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Social Psychiatry and Psychiatric Epidemiology
Erschienen in: Social Psychiatry and Psychiatric Epidemiology 9/2014

01.09.2014 | Original Paper

Sexual orientation disparities in mental health: the moderating role of educational attainment

verfasst von: David M. Barnes, Mark L. Hatzenbuehler, Ava D. Hamilton, Katherine M. Keyes

Erschienen in: Social Psychiatry and Psychiatric Epidemiology | Ausgabe 9/2014

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Abstract

Purpose

Mental health disparities between sexual minorities and heterosexuals remain inadequately understood, especially across levels of educational attainment. The purpose of the present study was to test whether education modifies the association between sexual orientation and mental disorder.

Methods

We compared the odds of past 12-month and lifetime psychiatric disorder prevalence (any Axis-I, any mood, any anxiety, any substance use, and comorbidity) between lesbian, gay, and bisexual (LGB) and heterosexual individuals by educational attainment (those with and without a bachelor’s degree), adjusting for covariates, and tested for interaction between sexual orientation and educational attainment. Data are drawn from the National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative survey of non-institutionalized US adults (N = 34,653; 577 LGB).

Results

Sexual orientation disparities in mental health are smaller among those with a college education. Specifically, the disparity in those with versus those without a bachelor’s degree was attenuated by 100 % for any current mood disorder, 82 % for any current Axis-I disorder, 76 % for any current anxiety disorder, and 67 % for both any current substance use disorder and any current comorbidity. Further, the interaction between sexual orientation and education was statistically significant for any current Axis-I disorder, any current mood disorder, and any current anxiety disorder. Our findings for lifetime outcomes were similar.

