Abstract
Background:Poor mental health is prevalent in lesbian, gay and bisexual (LGB) people due in part to social stigma. The social, psychological and clinical risk factors for self-harm among LGB people are unclear, which limits our ability to predict when and how this will occur and, crucially, how to prevent it.Aims:Drawing on the cognitive-behavioral approach in clinical psychology, this study identifies the predictors of self-harm in LGB people in the United Kingdom.Results:Women, lesbians, those with lower income and younger people were more likely to engage in self-harm. Self-harmers exhibited much more discrimination, LGB victimization and, thus, internalized homophobia and depressive symptomatology than non-self-harmers. The structural equation model showed direct effects of age and gender, and indirect effects of income and sexual orientation, on self-harm, through the mediating variables of discrimination, LGB victimization and internalized homophobia.Conclusions:Consistent with the cognitive-behavioral model, the results indicate that exposure to situational stressors can increase the risk of developing a self-hatred and depressive psychological self-schema, resulting in greater risk of self-harm as a maladaptive coping strategy. An integrative clinical intervention for enhancing psychological wellbeing in LGB people is proposed to mitigate the risk of self-harm in this population.
Highlights
In the United Kingdom, there has been significant progress in the visibility, acceptance and rights of lesbian, gay and bisexual (LGB) people
Of lower socio-economic background, and of lesbian sexual orientation will be associated with more LGB victimization and discrimination, which in turn will be associated with more internalized homophobia and, self-harm
Our study focuses on the risk factors for self-harm in an ethnically diverse sample of LGB people in the United Kingdom
Summary
In the United Kingdom, there has been significant progress in the visibility, acceptance and rights of lesbian, gay and bisexual (LGB) people. LGB people experience significant inequalities in relation to mental health when compared to heterosexual people, including higher levels of depression, suicidal ideation, and self-harm (King et al, 2008). This study draws on the cognitive-behavioral model (Beck, 1976) to examine the associations between social ‘triggers’ (e.g., discrimination), psychological self-schemata (e.g., internalized homophobia) and the clinical variable of self-harm in an ethnically diverse sample of LGB people in the United Kingdom. There is a high prevalence of maladaptive, potentially destructive behaviors in LGB people with depressive symptomatology These include alcohol misuse, substance misuse and self-harm – these behaviors, though clearly maladaptive in the long term, may be enacted in an attempt to cope (see King et al, 2008; Liu & Mustanski, 2012). Self-harm serves only as a temporary strategy to escape and to communicate the distress that one is experiencing as a result of exposure to both internal and social threats
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