THE ROLE OF SCHOOL-BASED SUPPORT AND COPING SKILLS IN THE DEVELOPMENT OF ANXIETY IN LGBTQ YOUNG ADULTS

7/29/2019 THE ROLE OF SCHOOL-BASED SUPPORT AND COPING SKILLS IN THE DEVELOPMENT OF ANXIETY IN LGBTQ YOUNG

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LGBTQ SCHOOL-BASED SUPPORT

THE ROLE OF SCHOOL-BASED SUPPORT AND COPING SKILLSIN THE DEVELOPMENT OF ANXIETY IN LGBTQ YOUNG ADULTS

by

Jennifer PiccoloDecember 22, 2009

A dissertation submitted to theFaculty of the Graduate School of

the University at Buffalo, State University of New York

in partial fulfillment of the requirements for thedegree of

Doctor of Philosophy

Department of Counseling, School and Educational Psychology


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UMI Number: 3391075

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LGBTQ SCHOOL-BASED SUPPORT ii

Copyright

by

Jennifer A. Piccolo

2010

(ii)


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LGBTQ SCHOOL-BASED SUPPORT iii

Dedication

This dissertation is dedicated to all of the people in my life who have tolerated

my persistent crankiness, exasperating slowness, general unreliability,

and all of the other frustrating habits Ive developed during the past couple of years,

who magically still love me anyway.

I love you more than I can convey here,

I wouldnt have gotten here without you,

& I owe you one

(of everything).


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LGBTQ SCHOOL-BASED SUPPORT iv

Acknowledgements

I would like to express my deepest gratitude to Dr. Catherine Cook-Cottone for her guidance and

support as my academic advisor and committee chair. Her extraordinarily generous academic,

intellectual, and emotional support and encouragement over the years, and especially during the

dissertation process, have been amazing. I would also like to sincerely thank committee members

Dr. Amy Reynolds and Dr. Delucia-Waack for their guidance and generous support. They have all

gone above and beyond as dissertation committee members, and I am truly grateful.

Id also like to thank CSEP faculty for sharing their expertise and lending support throughout my

graduate education. I have genuinely enjoyed learning from all of you and its been a great

privilege to have been trained by such brilliant, kind, and funny people. Special thanks to Nancy

Myers for all of her support over the years.

Lastly, Id like to thank Dr. Lisa Dekeon and Dr. Amy Hequembourg for their immeasurable

understanding, wisdom, humor, and encouragement as I trudged through this dissertation. I am

enormously grateful and incredibly fortunate to have had their support.


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LGBTQ SCHOOL-BASED SUPPORT v

Table of Contents

Page

Dedication iii

Acknowledgements iv

Abstract x

I. Introduction 1

Definition of the Problem 1

Incidence/ Prevalence 6

Significance of the Study 9

Organization of the Study 10

Definition of Terms 10

Overview of Chapters 14

II. Review of the Literature 16

LGBTQ Identity Development 16

Stress and Resilience: A Minority Stress Framework 20

Daily Challenges as Minority Stress 22

Anxiety in LGBTQ Populations 35

Examining the Response of Schools 40

Supporting Resilience in LGBTQ Adolescents 44

III. Method and Procedures 48

Participants 48

Procedures 49


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LGBTQ SCHOOL-BASED SUPPORT vi

Instruments 50

Research Questions and Statistical Analyses 55

IV. Results 57

Research Question One: How Prevalent are Experiences of Disclosure-

Related Rejection and Generalized and Social Anxiety among LGBT

Young Adults?

57

Research Question Two: How Prevalent are the Identified Types of School-

Based Support?

58

Research Question Three: Which School-Based Supports Did LGBTQ

Young Adults Perceive as Most Helpful?

59

Research Question Four: Do an Individuals Experiences of Disclosure-

Related Rejection and Acceptance, LGBTQ-Related School-Based

Support, and Coping Behaviors Predict the Development

Of Trait Anxiety and/or Social Anxiety?

60

Research Question Five: Which Components of School-Based Support Best

Predict Active Coping Skills?

61

Research Question Six: Which Components of School-Based Support Best

Predict Levels of Trait- and Social Anxiety?

63

V. Discussion 65

Findings and Implications 65

Limitations and Implications for Future Research 70

References 72


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LGBTQ SCHOOL-BASED SUPPORT vii

Appendices 80

Appendix A: Informed Consent Document

Appendix B: Debriefing Script

Appendix C: Resources for Participants

Appendix D: Brief COPE Part 1

80

83

84

85

Appendix E: Brief COPE Part 2 87

Appendix F: State-Trait Anxiety Inventory (Trait Scale) 89

Appendix G: Brief Fear of Negative Evaluation Scale, Version II 90

Appendix H: Disclosure and School-Based Support Questionnaire 91

Appendix I: Tables 100


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LGBTQ SCHOOL-BASED SUPPORT viii

List of Tables

Page

Table 1: Demographic Characteristics of the Study Sample 100

Table 2: Sexual Orientation and Gender Identity of the Study Sample

Table 3: Characteristics of High Schools

102

103

Table 4: Descriptive Statistics for Brief COPE Subscales 104

Table 5: Descriptive Statistics for STAI-T, BFNE-II, Total Rejection, Total Acceptance,

Disengaged Coping, Active Coping, and School Support Index

105

Table 6: School Based Supports: Prevalence and Perceived Helpfulness 106

Table 7: Bivariate Correlations between Current Age and Presence of Individual

School Supports

Table 8: Bivariate Correlations between Age, Total Rejection, Total Acceptance,

Disengaged Coping, Active Coping, Number of School Supports, School

Support Index, Perceived Helpfulness of Each Support, and STAI-T and

BFNE-II Scores

107

108

Table 9: Partial Correlations between Total Rejection, Total Acceptance,

Disengaged Coping, Active Coping, Number of School Supports, School

Support Index, Perceived Helpfulness of Each Support, and STAI-T and

BFNE-II Scores (Controlling for Age)

Table 10: Regression Analysis for the Prediction of Trait Anxiety from Disclosure-

Related Rejection and Acceptance, Coping Responses, and School Support

Index

109

110


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LGBTQ SCHOOL-BASED SUPPORT ix

Table 11: Regression Analysis for the Prediction of Social Anxiety from Disclosure-

Related Rejection and Acceptance, Coping Responses, and School Support Index

111

Table 12: Regression Analysis for the Prediction of Active Coping from Age and

Perceived Helpfulness of Particular School-Based Supports

Table 13: Regression Analysis for the Prediction of Trait Anxiety from Age and


112

113

Table 14: Regression Analysis for the Prediction of Social Anxiety from Age and


114


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LGBTQ SCHOOL-BASED SUPPORT x

Abstract

This study examined the relationships between lesbian, gay, bisexual, transgender, queer,

and questioning (LGBTQ) young adults experiences of disclosure-related acceptance and

rejection, perceived helpfulness of LGBTQ-specific school-based support during high school,

current coping responses, and current level of generalized and social anxiety. Data were gathered

from 184 LGBTQ young adults nationwide via web-based survey. Results indicated that

disengaged coping responses predicted trait and social anxiety. Results did not evidence

relationships between active coping and trait or social anxiety. Perceived helpfulness of school

based supports did not predict coping behavior or anxiety. Implications for practice and future

research are discussed.


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LGBTQ SCHOOL-BASED SUPPORT 1

Chapter I

Definition of the Problem

Beginning at a young age, lesbian, gay, bisexual, transgender, queer, and questioning

(LGBTQ) individuals are confronted by an array of unique challenges. Many of these obstacles are

directly related to stigmatization based on sexual orientation or gender identity, and are therefore

not typically experienced by their heterosexual peers. These include the development and

disclosure of their LGBTQ identity; elevated likelihood of interpersonal rejection; proneness to

verbal, sexual, and physical victimization at school, work, and in the community; and exclusion

from heterosexist policies, traditions, and expectations. Despite decades of advocacy and

psychoeducation, members of the LGBTQ community continue to be the targets of discrimination,

harassment and exclusion based on their personal identities. As a result of these experiences,

LGBTQ individuals must contend with a unique combination of stressors (Meyer, 2003). These

stressors have been implicated in the greater incidence of certain mental health concerns among

LGBTQ individuals, including depression and anxiety disorders (e.g., Cochran, Sullivan, & Mays,

2003; DAugelli, 2002; Herek, Gillis, & Cogan, 1999; Koh & Ross, 2006; Pachankis & Goldfried,

2006; Sandfort, de Graaf, Bijl, & Schnabel, 2001).