Conclusions

The attenuated mental health disparity at higher education levels underscores the particular risk for disorder among LGBs with less education. Future studies should consider selection versus causal factors to explain the attenuated disparity we found at higher education levels.
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Literatur
1.
Bostwick WB, Boyd CJ, Hughes TL, McCabe SE (2010) Dimensions of sexual orientation and the prevalence of mood and anxiety disorders in the United States. Am J Public Health 100:468–475PubMedCentralPubMedCrossRef
2.
Cochran SD, Mays VM (2000) Relation between psychiatric syndromes and behaviorally defined sexual orientation in a sample of the US population. Am J Epidemiol 151:516–523PubMedCentralPubMedCrossRef
3.
Cochran SD, Sullivan JG, Mays VM (2003) Prevalence of mental disorders, psychological distress, and mental services use among lesbian, gay, and bisexual adults in the United States. J Consult Clin Psychol 71:53–61PubMedCrossRef
4.
Gilman SE, Cochran SD, Mays VM et al (2001) The risk of psychiatric disorders among persons reporting same-sex sexual partners in the national comorbidity survey. Am J Public Health 91:933–939PubMedCentralPubMedCrossRef
5.
Sandfort TG, de Graaf R, Bijl RV, Schnabel P (2001) Same-sex sexual behavior and psychiatric disorders: findings from the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Arch Gen Psychiatry 58:85–91PubMedCrossRef
6.
King M, Semlyen J, Tai SS et al (2008) A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people. BMC Psychiatry 8:70PubMedCentralPubMedCrossRef
7.
D’Augelli AR, Hershberger SL, Pilkington NW (2001) Suicidality patterns and sexual orientation-related factors among lesbian, gay, and bisexual youths. Suicide Life-Threat Behav 31:250–264PubMedCrossRef
8.
Kessler RC, McGonagle KA, Zhao S et al (1994) Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey. Arch Gen Psychiatry 51:8–19PubMedCrossRef
9.
Dohrenwend BP, Levav I, Shrout PE et al (1992) Socioeconomic status and psychiatric disorders: the causation-selection issue. Science 255:946–952PubMedCrossRef
10.
Kessler RC, Berglund P, Demler O et al (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62:593–602PubMedCrossRef
11.
Hasin DS, Goodwin RD, Stinson FS, Grant BF (2005) Epidemiology of major depressive disorder: results from the National Epidemiologic Survey on Alcoholism and Related Conditions. Arch Gen Psychiatry 62:1097–1106PubMedCrossRef
12.
Lorant V, Deliege D, Eaton W et al (2003) Socio-economic inequalities in depression: a meta-analysis. Am J Epidemiol 157:98–112PubMedCrossRef
13.
Grant BF, Hasin DS, Stinson FS et al (2005) Prevalence, correlates, co-morbidity, and comparative disability of DSM-IV generalized anxiety disorder in the USA: results from the National Epidemologic Survey on Alcohol and Related Conditions. Psychol Med 35:1747–1759PubMedCrossRef
14.
Himle JA, Baser RE, Taylor RJ et al (2009) Anxiety disorders among African Americans, blacks of Caribbean descent, and non-Hispanic whites in the United States. J Anxiety Disord 23:578–590PubMedCrossRef
15.
Compton WM, Thomas YF, Stinson FS, Grant BF (2007) Prevalence, correlates, disability, and comorbidity of DSM-IV drug abuse and dependence in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Arch Gen Psychiatry 64:566–576PubMedCrossRef
16.
Gilman SE, Breslau J, Conron KJ et al (2008) Education and race–ethnicity differences in the lifetime risk of alcohol dependence. J Epidemiol Community Health 62:224–230PubMedCentralPubMedCrossRef
17.
Hatzenbuehler ML, McLaughlin KA, Keyes KM, Hasin DS (2010) The impact of institutional discrimination on psychiatric disorders in lesbian, gay, and bisexual populations: a prospective study. Am J Public Health 100:452–459PubMedCentralPubMedCrossRef
18.
Cochran SD, Mays VM (2009) Burden of psychiatric morbidity among lesbian, gay, and bisexual individuals in the California Quality of Life Survey. J Abnorm Psychol 118:647–658PubMedCentralPubMedCrossRef
19.
Hatzenbuehler ML, McLaughlin KA, Slopen N (2013) Sexual orientation disparities in cardiovascular biomarkers among young adults. Am J Prev Med 44:612–621PubMedCentralPubMedCrossRef
20.
Bontempo DE, d’ Augelli AR (2002) Effects of at-school victimization and sexual orientation on lesbian, gay, or bisexual youths’ health risk behavior. J Adolesc Health 30:364–374PubMedCrossRef
21.
Russell ST, Seif H, Truong NL (2001) School outcomes of sexual minority youth in the United States: evidence from a national study. J Adolesc 24:111–127PubMedCrossRef
22.
Ueno K (2005) Sexual orientation and psychological distress in adolescence: examining interpersonal stressors and social support processes. Soc Psychol Q 68:258–277CrossRef
23.
Pearson J, Muller C, Wilkinson L (2007) Adolescent same-sex attraction and academic outcomes: the role of school attachment and engagement. Soc Probl 54:523–542PubMedCentralPubMedCrossRef
24.
Pachankis JE, Hatzenbuehler ML (2013) The social development of contingent self-worth in sexual minority young men: an empirical investigation of the “Best little boy in the world” hypothesis. Basic Appl Soc Psychol 35:176–190CrossRef
25.
