxiety (anxiety). The association of discrimination experiences and anxiety through distress tolerance was assessed using covariate-adjusted mediation modeling. Results indicated that sexual orientation-related discrimination experiences were significantly and positively associated with anxiety and that this association was mediated through lower distress tolerance. Significant indirect effects were specific to cognitive (versus somatic) anxiety symptoms. Results suggest that distress tolerance may be an explanatory mechanism in the association between discriminatory experiences and cognitive symptoms of anxiety and a potentially relevant target within clinical interventions to address anxiety-related health disparities among sexual minority adults. However, more sophisticated designs are needed to delineate causal associations.
authors.affiliation: University of Houston, Department of Psychological, Health, & Learning Sciences, 491 Farish Hall, Houston, TX 77204-5029, USA. Electronic address: Lrreitzel@uh.edu.
authors.forename: Lorraine R
authors.initials: LR
authors.lastname: Reitzel
authors.affiliation: University of Houston, Department of Psychological, Health, & Learning Sciences, 491 Farish Hall, Houston, TX 77204-5029, USA.
authors.forename: Nathan Grant
authors.initials: NG
authors.lastname: Smith
authors.affiliation: University of Houston, Department of Psychological, Health, & Learning Sciences, 491 Farish Hall, Houston, TX 77204-5029, USA.
authors.forename: Ezemenari M
authors.initials: EM
authors.lastname: Obasi
authors.affiliation: University of Houston, Department of Psychological, Health, & Learning Sciences, 491 Farish Hall, Houston, TX 77204-5029, USA.
authors.forename: Margot
authors.initials: M
authors.lastname: Forney
authors.affiliation: Departments of Preventive Medicine and Psychology, University of Southern California Keck School of Medicine, Los Angeles, CA, USA.
authors.forename: Adam M
authors.initials: AM
authors.lastname: Leventhal
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008913:Minority Groups / Q000523:psychology*; D010465:Perception; D055500:Resilience, Psychological; D012725:Sexual Behavior / Q000523:psychology; D000072339:Sexual and Gender Minorities / Q000523:psychology*; D063508:Social Discrimination / Q000523:psychology*; D011795:Surveys and Questionnaires; D013781:Texas
keywords: Anxiety; Discrimination; Distress tolerance; Emotional dysregulation; Sexual minority