Research has demonstrated that effective coping skills and social supports are directly

related to positive adjustment among LGBTQ youth and may offer protection against stressors

(Cohen, 2004; Detrie & Lease, 2007; Martin & Hetrick, 1988; Pringle & Mallon, 2003; Safren &

Heimberg, 1999). In fact, a growing body of research suggests that when these and other

psychosocial factors (e.g., socioeconomic status, family mental health, family support) are

controlled for, significant differences in distress indicators between LGBTQ and heterosexual


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adolescents are greatly reduced or eliminated (Busseri, Willoughby, Chalmers, & Bogaert, 2008;

Elze, 2002; Safren & Heimberg, 1999). There is also evidence to suggest that social anxiety may be

a barrier to obtaining social support and engaging in positive events, over and above the effects of

sexual orientation (Safren & Pantalone, 2006). In their study of LGB and heterosexual youths, the

authors explain that during adolescence, young people typically experience social pressure to

conform to heterosexual social and dating behaviors. In response to this pressure, many LGB

adolescents make efforts to hide their sexual orientation. Toward that end, they may avoid

participation in the social situations that typically provide access to supportive peer networks

(Safren & Pantalone). In another study of young gay and heterosexual men between the ages of 18

and 24, Pachankis and Goldfried (2006) found that gay men reported greater fear of negative

evaluation and social interaction anxiety, and lower self-esteem than heterosexual men. They also

found that gaymen who were less open about their sexual orientation as well as those who were

less comfortable with being gaywere more likely to experience anxiety in social interactions.

These findings have important implications for the attainment of social support, a crucial protective

factor for LGBTQ individuals (Detrie & Lease, 2007; Martin & Hetrick, 1988; Pringle & Mallon,

2003; Safren & Heimberg, 1999). They also offer guidance for the provision of supports for

LGBTQ youth, as social anxiety may present a potential barrier to service utilization.

Disclosure

Adolescence isa time of significant growth and development, and a critical period for

identity formation. Many LGBTQ youth experience significant challenges related to the emerging

awareness of their sexual orientation and gender expression for the first time during this life stage

(e.g., Floyd & Stein, 2002; Maguen, Floyd, Bakeman & Armistead, 2002; Mosher, 2001). In

addition to their own developing identity as a LGBTQ person, these youth are often faced with


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decisions related to the disclosure of their sexual orientation or gender identity to others. In recent

years, LGBTQ individuals have been coming out at younger ages than ever before (Floyd &

Bakeman, 2006). In some cases, disclosure of ones sexual orientation or gender identity is not a

choice. For example, an individual may be outed by someone else, or their gender expression

may lead others to draw conclusions about their sexual orientation and gender identity (Carragher

& Rivers, 2002). Decisions regarding if, when, how, and to whom one might disclose are

complicated by a variety of complex factors. For example, internalized homophobia has been

shown to negatively correlate with disclosure of sexual orientation (Herek et al., 1997; Jellison &

McConnell, 2003). Individual development of self-identification may also be related to disclosure.

One study of 2,401 lesbian and bisexual women suggested that the longer women self-identified as

lesbian or bisexual, the more likely they were to self-disclose (Morris, Waldo, & Rothblum, 2001).

Further, they reported that the more involved with the LGBTQ community that an individual was,

the greater the likelihood that she would disclose her sexual orientation.

The psychological impact of disclosure is equally complicated. For example, Morris et al.

(2001) found that an individuals degree of disclosure predicted lower psychological distress.

However, other studies have proposed a different set of findings. For example, in their study of 350

LGB youth aged 14 to 21, DAugelli, Pilkington, and Hershberger (2002) discovered that the

earlier young people came out to self and others, the more they were victimized in high school.

Clearly, the implications of disclosure can vary and are influenced by a variety of complex factors.

LGBTQ youth who disclose their sexual orientation or gender identity as well as those who

are assumed to be LGBTQ based on appearance or behavior are often met with rejection from

parents, family members, peers, teachers, and other members of their communities (DAugelli,

Grossman, & Starks, 2005; DAugelli, Hershberger, & Pilkington, 1998; Kosciw, Greytak, & Diaz,


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2009; Murdock & Bolch, 2005). Unlike members of many other minority groups, LGBTQ youth

often do not have the support of their families, places of worship, or other cultural organizations to

provide an identity framework or to serve as a buffer against the hostility that they face (Taylor,

2000). Rejection by parents and other family members during adolescence have been associated

with negative health outcomes for LGBTQ young adults, including depression, suicidality,

substance abuse, and unprotected sex (Ryan, Huebner, Diaz, & Sanchez, 2009). Many LGBTQ

youth are at risk of encountering these difficulties, as parents initial reactions to a childs

disclosure of his or her sexual orientation are often negative (DAugelli et al., 1998). Family

support, when combined with self-acceptance, has been found to mediate the relationship between

victimization and mental health for LGBTQ youth (Hershberger & DAugelli, 1995). A study of

542 LGB youths from community settings also suggested that mental health symptoms were

significantly related to parents reactions to disclosure of sexual orientation (DAugelli, 2002).

The disclosure of ones sexual orientation can result in an interruption or complete loss of

social supports (DAugelli et al., 1998). In his study of 542 LGBT adolescents, DAugelli (2002)

found that more than one third lost friends due to their sexual orientation. In addition, he found that

those individuals who had lost friends reported more mental health problems and more past suicide

attempts than those who did not lose friends. Support from family and friends, where it exists, has a

clear positive impact on LGBTQ youth. Unfortunately, rejection can have equally apparent

detrimental effects on mental health outcomes, including emotional distress, depression, anxiety,

suicidality, substance abuse, high-risk sexual behaviors, academic disengagement, school

avoidance, and externalizing behaviors (Almeida, Johnson, Corliss, Molnar, & Azrael, 2009;

Birkett, Espelage, & Koenig, 2009; Hatzenbuehler, McLaughlin, & Nolen-Hoeksema, 2008; Ryan

et al., 2009).


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Protective Factors in LGBT Development and Disclosure

LGBTQ youth often possess adaptive strengths and interpersonal resources that may help to

buffer against the impact of stressors such as heterosexism, exclusion, peer rejection and

victimization. Research has demonstrated that effective coping skills and social supports are

directly related to positive adjustment and may offer protection against stress (Safren & Heimberg,

1999).

Coping as a protective factor.Individual differences in coping response have been shown

to affect mental health outcomes (e.g., Szymanski & Owens, 2008). Coping responses during

childhood and adolescence may affect the impact of stress on both current and future mental health

(Compas, Connor-Smith, Saltzman, Thomsen, & Wadsworth, 2001). The development of

characteristic adaptive or maladaptive coping responses during childhood and adolescence may be

a precursor to adult coping styles (Compas et al., 2001). Individual differences in coping behavior

may have important implications for mental health outcomes; therefore, the development of

effective coping skills may be an area of particular interest for school-based intervention.

School-based support as a protective factor. Specific school-based supports have the

potential to mitigate the damaging effects of the compounded stressors experienced by LGBTQ

youth. School-based support in the form of Gay-Straight Alliances (GSAs), comprehensive anti-

harassment policies, supportive school staff, and LGBTQ-related resources and curricula appear to

alleviate some of the difficulties faced by LGBTQ students. For example, GSAs have been shown

to improve school climate and school-related experiences (e.g., academic performance, social

relationships, feelings of belongingness) for LGBTQ students (Kosciw & Diaz, 2006; Lee, 2002;

Todd, 2001). According to the 2007National School Climate Survey (NSCS)conducted by


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Kosciw, Diaz, and Greytak (2008) for the Gay, Lesbian, and Straight Education Network

(GLSEN), LGBTQ students in schools with GSAs are more likely to feel safe in school than

students whose schools do not have a GSA.This and the surveys other findings have important

implications for school psychologists and other school-based mental health service providers. There

is a clear need for effective supports for LGBT youth in our schools. More research is needed as we

move toward an understanding of protective factors for these students. School-based supports such

as GSAs, inclusive curricula and supportive adults, as well as specific school-wide efforts to

minimize LGBT students experiences of rejection in school, may buffer against the effects of

rejection experienced elsewhere.