Hasin DS, Stinson FS, Ogburn E, Grant BF (2007) Prevalence, correlates, disability, and comorbidity of DSM-IV alcohol abuse and dependence in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Arch Gen Psychiatry 64:830–842PubMedCrossRef
26.
Grant BF, Harford TC, Muthen BO et al (2007) DSM-IV alcohol dependence and abuse: further evidence of validity in the general population. Drug Alcohol Depend 86:154–166PubMedCrossRef
27.
Bills DB (2003) Credentials, signals, and screens: explaining the relationship between schooling and job assignment. Rev Educ Res 73:441–449CrossRef
28.
Jaeger DA, Page ME (1996) Degrees matter: new evidence on sheepskin effects in the returns to education. Rev Econ Stat 78:733–740CrossRef
29.
Canino G, Bravo M, Ramirez R et al (1999) The Spanish alcohol use disorder and associated disabilities interview schedule (AUDADIS): reliability and concordance with clinical diagnoses in a Hispanic population. J Stud Alcohol 60:790–799PubMed
30.
Grant BF (1995) Comorbidity between DSM-IV drug use disorders and major depression: results of a national survey of adults. J Subst Abuse 7:481–497PubMedCrossRef
31.
Grant BF, Harford TC, Dawson DA et al (1995) The Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS): reliability of alcohol and drug modules in a general population sample. Drug Alcohol Depend 39:37–44PubMedCrossRef
32.
Grant BF, Dawson DA, Stinson FS et al (2003) The alcohol use disorder and associated disabilities interview schedule-IV (AUDADIS-IV): reliability of alcohol consumption, tobacco use, family history of depression and psychiatric diagnostic modules in a general population sample. Drug Alcohol Depend 71:7–16PubMedCrossRef
33.
Hasin D, Paykin A (1999) Alcohol dependence and abuse diagnoses: concurrent validity in a nationally representative sample. Alcohol Clin Exp Res 23:144–150PubMed
34.
35.
Williams DR, Gonzalez HM, Neighbors H et al (2007) Prevalence and distribution of major depressive disorder in African Americans, Caribbean blacks, and non-Hispanic whites: results from the National Survey of American Life. Arch Gen Psychiatry 64:305–315PubMedCrossRef
36.
Hatzenbuehler ML (2010) Social factors as determinants of mental health disparities in LGB populations: implications for public policy. Social Issues and Policy Review 4:31–62CrossRef
37.
McLaughlin KA, Hatzenbuehler ML, Keyes KM (2010) Responses to discrimination and psychiatric disorders among Black, Hispanic, female, and lesbian, gay, and bisexual individuals. Am J Public Health 100:1477–1484PubMedCentralPubMedCrossRef
38.
39.
Meyer IH (2003) Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull 129:674–697PubMedCentralPubMedCrossRef
40.
D’Augelli AR, Pilkington NW, Hershberger SL (2002) Incidence and mental health impact of sexual orientation victimization of lesbian, gay, and bisexual youths in high school. Sch Psychol Q 17:148–167CrossRef
41.
Savin-Williams RC (1994) Verbal and physical abuse as stressors in the lives of lesbian, gay male, and bisexual youths: associations with school problems, running away, substance abuse, prostitution, and suicide. J Consult Clin Psychol 62:261–269PubMedCrossRef
42.
Garofalo R, Wolf RC, Kessel S et al (1998) The association between health risk behaviors and sexual orientation among a school-based sample of adolescents. Pediatrics 101:895–902PubMedCrossRef
43.
DuRant RH, Krowchuk DP, Sinal SH (1998) Victimization, use of violence, and drug use at school among male adolescents who engage in same-sex sexual behavior. J Pediatr 133:113–118PubMedCrossRef
44.
Himmelstein KE, Brückner H (2011) Criminal–justice and school sanctions against nonheterosexual youth: a national longitudinal study. Pediatrics 127:49–57PubMedCentralPubMedCrossRef
45.
Ayduk O, Mendoza-Denton R, Mischel W et al (2000) Regulating the interpersonal self: strategic self-regulation for coping with rejection sensitivity. J Personal Soc Psychol 79:776–792CrossRef
46.
47.
Masten AS, Curtis WJ (2000) Integrating competence and psychopathology: pathways toward a comprehensive science of adaptation in development. Dev Psychopathol 12:529–550PubMedCrossRef
48.
49.
Funk RB, Willits FK (1987) College attendance and attitude change: a panel study, 1970–81. Soc Educ 60(4):224–231
50.
Moore LM, Ovadia S (2006) Accounting for spatial variation in tolerance: the effects of education and religion. Soc Forces 84:2205–2222CrossRef
51.
Pascarella ET, Terenzini PT (1991) How college affects students: findings and insights from twenty years of research. Jossey-Bass, San Francisco
52.
McPherson M, Smith-Lovin L, Cook JM (2001) Birds of a feather: homophily in social networks. Annu Rev Soc 27:415–444CrossRef
53.
Cottler LB, Grant BF, Blaine J et al (1997) Concordance of DSM-IV alcohol and drug use disorder criteria and diagnoses as measured by AUDADIS-ADR, CIDI and SCAN. Drug Alcohol Depend 47:195–205PubMedCrossRef
54.
55.
Metadaten
Titel
Sexual orientation disparities in mental health: the moderating role of educational attainment
verfasst von
David M. Barnes
Mark L. Hatzenbuehler
Ava D. Hamilton
Katherine M. Keyes
Publikationsdatum
01.09.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Social Psychiatry and Psychiatric Epidemiology / Ausgabe 9/2014
Print ISSN: 0933-7954
Elektronische ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-014-0849-5

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