Kaprinis Stergios, Charalampakis Anastasios
Second Department of Psychiatry, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Front Sociol. 2025 Jul 24;10:1638766. doi: 10.3389/fsoc.2025.1638766. eCollection 2025.
LGBTQ+ individuals are disproportionately affected by depression, anxiety, and suicidal ideation, primarily due to persistent social exclusion, prejudice, and systemic discrimination rather than any inherent psychopathology. This review synthesizes contemporary theoretical frameworks, including the Minority Stress Model, the Psychological Mediation Framework, and the Rejection Sensitivity Model, to examine the internalization of systemic marginalization and its manifestation as psychological distress. Significant mediators, such as internalized stigma, emotional dysregulation, and rejection sensitivity, are investigated alongside structural determinants, such as familial rejection and intersectional oppression. Contemporary insights from social psychology, psychiatry, and neuroscience were used in this study. Neurobiological data indicate that chronic minority stress modifies the limbic-prefrontal circuitry, disrupts the hypothalamic- pituitary-adrenal (HPA) axis, and increases allostatic load. The implications for clinical practice and public health were analyzed, emphasizing the importance of community-based resilience initiatives, inclusive policy reforms, and LGBTQ+-affirmative therapy. The article concludes by outlining the theoretical constraints and proposing future avenues for participatory and multidisciplinary studies.
LGBTQ+群体受抑郁症、焦虑症和自杀意念的影响尤为严重,这主要是由于持续存在的社会排斥、偏见和系统性歧视,而非任何内在的精神病理学问题。本综述综合了当代理论框架,包括少数群体压力模型、心理调解框架和拒绝敏感性模型,以研究系统性边缘化的内化及其作为心理困扰的表现。同时还研究了重要的中介因素,如内化耻辱感、情绪失调和拒绝敏感性,以及结构性决定因素,如家庭排斥和交叉压迫。本研究采用了社会心理学、精神病学和神经科学的当代见解。神经生物学数据表明,长期的少数群体压力会改变边缘-前额叶回路,扰乱下丘脑-垂体-肾上腺(HPA)轴,并增加应激负荷。分析了对临床实践和公共卫生的影响,强调了基于社区的复原力倡议、包容性政策改革和LGBTQ+肯定疗法的重要性。文章最后概述了理论限制,并提出了参与性和多学科研究的未来途径。