Incidence and Prevalence

School-Based Support

Gay-Straight Alliances. In a 2006 GLSEN report on the growing number of GSAs in the

United States, Kosciw and Diaz found that 47% of LGBT high school students across the country

reported having a GSA. Despite the increasing prevalence of GSAs and other LGBTQ-supportive

student groups in schools, most districts still lack such social opportunities for LGBTQ students.

The report also indicated that African American LGBTQ students were less likely to have a GSA in

their school than other students of color, particularly those who attended schools where the student

population was predominantly African American. LGBTQ students in the South and in small towns

or rural areas were least likely to have a GSA in their schools.

Inclusive curricula. School curricula rarely include positive mention of LGBTQ people or

issues. Kosciw et al. (2008) found that only 10.5% of high school students who responded to the

GLSEN 2007 NSCS were exposed to positive representations of LGBTQ people, history or events

in their classes. In their 2001 study, SEICUS reported that 80.6% of LGBT students surveyed


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indicated that there were no positive portrayals of LGBT people, history, or events in any of their

classes.

Inclusive language in school policies. Students whose schools had a safe school policy that

included protections based on sexual orientation and/or gender identity/expression reported that

they heard fewer homophobic remarks, experienced lower levels of victimization related to their

sexual orientation, and were more likely to report incidents of harassment and assault to school

staff (Kosciw et al., 2008). They were also more likely to report that staff intervened when hearing

homophobic remarks. However, less than one in five or 18.7% of NSCS respondents attended a

school with a comprehensive policy for reporting harassment and assault that specifically

mentioned sexual orientation (37.6% reported a generic policy). Almost half of students surveyed

reported that their schools did not have any type of safe school policy in place.

Supportive faculty. The presence of supportive staff contributed to a range of positive

indicators among NSCS respondents including fewer reports of missing school, greater academic

achievement, higher educational aspirations and a greater sense of belonging to their school

community (Kosciw et al., 2008). However, the survey also found that the majority (60.8%) of

students who were harassed or assaulted in school did not report the incident to school staff,

believing little or no action would be taken or the situation could become worse if reported.

Alarmingly, almost a third (31.1%) of the students who did report an incident said that school staff

did nothing in response. In their 2001 report, the Sexuality Information and Education Council of

the United States (SEICUS) found that 25% of students surveyed perceived that teachers exhibited

significant prejudice against LGBT students, and 38.2% reported not feeling comfortable speaking

about LGBT issues to teachers or staff in class. In another study, 80% of prospective teachers and

67% of guidance counselors surveyed reported at leastsome negative attitudes toward LGBT


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people (Todd, 2001). The study also found that less than 20% of teachers surveyed had received

training on LGBT students and the unique issues they face.

Risk Factors

Disclosure-related rejection. Reactions to disclosure of sexual orientation and gender

identity vary widely. LGB adolescents report fear of negative reactions and rejection as the primary

reason for their reluctance to disclose to friends and parents (DAugelli, et al., 2005; Diamond &

Lucas, 2004). LGB youth cite a variety of reasons for not disclosing to their parents, including fears

of harassment, rejection, or eviction; fear of relationship deterioration; and not having close

relationships with parents (DAugelli et al., 2005). DAugelli (2002) found that more than one third

of a sample of 542 LGBT adolescents had lost friends due to their sexual orientation. DAugelli et

al. (2005) found a relatively even split between positive and negative parental reactions to

disclosure. Depending on parent and child gender, 27 to 39% of participants described a parents

reaction as negative; 12 to 18% reported very negative responses.

Anxiety disorders in LGBT populations. The lifetime prevalence rate for Generalized

Anxiety Disorder in the general population has been estimated at 5.7% (Kessler, Berglund, Demler,

Jin, & Walters, 2005). Results from the National Comorbidity Study (1994) found that the lifetime

prevalence rate for social anxiety disorder was 13.3% (Kessler et al.). In their study of LGB and

heterosexual adolescents between the ages of 16 and 21, Safren and Pantalone (2006) found that

LGB youths reported greater social anxiety than did their heterosexual peers. Other studies have

also suggested a higher incidence of anxiety disorders and anxiety-related symptoms among

LGBTQ populations than in the general population or strictly heterosexual populations (e.g.,

Cochran, Sullivan & Mays, 2003; Gilman et al., 2001; Pachankis & Goldfried, 2006; Sandfort, de

Graaf, Bijl & Schnabel, 2001). In their 2008 review, King et al. concluded that the lifetime


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prevalence of any anxiety disorder among LGB men and women was twice that of heterosexual

men and women, and that the 12-month prevalence among LGB individuals was approximately 1.5

times higher.

Significance of the Present Study

To date, there has been little research on the potential role of school-based

psychoeducational interventions as protective factors for LGBTQ youth.In addition to GSAs and

other general school supports for LGBTQ students, interventions aimed at the development of

effective coping responses may (a) help youth to confront the uncertainty of decisions related to

disclosure, and (b) help to buffer the potentially negative effects of disclosure-related rejection on

the manifestation of anxiety and other mental health concerns. However, the complex relationships

between disclosure, acceptance, rejection, coping responses, anxiety, and school-based support

remain unknown.

This study seeks to inform current school practices regarding the provision of resources and

support to LGBTQ students. It will examine the relationships between LGBTQ individuals

experiences of disclosure-related acceptance and rejection, school-based support, current coping

responses, and current level of generalized and social anxiety. Specifically, the study will attempt

to discern which elements of school-based support are perceived by LGBTQ young adults as most

helpful, as well as those elements that are associated with more effective coping skills and lower

levels of anxiety in that population. In addition, the results will suggest whether school-based

support and positive coping responses might serve as protective factors against the effects of

disclosure-related rejection and the manifestation of anxiety among LGBTQ young adults.


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Organization of this Study

The present study seeks to examine the relationship between LGBTQ individuals

experiences of disclosure-related acceptance and rejection, school-based support, current coping

responses, and current level of generalized and social anxiety. Young adult participants were

recruited to complete a web-based survey through nationwide LGBTQ-related email lists, online

discussion boards, and LGBTQ community organizations. The survey included the following

measures: the Disclosure and School-Based Support Questionnaire, a researcher-constructed

qualitative measure of demographic information, experiences related to disclosure of sexual

orientation, and school-based support; the Brief COPE, a measure 14 conceptually differentiable

coping reactions (Carver, 1997); the Brief Fear of Negative Evaluation Scale, Version 2 (BFNE-II;

Carleton, McCreary, Norton & Asmundson, 2006), a measure of social anxiety; and the Spielberger

State-Trait Anxiety Inventory- Trait Version (STAI-T; Spielberger, 1983), a measure of the stable

propensity to experience anxiety.

Definition of Terms

Sexual Orientation

Sexual orientation refers to an enduring pattern of emotional, romantic, and/or sexual

attractions to men, women, or both sexes. Sexual orientation also refers to a persons sense of

identity based on those attractions, related behaviors, and membership in a community of others

who share those attractions (American Psychological Association, 2008).

Transgender

Transgender is an umbrella term used to describe people whose gender identity (sense of

themselves as male or female) or gender expression differs from that usually associated with their

birth sex (American Psychological Association, 2006).


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Genderqueer

Genderqueer refers to individuals who do not solidly identify with one particular gender.

Transgender Heterosexual

This term is used to describe the sexual orientation of a transgender person whose primary

sexual attraction is to individuals of the opposite gender identity (e.g., a trans person who

identifies as female and is attracted to individuals, both trans- and cisgender, who identify as male).

