Division of Infectious Diseases, Department of Medicine, Long School of Medicine, University of Texas Health Science Center San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA.
Division of Infectious Diseases, Department of Medicine, Georgetown University Medical Center, Washington, DC, USA.
AIDS Behav. 2023 Oct;27(10):3171-3182. doi: 10.1007/s10461-023-04037-9. Epub 2023 Mar 21.
Among sexual minority men (SMM), internalized homophobia (IH) has been consistently associated with increased depression symptoms. However, some SMM experiencing IH demonstrate resilience to buffer against depression symptoms. In this analysis, we used the Stress Process Model (SPM) as a conceptual framework to explore individual-level psychosocial resilience (ILPR) factors serving as a buffer of the IH-depression relationship. To utilize the SPM to explore whether four ILPR factors, including volunteerism, optimism, religiosity/spirituality, and global resiliency measure mediate the relationship between IH and depression symptoms among middle-aged and older SMM living with and without HIV. We used exploratory and confirmatory factor analysis to construct measurement models for the four ILPR factors. We examined whether the four ILPR factors mediated the IH-depression relationship. IH was significantly and positively associated with depression symptoms. There was a partial mediation of the IH-depression association by the four ILPR. Specifically, we found statistically significant indirect effects of optimism and the global resilience measure and supporting buffering effects of the IH-depression association. Although, the indirect effects religiosity/spirituality on the IH-depression relationship was significant, it did not support a buffering of effect. The indirect effects of volunteerism were not statistically significant. Our findings highlight the potential role of ILPR factors in the development of resilience against the negative effects of IH. Implications of these results for future research and practice are discussed.
在性少数群体男性(SMM)中,内化的恐同症(IH)与抑郁症状的增加一直密切相关。然而,一些经历 IH 的 SMM 表现出适应能力来缓冲抑郁症状。在这项分析中,我们使用应激过程模型(SPM)作为概念框架,探讨个体心理社会适应力(ILPR)因素作为 IH-抑郁关系的缓冲因素。利用 SPM 来探讨在同时患有和不患有 HIV 的中老年 SMM 中,四个 ILPR 因素(包括志愿服务、乐观、宗教信仰/灵性和整体适应力测量)是否作为 IH 和抑郁症状之间关系的中介因素。我们使用探索性和验证性因子分析来构建四个 ILPR 因素的测量模型。我们检验了四个 ILPR 因素是否介导了 IH-抑郁关系。IH 与抑郁症状显著正相关。四个 ILPR 部分介导了 IH-抑郁关系。具体来说,我们发现乐观和整体适应力测量对 IH-抑郁关系的间接影响具有统计学意义,并且支持 IH-抑郁关系的缓冲作用。虽然宗教信仰/灵性对 IH-抑郁关系的间接影响具有统计学意义,但它并没有支持缓冲效果。志愿服务的间接效应不具有统计学意义。我们的研究结果强调了 ILPR 因素在 IH 负面影响产生的适应力发展中的潜在作用。这些结果对未来的研究和实践具有重要意义。