Department of Neurology, McGill University, Montreal, Quebec, Canada.
Psychosom Med. 2013 Feb;75(2):103-16. doi: 10.1097/PSY.0b013e3182826881. Epub 2013 Jan 29.
Lesbian, gay, and bisexual (LGB) individuals-particularly those who have not disclosed their sexual orientation-are believed to experience increased chronic stress in comparison with heterosexuals. This interdisciplinary study assessed whether psychiatric symptoms (self-rated anxiety, depression, and burnout), stress hormone profiles (diurnal cortisol), and physiological dysregulations (allostatic load [AL]) would differ for a) LGBs versus heterosexuals and b) disclosed LGBs versus nondisclosed LGBs.
The study included 87 healthy participants (mean [SD] age=24.6 [0.6] years; LGB n=46, 43% women; and heterosexual n=41, 49% women). Diurnal cortisol sampled at five time points was averaged for 2 days. AL indices were based on an algorithm incorporating 21 biomarkers representing neuroendocrine, immune/inflammatory, metabolic, and cardiovascular functioning. Psychological measures were assessed with well-validated questionnaires.
Between-group results revealed no significant differences in symptoms of anxiety and burnout, nor among diurnal cortisol levels between sexual orientations. By contrast, gay/bisexual men unexpectedly had lower depressive symptoms (p=.003) and AL levels (p=.043) compared with heterosexual men. Within-group results revealed that disclosed LGBs had fewer psychiatric symptoms (p values<0.01) and lower cortisol levels +30 minutes upon awakening (p=.004) compared with nondisclosed LGBs. Disclosure was not significantly related to AL levels.
LGBs did not manifest more stress-related problems than did heterosexuals. Life transitions like disclosing to one's family and friends may be protective against psychopathologies and hyperactive cortisol awakening responses. Our novel findings underline the roles disclosure processes have on positive health and well-being for sexual minorities.
同性恋、双性恋和无性恋（LGB）个体——尤其是那些尚未公开自己性取向的个体——被认为比异性恋者承受更多的慢性压力。这项跨学科研究评估了精神病症状（自我评估的焦虑、抑郁和倦怠）、应激激素谱（日间皮质醇）和生理失调（全身适应不良负荷[AL]）是否会因以下原因而有所不同：a）LGB 与异性恋者，b）公开 LGB 与未公开 LGB。
该研究纳入了 87 名健康参与者（平均[标准差]年龄=24.6[0.6]岁；LGB 组 n=46，43%为女性；异性恋组 n=41，49%为女性）。在两天内平均采集了 5 个时间点的日间皮质醇。AL 指数基于一个算法，该算法结合了 21 种生物标志物，代表神经内分泌、免疫/炎症、代谢和心血管功能。心理测量采用经过充分验证的问卷进行评估。
组间结果显示，焦虑和倦怠症状以及性取向之间的日间皮质醇水平没有显著差异。相比之下，男同性恋/双性恋者的抑郁症状（p=0.003）和 AL 水平（p=0.043）出人意料地低于异性恋男性。组内结果显示，与未公开的 LGB 相比，公开的 LGB 有较少的精神症状（p 值<0.01）和更低的皮质醇水平（醒来后 30 分钟时，p=0.004）。公开身份与 AL 水平没有显著关系。
LGB 没有表现出比异性恋者更多的与压力相关的问题。像向家人和朋友公开自己的身份这样的生活转变可能有助于预防精神病理学和皮质醇觉醒反应过度。我们的新发现强调了公开身份过程对性少数群体的积极健康和幸福的作用。