Pansexual

Pansexual refers to sexual orientation and describes an individual who is attracted to others

without regard for gender identity or biological sex (i.e., is attracted to people of all genders and

sexes).

Queer

Some members of the LGBTQ community have reclaimed the term queeras a synonym for

LGBTQ. It describes a non-heterosexual orientation and is often associated with activism and

rejection of strict categorical labels.

Questioning

Individuals who are just beginning to explore the possibility of a non-heterosexual

orientation as well as those who are uncertain of their sexual orientation are often described as

questioning.

Coming Out

Coming out refers to the disclosure of ones sexual orientation and/or gender identity to

others.


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Degree of Disclosure

Also referred to in the literature as outness, a persons degree of disclosure indicates the

extent to which the individual has told others of his or her LGBTQ identity. The term degree takes

into account a variety of factors, including the number of people to whom one has disclosed, the

relational groups to whom one has disclosed (e.g., LGBTQ friends, heterosexual friends, parents,

siblings, extended family, teachers, religious community, etc.), the amount of information disclosed

(e.g., LGBTQ identity only, feelings about ones identity, information about relationships and

partners, etc.), the settings in which one has disclosed (e.g., home, school, work, neighborhood,

etc.), and the extent to which one has integrated the open expression of his or her LGBTQ identity

into daily interactions with others (e.g., mentioning ones partner in casual conversation, bringing

partner to social events, displaying a photo of partner, etc.).

Disclosure-Related Rejection

Disclosure-related rejection is defined as interpersonal rejection experienced by a LGBTQ

individual in response to his or her disclosure of sexual orientation and/or gender identity.

School Climate

According to Freiberg and Stein (1999), school climate is defined as that quality of a

school that helps each individual feel personal worth, dignity, and importance, while

simultaneously helping create a sense of belonging to something beyond ourselves (p. 11).

School-based support

School-based support for LGBTQ students refers to any of the following: LGBTQ-

inclusive policies, curricula, activities, and resources; supportive and responsive teachers and staff;

a LGBTQ-safe school climate; a Gay-Straight Alliance or similar student club, etc.


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Gay-Straight Alliance

A Gay-Straight Alliance (GSA) is a student-led club that aims to provide a safe place for

LGBTQ students and straight allies to come together to discuss their shared experiences, plan

activities and events, address name-calling and harassment, and promote respect for all students

(GLSEN, 2006).

Comprehensive Anti-Harassment Policy

A school policy designed to protect students and staff by explicitly prohibiting harassment.

A comprehensive policy specifically includes harassment based on sexual orientation or gender

identity/ expression in addition to race, color, gender, religion, age, national origin, ethnicity,

disability, veteran or military status, marital status, citizenship status, or any other legally protected

status (New York University Office of Equal Opportunity, 2006).

Comprehensive Non-Discrimination Policy

A school policy designed to protect students and staff by explicitly prohibiting

discrimination. A comprehensive policy specifically includes discrimination based on sexual

orientation or gender identity/ expression in addition to race, color, gender, religion, age, national

origin, ethnicity, disability, veteran or military status, marital status, citizenship status, or any other

legally protected status (New York University Office of Equal Opportunity, 2006).

Coping

Coping has been defined by Lazarus and Folkman (1984) as constantly changing cognitive

and behavioral efforts to manage specific external and/or internal demands that are appraised as

taxing or exceeding the resources of the person (p. 141).


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Fear of Negative Evaluation

Fear of negative evaluation is a latent construct believed to promote the development of

more general fears, anxiety and psychopathologies (Carleton, Collimore & Asmundson, 2007).

Research findings and several cognitive models support the idea that social anxiety is derived in

part from fears of perceived negative evaluation (e.g., Clark & Wells, 1995; Rapee & Heimberg,

1997).

Social Anxiety

Social anxiety refers to the perception of ones environment as threatening, along with the

fear of social interactions (Safren & Pantalone, 2006).

Trait Anxiety

Trait anxiety refers to a stable propensity to experience anxiety, and tendencies to perceive

stressful situations as threatening. Trait anxiety implies differences between people in the

disposition to respond to stressful situations with varying amounts of state anxiety (Spielberger,

1983).

Generalized Anxiety

Generalized Anxiety Disorder (GAD) is characterized by long-term, intense and excessive

worry, and is a chronic, relatively common disorder with high rates of comorbidity (Brown &

Barlow, 1992). GAD has been conceptualized by Mennin, Turk, Heimberg and Carmin (2004) as

being characterized by the experience of intense emotion, limited understanding of the emotional

experience, poor ability to adaptively modulate emotions, and an aversive response to emotions.

Overview of Chapters

Chapter I defines the problem of negative mental health outcomes (i.e., anxiety symptoms)

as they relate to sexual orientation disclosure-related rejection and individual coping responses. The


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need for additional school-based supports in the form of psychoeducational interventions to

develop and strengthen effective coping skills is also discussed. Additionally, the organization of

the study is described and key terms are defined.

Chapter II will provide an extensive review of the literature related to LGBT identity

development, challenges faced by LGBT youth and the correlates of these challenges, anxiety

disorders in LGBT populations, and evidence-based protective factors such as positive coping

responses and school-based support for LGBT students.

Chapter III outlines the methods and procedures related to the present study. The sample,

recruiting process, survey measures, and procedures for data collection and data analysis are

described.

Chapter IV will report the results of the present study and answer the research questions.

Chapter V will include a discussion of the implications of the findings, limitations of the study, and

suggestions for future research.


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Chapter II

Review of the Literature

The National Association of School Psychologists (NASP) Position Statement on Gay,

Lesbian, Bisexual, Transgender, and Questioning Youth supports equal access to education and

mental health services for gay, lesbian, bisexual, transgender and questioning (GLBTQ) youth

within public and private schools (NASP, 2006). The Statement asserts that education and

advocacy must be used to reduce discrimination and harassment against GLBTQ youth by students

and staff. As the major social context for school-aged individuals, schools are in a position to

strongly influence outcomes for LGBTQ youth.

LGBT Identity Development

Creating Identity: A Critical Process

Recognition and acceptance of their LGBTQ identity is a major developmental process for

LGBTQ adolescents (Malyon, 1981) and may serve as an important protective factor. Studies have

shown that a positive sexual identity can serve as a buffer against the negative effects of stress

(Meyer, 2003; Hershberger & DAugelli, 1995). Several models of identity development locate

self-acceptance as central to psychological health (e.g., Cass, 1984; Jordan& Deluty, 1998;

Luhtanen, 2003), and there is evidence that a positive LGBTQ identity predicts psychological well-

being and positive self-perception (Crawford, Allison, Zamboni, & Soto, 2002; Frable, Wortman,

& Joseph, 1997; Kertzner, 2001).

It has been established that LGBTQ youth must contend with an array of unique challenges

in the world as they know it (e.g., DAugelli, Pilkington & Hershberger, 2002; Elze, 2003; Kosciw,

Diaz & Greytak, 2008). Such obstacles may interfere with the development of a healthy and self-

affirmative LGBTQ identity, with further effects on psychological well-being. Developmental


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supports to encourage positive identity formation may be an important area of focus for

intervention with LGBTQ adolescents.

Self-Concept and Identity Formation

The construction of a clear and relatively stable self-concept is one of the major

developmental tasks of adolescence (Erikson, 1968). For a variety of reasons, LGBTQ adolescents

often find it difficult to positively integrate their sexual orientation and/or gender identity (SI/GI)

into their self-concept and identity (Radkowski & Siegel, 1997). It has been suggested that only

those aspects of the self that an individual values affect his or her self-esteem (Salmivalli, 1998).

Interestingly, LGBTQ adolescents tend to assign a more global relevance to their sexual orientation

than it warrants (Hammersmith, 1987). Self-concept is constructed partly through social interaction,

as feedback confirms or disconfirms an individuals beliefs about him- or herself (Epstein, 1973).

For LGB adolescents, this feedback system may work somewhat differently. Hammersmith (1987)

proposed the notion that a lack of congruence between the normative heterosexual identity all

adolescents are prepared for and an emerging LGB identity creates a state of cognitive dissonance.

