4 - (SYM 7) Thwarted Belonging Needs: A Mechanism Prospectively Linking Multiple Levels of stigma and Interpersonal Outcomes Among Sexual Minorities

Background: It is well-documented that exposure to stigma is robustly associated with negative mental health outcomes and is a fundamental cause of health disparities between stigmatized and non-stigmatized populations. Extending this body of work, researchers have begun to propose and test psychosocial mechanisms linking stigma and mental health. For example, one way that stigma—operating at interpersonal (e.g., discrimination) and individual (e.g., internalized stigma) levels—indirectly affects mental health is by disrupting social relationships, leading to adverse interpersonal outcomes (e.g., loneliness), which in turn are associated with poor mental health. Despite growing evidence for this pathway, a limited body of research has: (1) conceptualized and tested the multitude of psychosocial mechanisms through which stigma causes adverse interpersonal outcomes; and (2) incorporated the effect of “up-stream” macro-social contextual influences (e.g., structural stigma—societal-level conditions, cultural norms, and institutional policies that constrain the opportunities, resources, and wellbeing of the stigmatized). As a result, the field lacks a comprehensive understanding of the various ways in which stigma—operating across multiple levels of influence (i.e., individual, interpersonal, and structural)—indirectly interferes with social relationships in ways that increase risk for poor mental health.

Methods: To address this gap, we examined whether stigma—measured at individual, interpersonal, and structural levels—prospectively affected loneliness by thwarting fundamental belonging needs among a longitudinal sample of 315 gay men.

Results: Results indicated that thwarted belonging needs prospectively mediated the association between interpersonal discrimination, internalized homonegativity, and concealment motivation and changes in loneliness. In addition, the prospective association between objectively measured structural stigma and loneliness was serially mediated by perceptions of structural stigma and thwarted belonging needs.

Conclusions: To guide future work, we propose a model outlining pathways by which stigma may lead to loneliness by increasing biological, motivational, cognitive, affective, and behavioral mechanisms that thwart belonging needs, and in turn, compromise mental health.