1 - (SYM 7) Hypervigilance: An Understudied Mediator of the Longitudinal Relationship Between Stigma and Internalizing Psychopathology Among Sexual Minority Young Adults

Background: Hypervigilance is often theoretically invoked as a psychological mechanism linking stigma to internalizing psychopathology among sexual minorities. Empirically, however, hypervigilance is rarely explicitly assessed, but is instead commonly conflated with putatively related constructs, including sexual orientation-related rejection sensitivity and rumination, hindering conceptual and mechanistic understandings of this process.

Methods: To clarify these constructs, we embedded a novel hypervigilance measure within a longitudinal, population-based study of 811 sexual minority young adults (ages 17–34; 68.1% bisexual, 23.8% lesbian/gay, 8.1% other sexual minority identities; 71.1% cisgender women, 21.9% cisgender men, 0.6% transgender women, 1.8% transgender men, 4.6% genderqueer). This ongoing investigation also included repeated measures of interpersonal stigma experiences (e.g., perceived discrimination), stigma-related processes (e.g., sexual orientation-related rejection sensitivity and rumination), and internalizing (e.g., anxiety, depression) symptoms.

Results: Hypervigilance—but neither sexual orientation-related rejection sensitivity nor rumination, with which it was only weakly correlated—uniquely mediated prospective associations between perceived discrimination and anxiety and depression symptoms two years later, explaining up to 40% of these effects. Supplemental analyses using an alternative measure of interpersonal stigma (i.e., sexual orientation-related victimization) offered even stronger support for the uniquely mediating role of hypervigilance. In serial mediation models, sexual orientation-related rejection sensitivity and rumination prospectively predicted hypervigilance on these longitudinal paths.

Conclusions: Results suggest that hypervigilance represents a distinct construct and transdiagnostic mechanism through which stigma-related experiences and processes undermine sexual minority mental health. Specifically, findings indicate that sexual orientation-related rejection sensitivity and rumination may reflect conceptually and temporally distinct processes that antecede and modulate—rather than co-constitute and co-occur with—hypervigilance. Existing psychological interventions adapted for sexual minorities, which primarily draw on cognitive-behavioral therapy principles, may confer additional benefits by explicitly addressing hypervigilance.