This internal conflict can complicate and impede the formation of a positive identity and self-

concept.

Additionally, internalized homophobia, or non-conscious negative thoughts, feelings, and

attitudes held by LGBTQ people about homosexuality, often plays a considerable role in the

identity formation of LGBTQ adolescents (Radkowski & Siegel, 1997). Internalized homophobia

triggers feelings of shame about ones identity and can be difficult to combat due to its unconscious

nature and often subtle perpetuation by established social policies, laws, family traditions and

expectations, religious beliefs, and negative images in the media (Radkowski & Siegel). Taken

together, this cumulative understanding of self-concept and identity development supports the


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notion that negative feelings about ones sexual orientation or gender identity plays a significant

role in a LGBTQ adolescents developing sense of self.

Theories of LGBTQ Identity Development

Stage-sequential models.A number of researchers have described sexual orientation

identity formation using stage-sequential models, which specify a standard set of experiences

occurring in an expected sequence (e.g., Cass, 1979; Troiden, 198; Coleman, 1982). These models

typically refer to early awareness of same-sex attraction followed by exploration of a lesbian or gay

identity. To illustrate, The Cass Model (1979, 1984) consists of six non-age-specific stages: identity

awareness, in which individuals become conscious of their difference; identity comparison, in

which the individual thinks he or she may be lesbian or gay but tries to act heterosexual; identity

tolerance, in which the individual realizes that he or she is lesbian or gay; identity acceptance, in

which the individual begins to explore the lesbian and/or gay community; identity pride, in which

the individual becomes an active member of the lesbian and/or gay community; and finally,

synthesis, in which the individual fully accepts him- or herself as well as others.

Troidens (1989) model consists of four age-specific stages: before puberty, sensitization

occurs, in which the individual has lesbian or gay feelings or experiences without understanding the

implications for his or her identity; during adolescence, identity confusion occurs, during which the

individual realizes that he or she may be lesbian or gay; identity assumption, in which the

individual comes out as being lesbian or gay; and commitment, in which the individual lives as a

lesbian or gay person. Coleman (1982) proposed five stages:pre-coming outin which the

individual knows that something is different about him- or herself, but does not have same-sex

feelings; coming out, in which the individual has admitted to him- or herself that he or she has

same-sex feelings but may still lack a clear understanding of his or her sexuality; exploration, in


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which the individual begins to experiment with his or her new sexual identity;first relationships, in

which the individual learns same-sex relationship skills; and identity integration, in which the

individual combines both the private and public selves into an integrated identity.

Life-course developmental models.In contrast to the assumed universality and sex-

centered pattern of stage-sequential models, recent studies have identified multiple trajectories for

the timing and sequencing of milestone events (e.g., DAugelli, 1994; Diamond, 1998; Dube, 2000;

Floyd & Stein, 2002; Savin-Williams & Diamond, 2000). These authors have acknowledged an

identity-centered process of development that centers around an internal sense of identity over

sexual practices (Dube, 2000). Savin-Williams and Diamond (2000) found that among their sample

of 164 LGB individuals aged 16 to 27, the identity-centered pattern (i.e., a label first sequence)

occurred for 80% of women, whereas for men, the sex-centered pattern (i.e., sex first sequence)

was reported 51% of the time. In her study of 89 self-described lesbian, bisexual, and unlabeled

women aged 16 to 23, Diamond (1998) learned that a majority of women denied at least one of the

following: childhood indicators of sexual orientation, stability in same-sex attractions, or awareness

of same-sex attractions prior to the conscious process of sexual questioning. There is some

evidence to suggest that women tend to reach milestones related to awareness and self-

identification at later ages than do men (e.g., Diamond; Savin-Williams & Diamond; Schneider,

2001).

Multi-faceted model.An inclusive model of sexual identity formation was developed by

Fassinger (1998) to reflect a simultaneous progression through both individual and group

membership aspects of sexual identity.Fassingers multi-faceted model is stage-based and includes

four phases of individual sexual identity development as well as four parallel phases of group

membership identity development. However, individuals do not necessarily progress through the


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individual and group phases concurrently (i.e., one may be at individual identity phase x and

group membership identity phase y at any given time). Within this multi-faceted model, the

individual sexual identity and group membership identity phases include: Awareness, Exploration,

Deepening/Commitment, and Internalization/Synthesis.

A final consideration concerns the differential developmental trajectories described by

Savin-Williams (1998). LGBQ identity formation is a complex individual process such that no two

people will share the same developmental course. Not only do LGBQ individuals differ among

themselves in terms of developmental experiences, but they also share many developmental

characteristics and experiences with their heterosexual peers (Savin-Williams & Diamond, 2000).

Savin-Williams and Diamond note that lesbian and bisexual women may be more similar in their

developmental trajectories to heterosexual women than they are to gay or bisexual men. Established

models of sexual identity development may not reflect the effects of race and ethnicity on

milestone experiences and will require modification if they are to apply to non-White youth (Dube

& Savin-Williams, 1999). It is also important to note that LGBQ youth are increasingly likely to

use queer or another nongender-based label, or to reject labeling their identities at all. This choice

reflects a philosophy of nongender-based models of sexuality that transcend the convention of

categorization (Savin-Williams, 2005).

Stress and Resilience: A Minority Stress Framework

Minority Stress

Social stress theory posits that in addition to personal events, conditions in the social

environment are also sources of stress that may negatively affect mental and physical health (e.g.,

Allison, 1998; Clark, Anderson, Clark & Williams, 1999; Meyer, 1995).Minority stress refers to

the idea that stigma, prejudice, and discrimination create a hostile and stressful social environment


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that may lead to mental health problems among members of a stigmatized minority group (Meyer,

1995; 2003). The minority stress model is rooted in sociological and social psychological theories

related to the harmful effects of adverse social conditions (i.e., prejudice, stigma) on individuals

and groups (e.g., Allport, 1954; Crocker, Major & Steele, 1998).

Stress Processes

The assumptions underlying the concept of minority stress are as follows: (a) minority

stress is unique, in that it is additive to general stressors experienced by all people and requires

additional adaptation efforts; (b) minority stress is chronic, or related to relatively stable underlying

social and cultural structures; and (c) minority stress is socially based, stemming from social

processes, institutions, and structures beyond the individual (Meyer, 2003). Meyer suggests a

distinction between distal andproximal stressors, and explains that distal social attitudes gain

psychological importance through cognitive appraisal and become proximal concepts with

psychological importance to the individual. He identifies four processes of minority stress relevant

to LGB individuals (Note: transgender individuals were not included in this theoretical review): (a)

external, objective stressful events and conditions (chronic and acute), (b) expectations of such

events and the vigilance this expectation requires, (c) concealment of ones sexual orientation, and

(d) the internalization of negative societal attitudes. He also describes stress processes specific to

LGB individuals, including the experience of prejudice events, expectations of rejection,

concealment of ones sexual orientation and internalized homophobia.

Coping Processes

In addition to stress processes, Meyers model also includes ameliorative coping processes

as they relate to the mental health of LGB individuals. There is a wealth of evidence to suggest that

individual members of stigmatized groups respond to prejudice with coping and resilience (e.g.,


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Allport, 1954; Clark, Anderson, Clark, & Williams, 1999). Stigmatized individuals use both

personal- and group-level resources to cope with negative experiences (Branscombe & Ellemers,

1998).

Minority coping refers to a group-level resource related to the groups ability to create self-

enhancing structures to offset stigma (Meyer, 2003). However, environmental and personality

factors affect an individuals ability to access and use group-level resources (Meyer). When even

otherwise-resourceful individuals are unable to access group-level resources, their capacity to cope

will be limited (Meyer). Group solidarity and cohesiveness are important resources that serve to

protect members from the potential effects of minority stress (Clark et al., 1999: Crocker & Major,

1989; Meyer). Minority group affiliation is a crucial group-level coping resource that: (a) allows

stigmatized individuals to experience social environments in which they are not stigmatized; (b)

provides support for negative evaluation of the stigmatized group; and (c) encourages reappraisal of

prejudicial and discriminatory experiences, thus reducing their effects on psychological well-being

(Meyer). In these ways, group members may be able to adopt some of the groups self-enhancing

attitudes, values and structures (Meyer). This conceptualization of individual coping in the context

of group coping resources highlights the clear need for accessible school-based group-level

resources for LGBTQ youth.

Daily Challenges as Minority Stress

LGBTQ youth are confronted with a variety of unique stressors related to their sexual

orientation and/or gender identity not experienced by their heterosexual peers (e.g., Bontempo &

DAugelli, 2002; DAugelli, Pilkington, & Hershberger, 2002; Kosciw & Diaz, 2006; Kosciw,

Diaz, & Greytak, 2008; Murdock & Bolch, 2005; Pearson, Muller, & Wilkinson, 2007; Rivers,

2001). Since 1999, the Gay, Lesbian, and Straight Education Network (GLSEN) has conducted a


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comprehensive survey every two years to document the experiences of LGBTQ students. The 2007

National School Climate Survey (NSCS; Kosciw et al., 2008) describes the experiences of 6,209

LGBTQ students aged 13 to 21 (M=15.9) from all 50 states and the District of Columbia (22.2%

Northeast, 30.1% South, 22.6% Midwest, 25.1% West). Students were largely in 10th or 11th

grade, but ranged from grade 6 through 12. They attended urban (32.4%), suburban (42%) and

small town/rural (25.6%) schools. Most attended public schools (92.5%). Approximately 64% of

their sample was White, 5.8% was African American or Black, 13% was Hispanic or Latino/a,

4.1% was Asian or Pacific Islander, 6.2% was Native American, American Indian or Alaska

Native, and 5.4% was Multiracial. The sample was 57.7% female, 33.4% male, 4.8% transgender,

and 4% other gender identity (e.g., genderqueer, androgynous). Gay and lesbian students comprised

53.6% of the sample, 42% identified as bisexual, and 4.6% reported another sexual orientation

(e.g., queer, asexual). Notably, the researchers took steps to increase representation of transgender

youth and youth of color by recruiting from organizations that serve those populations. To address

a previous sampling limitation, they reached youth who were not connected to the LGBTQ

community (e.g., those from Southern states and small town or rural areas, middle school students)

via MySpace, a popular social networking website.

According to the 2007 NSCS (Kosciw et al., 2008), LGBTQ youth are prone to verbal and

physical harassment, physical assault, and lack of staff intervention and support. They are likely to

feel unsafe in their schools, are at greater risk for absenteeism, and face academic consequences.

Sexual minority youth must also navigate the disclosure of their LGBTQ identity to others and

cope with related consequences (DAugelli, Hershberger, & Pilkington, 1998; Floyd & Stein, 2002;

Savin-Williams, 1998). As a result of these challenges, LGBTQ youth may be at risk for a variety

of mental health and behavioral concerns (Bontempo & DAugelli, 2002; Busseri, Willoughby,


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Chalmers, & Bogaert, 2008; DAugelli, 2002; DAugelli, et al., 2005; DAugelli, Pilkington, &

Hershberger, 2002; Rivers, 2001).

Most studies have not adequately examined school experiences that may be unique to

transgender students. Studies have typically excluded transgender youth or folded them into the

larger LGBTQ identity without asking questions specific to their gender identity- and

presentation-related experiences. A relatively small number of studies dedicated to transgender

youth and their school experiences have been published in recent years. A recent focus-group study

in New York City found that transgender youth did not feel safe or supported in their schools

(Grossman & DAugelli, 2006). Also, in a study conducted in Philadelphia, approximately 75% of

transgender youth also reported that their schools did not provide them with a safe environment

(Sausa, 2005).

Hostile School Climate

The GLSEN 2007 NSCS found that many LGBT students are subject to verbal and physical

harassment and assault because of their sexual orientation or gender identity (Kosciw et al, 2008).

Nearly three-fourths (73.6%) of student respondents heard homophobic remarks frequently or often

at school, and nine out of ten students heard gay used in a negative way often or frequently. More

than half (60.8%) of respondents reported that they felt unsafe in school because of their sexual

orientation, and more than a third (38.4%) felt unsafe because of their gender expression. The

majority (60.8%) of students who were harassed or assaulted in school did not report the incident to

school staff, believing little or no action would be taken or the situation could become worse if

reported. Alarmingly, nearly a third (31.1%) of the students who did report an incident said that

school staff did nothing in response.


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Verbal Harassment

Verbal harassment is an emotionally damaging reality for many LGBTQ students. Nearly

nine out of ten students (86.2%) who responded to the GLSEN 2007 NSCS reported being verbally

harassed (i.e., called names or threatened) at school because of their sexual orientation, and two-

thirds (66.5%) of students were verbally harassed because of their gender expression (Kosciw et al.,

2008). In their study on the impacts of sexual orientation victimization on mental health, DAugelli,

Pilkington, and Hershberger (2002) found that high school victimization correlated with mental

health symptoms, and especially with post-traumatic stress symptoms.

Physical Harassment and Assault

There is evidence that attacks based on ones sexual orientation tend to affect victims more

negatively than do crimes in general (Herek, Cogan, Gillis, & Glint, 1997). Heightened risk of

physical assault based on their sexual orientation and/or gender identity is a critical reality for

LGBTQ youth (Bontempo & DAugelli, 2002; DAugelli, Pilkington, & Hershberger, 2002). Of

students responding to the GLSEN 2007 NSCS, almost half (44.1%) had been physically harassed

(i.e., pushed or shoved) at school in the past year because of their sexual orientation and three out

of ten students (30.4%) because of their gender expression (Kosciw et al., 2008). The 2007 NSCS

also found that 22.1% of students reported being physically assaulted (i.e., punched, kicked, or

injured with a weapon) because of their sexual orientation and 14.2% because of their gender

expression.

Identity Concealment and the Self as a Limited Resource

Baumeister, Bratslavsky, Muraven, and Tice (1998) examined ego depletion and the active

self as a limited resource. Their results suggest that an individuals capacity for active volition is

limited, and that a variety of seemingly unrelated acts share a common resource. Specifically, they


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reported that decision making, self-control, and active responding share a common resource and

cause ego depletion (i.e., after one initial act of volition, less of this resource remains available for

subsequent acts). In a related investigation, Smart and Wegner (1999) studied concealable stigma

and mental control. Results indicated that individuals who concealed their stigmas became

preoccupied with the control of stigma-relevant thoughts, and exhibited more secrecy, suppression,

intrusive thoughts, and projection of stigma-related thoughts. The authors also considered potential

benefits of passing, in which a socially stigmatized individual is able to conceal his or her stigma,

thereby minimizing its impact on social interactions. Identified benefits included social acceptance,

avoidance of discrimination, and escaping the burden of disclosure. However, concealment requires

sustained mental effort during interactions, and can distract the individual from important relational

aspects of social interactions (Smart & Wegner).

While this research was conducted in the context of eating disorders, the findings are

relevant to LGBTQ identities. To varying degrees, LGBTQ individuals move through their daily

lives in a constant cognitive and emotional multitasking state. They must simultaneously decide

whether or not to disclose their sexual orientation or gender identity to those they encounter while

controlling their emotional responses to experiences of victimization and rejection (Crocker, et al.,

1998; Smart & Wegner, 2000). For LGBTQ youth, this can leave few internal resources for active

responding in the classroom or social situations.

Disclosure: If, When, How, and to Whom?

Correlates of disclosure.An individuals degree of sexual orientation/gender identity

disclosure has been linked to a range of both person-centered and contextual factors. Some studies

have associated outness with positive identity development and mental health (cf., Jordan &

Deluty, 1998; Miranda & Storms, 2001). Internalized homophobia has also been shown to


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negatively correlate with disclosure of sexual orientation (Herek et al., 1997; Jellison &

McConnell, 2003). Others such as McCarn and Fassinger (1996) have suggested that a persons

degree of disclosure may be more a reflection of a particular social context (i.e., whether there are

visible LGBTQ role models; whether the context is LGBTQ affirming). As noted, there has been a

trend in recent years toward disclosure at a younger age (Floyd & Bakeman, 2006). In their study

of 767 LGB individuals aged 18 to 74, Floyd and Bakeman examined the effects of age and the

calendar year (i.e., historical context) when individuals first self-identified as LGB on their sexual

orientation identity development. Specifically, they examined the timing and sequencing of seven

coming out experiences: first awareness of same-sex attraction; first sexual experiences with

opposite-sex partners; first sexual experiences with same-sex partners; self-identification as LGB;

disclosure to someone other than a parent; disclosure to mother; and disclosure to father. Their data

revealed trends toward earlier disclosure of sexual orientation to others, with an average age at

disclosure of younger than 18 years.

DAugelli, Grossman, and Starks (2005) examined data from a longitudinal study of LGB

youth (aged 15 to 19) in New York City and surrounding suburbs. Their sample consisted of 293

adolescents who lived with one or both parents who had raised them. Regression analysis revealed

that gay self-identification (based on Kinsey rating), greater childhood gender atypicality, less

internalized homophobia, more family support, and less fear of parental harassment or rejection

were related to parental awareness of sexual orientation. Gender, age of first disclosure, and years

of awareness were not significant predictors of parental awareness. The model explained 58% of

the variance and correctly classified 86% of the cases.

A variety of additional factors associated with disclosure also have been offered by

researchers. In their study of 2,401 lesbian and bisexual women, Morris, Waldo, and Rothblum


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(2001) learned that differences in individual identity development may also be related to disclosure.

Their data suggested that the longer women self-identified as lesbian or bisexual, the more likely

they were to self-disclose. Floyd and Bakemans (2006) results also suggested that individuals who

self-identified during adolescence (as opposed to adulthood) were more likely to demonstrate

identity-centered sequences in which self-identification preceded same-sex sexual experiences. In

terms of community involvement, Morris, Waldo, and Rothblum reported that among lesbian and

bisexual women, greater involvement in the LGBTQ community was associated with an increased

likelihood of disclosure of sexual orientation.

Complex choices: Disclosure vs. identity concealment.Many LGBTQ youth experience

significant challenges related to the emerging awareness of their sexual orientation and gender

identity for the first time during early adolescence (e.g., Floyd & Bakeman, 2006; Mosher, 2001).

In addition to their own developing identity as a LGBTQ person, these youth are often faced with

decisions related to the disclosure of their sexual orientation or gender identity to others (i.e.,

coming out). In some cases, disclosure of ones sexual orientation or gender identity is not a

choice; an individual may be outed by someone else, or their gender expression may lead others

to draw conclusions about their sexual orientation and gender identity (Carragher & Rivers, 2002).

In recent years, LGBTQ individuals have been coming out at younger ages than ever before (Floyd

& Bakeman, 2006). Research findings related to early disclosure have been inconsistent. Several

studies have identified coming out at a young age as a risk factor (e.g., DAugelli, Pilkington, &

Hershberger, 2002), perhaps due to poor access to resources and the absence of important coping

skills among younger adolescents. Other studies have suggested that early disclosure can serve as a

protective factor (Floyd & Stein, 2002), citing the possibility that earlier disclosure may in fact

encourage positive identity development if resources are provided early on in the process. As such,


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schools must be prepared to support LGBTQ adolescents as they navigate this complicated, and

sometimes turbulent, process.

Decisions regarding if, when, how, and to whom one might disclose are complicated by a

variety of interconnected factors including religious and cultural beliefs, the anticipated reaction,

real or perceived safety, relationship factors, and subjective distress about concealment (Corrigan &

Matthews, 2003; DAugelli et al., 2005; Mosher, 2001; Savin-Williams & Ream, 2003). LGB

youth cite a variety of reasons for not disclosing to their parents, including fears of harassment,

rejection, or eviction; fear of relationship deterioration; and not having close relationships with

parents (DAugelli et al., 2005). Predicting the potential impact of disclosure can be quite complex.

To illustrate, a study of 2401 lesbian and bisexual women found that an individuals degree of

disclosure predicted lower psychological distress (Morris, Waldo, & Rothblum, 2001). However,

other studies have proposed different findings. For example, in their study of 350 LGB youth aged

14 to 21, DAugelli, Pilkington, and Hershberger (2002) discovered that the earlier young

individuals came out to themselves and others, the more they were victimized in high school.

LGBTQ youth who disclose their sexual orientation or gender identity, by choice or through

the assumptions of others, are often met with rejection (Cohen & Savin-Williams, 1996; DAugelli,

Hershberger, & Pilkington, 1998; Ryan, Huebner, Diaz, & Sanchez, 2009; Savin-Williams, &

Ream, 2003). Unlike members of many other minority groups, LGBTQ youth often do not have the

support of their families, places of worship, or other cultural organizations to provide an identity

framework or to serve as a buffer against the hostility that they face (Taylor, 2000). In their study

of 156 LGB youths (ages 14 to 21), Rosario, Schrimshaw, and Hunter (2009) found that a greater

number of rejecting reactions from important individuals was associated with more concurrent and

subsequent substance use and abuse. Accepting reactions were found to moderate the negative


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association of rejection with alcohol use, but not with tobacco or marijuana use or substance abuse

symptoms. These findings suggest that it may be the number of accepting and rejecting reactions

that influence outcomes rather than the number of disclosures per se; however, more research is

needed to examine other outcomes of interest.

Family reaction. Family support may play an important protective role for LGBTQ

adolescents. To illustrate, in their study of LGB youth aged 15 to 21, Hershberger and DAugelli

(1995) found partial evidence for the mediating role of family support and self-acceptance in the

relationship between victimization, mental health and suicidality. Specifically, their analyses

revealed that family support buffered against the effects of victimization when the level of

victimization was low. Unfortunately, in cases of moderate or high victimization, family support

was not protective.

LGB youth cite a variety of reasons for not disclosing to their parents, including fears of

harassment, rejection, or eviction; fear of relationship deterioration; and not having close

relationships with parents (DAugelli et al., 2005). Parents reactions to a childs disclosure of his

or her sexual orientation or gender identity can be negative (Cohen & Savin-Williams, 1996;

DAugelli, Hershberger, & Pilkington, 1998; Ryan, Huebner, Diaz, & Sanchez, 2009; Savin-

Williams, & Ream, 2003). A variety of factors may influence a parents negative reaction to

disclosure, including feelings of guilt related to a belief that they caused their child to be LGBTQ

or experiencing conflict between love for their child and anger or resentment over the perceived

loss of their heterosexual child (Goldfried & Goldfried, 2001).Some recent studies have suggested

greater parental acceptance of a childs sexual orientation. For example, Garofalo, Mustanski, and

Donenberg (2008) found that among their sample of 302 urban gay and bisexual young men, 82.7%

of those with a mother or stepmother reported that she definitely knew their sexual orientation.


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Further, most of these mothers were described as accepting (53.4%) or tolerant (30.3%). Among

participants with a father or stepfather, 70.4% reported that their father definitely knew about their

sexual orientation, with the majority of these fathers accepting (48.9%) or tolerant (25.3%).

Peer reaction.The disclosure of ones sexual orientation may result in an interruption or

loss of social supports (DAugelli et al., 1998). Although greater disclosure has been associated

with larger peer networks, outness may also be also related to loss of friendships and

friendship-related worry among sexual minority youth (Diamond & Lucas, 2004). In their 1995

study, DAugelli and Hershberger found that LGB adolescents reported a fear of rejection by peers

following disclosure of their sexual identity. In his study of 542 LGBT adolescents, DAugelli

(2002) found that more than one third had lost friends due to their sexual orientation. In addition,

he found that those individuals who had lost friends reported more mental health problems and

more past suicide attempts than those who did not lose friends.

Obstacles to Academic Success

Negative school experiences can have serious implications for LGBTQ students academic

success. According to the GLSEN 2007 NSCS (Kosciw et al., 2008), LGBTQ youth are prone to

verbal and physical harassment, physical assault, and lack of staff intervention and support. As a

result, they are likely to feel unsafe in their schools, are at greater risk for absenteeism, and face

academic consequences. More than half (60.8%) of respondents reported that they felt unsafe in

school because of their sexual orientation, and more than a third (38.4%) felt unsafe because of

how they expressed their gender (Kosciw et al.). This pervasive fear can be a significant distraction

for some LGBTQ students and may have serious implications for their academic success.

Absenteeism. The 2007 NSCS found that LGBTQ students were more than five times more

likely to have skipped school in the last month because of feeling unsafe than the general


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population of secondary school students (Kosciw et al., 2008). In addition, experiences of

harassment were related to absenteeism among respondents. Students who had experienced high

frequencies of verbal harassment related to their sexual orientation or gender expression were twice

as likely to have missed school in the past month than those who had not experienced frequent

harassment. Students who had experienced high frequencies of physical harassment because of

their LGBTQ identity were almost three times more likely than other students to have missed

school in the past month due to feeling unsafe (physical harassment based on sexual orientation:

68.9% versus 25.4%, physical harassment based on gender expression: 70.8% versus 28.4%).

Results from a biennial California survey of adolescent risk behaviors found that students who were

victimized in school because they were gay or lesbian or simply perceived to be were more than

three times as likely as students who were not harassed for this reason to have missed school

because they felt unsafe (Russell et al., 2006).

Academic achievement and goals. The GLSEN 2007 NSCS found that a higher frequency

of harassment was related to lower academic achievement among LGBTQ students (Kosciw et al.,

2008). The average grade point average of students who experienced frequent physical harassment

because of their sexual orientation or gender expression was almost half a grade lower than that of

LGBTQ students experiencing less harassment. In addition, LGBTQ students who endorsed more

frequent physical harassment were also less likely to report plans to attend college. Specifically,

41.5% of students who experienced high frequencies of physical harassment did not plan to go to

college compared to 30.1% of those who had not experienced high frequencies of physical

harassment. Overall, LGBTQ students were almost twice as likely as the general population of

students to report that they were not planning to pursue any post-secondary education (i.e.,

obtaining a high school diploma only or not finishing high school). A recent study using data from


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The National Longitudinal Study of Adolescent Health, which has followed into young adulthood a

nationally representative sample of young people who were in grades 7-12 during the 1994-95

school year, suggested that sexual minority youth felt less connected and engaged with their school

community than their heterosexual peers (Pearson, Muller, & Wilkinson, 2007). These youth,

particularly gay and bisexual young men, performed worse academically and were less prepared for

postsecondary education (Pearson et al.).

Mental Health and Wellness

The majority of research has supported the conclusion that LGBTQ individuals experience a

higher prevalence of mental health concerns than do heterosexuals (see King et al., 2008 for a

review and meta-analysis; Meyer, 2003). Methodologically, early studies examining risk (e.g.,

suicide) among LGB youth were often not representative of LGB youth as a group because

participants were typically recruited from service providers. These young people were already

seeking mental health services, which created biased samples (Mustanski, 2008).

Ecological models of human development (Bronfenbrenner, 1979) describe interactions

between multiple individuals, contexts, and spheres of influence that shape an individuals

development. Until recently, most studies have examined only single variables in the prediction of

mental health outcomes among LGBT youth as opposed to the use of a multivariate approach

(Mustanski, 2008). Historically, research with LGBTQ youth has typically focused on risks directly

related to sexual orientation and/or gender identity (e.g., victimization, age at self-labeling), often

ignoring risk factors identified among general adolescent samples such as personality variables,

mental and addictive disorders, impulsivity, hopelessness, lack of a peer social network, and early

puberty (Elze, 2002; Mustanski, 2008; Safren & Heimberg, 1999).


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More recent research efforts have revealed that when other factors are controlled, many of

the differences between LGBTQ youth and their heterosexual peers on indices of mental health

disappear (cf., Busseri, Willoughby, Chalmers, & Bogaert, 2008; Elze, 2002; Safren & Heimberg,

1999). To illustrate, in their study of 56 LGB youth and 48 heterosexual youth, Safren and

Heimberg discovered that when other psychosocial predictors of present distress were controlled

(i.e., stress, social support, and coping), significant differences between LGB and heterosexual

youth in depression, hopelessness, and present suicidality disappeared. The authors suggest that

based on their findings, environmental factors associated with sexual orientation, which can be

targeted and changed through prevention and intervention efforts, play a major role in predicting

distress in this population.

It has been reported in the literature that LGBTQ youth experience an elevated risk of

suicidality. LGBTQ adolescents are particularly vulnerable to victimization because it often occurs

before they have developed sufficient self-protective resources. It may be that existing in a

homophobic environment while lacking the personal resources with which to deal with harassment

and marginalization contributes to the elevated prevalence of suicidal behavior among LGBT youth

(McFarland, 1998). In his 2001 investigation, Sadowski concluded that the suicide rate among

LGBT youth was four times that of their heterosexual peers. It also has been reported that LGBT

youth are the victims of 30% of all completed teen suicides, yet they comprise only 5 to 10% of the

total youth population (Todd, 2001). In a sample of gay and bisexual male adolescents, substance

use, feminine gender presentation, age at the time of self-labeling, and gay-related stressors (e.g.,

disclosure of sexual orientation) were identified as risk factors for suicide attempts (Remafedi,

Farrow, & Deisher, 1991). Another study found that loss of friends, low self-esteem, hostility,

feminine gender presentation, and age at the time of self-labeling were associated with suicide


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attempts among gay and bisexual young men (DAugelli & Hershberger, 1993). Among gay and

bisexual young women in that sample, loss of friends and more frequent visits to gay bars were

associated with suicide attempts.

LGBT youth may be more likely than their heterosexual peers to abuse drugs and/or alcohol

(Jordan, 2000). In their 1995 study, Rotheram-Borus, Rosario, Van Rossem, Reid, and Gillis found

that LGBT youth may also use substances as a method of rationalizing their same-sex feelings, or

as a way to reduce the anxiety they feel when in a gay or lesbian situation. They also reported that

frequent unprotected sexual encounters and suicide attempts have been found to increase with

substance use. LGBT youth may become sexually active at an earlier age than their straight peers in

an effort to prove that they are normal, which presents a greater risk of sexually transmitted

infections and pregnancy (Rotheram-Borus et al., 1995). They may also use substances as a result

of the lack of age-appropriate social outlets such as parties or dances (Jordan, 2000).

Anxiety in LGBTQ Populations

Etiology and Prevalence

From a learning theory perspective, an individuals early learning history and

temperamental vulnerabilities together affect the emotional consequences of adverse and stressful

life events (Mineka & Zinbarg, 1996). Individual differences in these factors may affect ones

susceptibility to the development of problematic anxiety. A number of intervening psychosocial

factors and life experiences have been associated with the manifestation of anxiety, including the

family environment, peer relationships, information processing styles and conditioning experiences

(Hudson & Rapee, 2000). More generally, demographic risk factors for the development of anxiety

disorders in children and adolescents include sex, age, socioeconomic status, race and familial

factors (i.e., environmental and genetic; Merikangas, 2005). Individual and contextual


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vulnerabilities include temperament and personality (e.g., behavioral inhibition, anxiety sensitivity,

vigilance to threat); comorbid psychiatric and medical disorders; biological factors (e.g., autonomic

reactivity, respiratory sensitivity, neurobiologic factors); life events and stressors; drug use; and

parenting (for a thorough discussion of these factors, see Merikangas, 2005). The present study is

concerned with two specific manifestations of anxiety: (1) generalized (or trait) anxiety and (2)

social anxiety, known at clinical levels as social phobia.

Etiology of generalized anxiety disorder.Generalized anxiety disorder (GAD) is

primarily characterized by chronic excessive worry about a number of events or activities that is

difficult to control (Mineka & Zinbarg, 2006). It is generally agreed that worry is the central feature

of GAD and serves as a self-reinforcing cognitive avoidance response (Mineka & Zinbarg). It has

been suggested that uncontrollable and unpredictable adverse events may play an important role in

the development of generalized anxiety (e.g., Barlow, 2002; Mineka & Zinbarg, 1996). There is

limited evidence that individuals with GAD may be more likely to have a history of childhood

trauma than are those with a number of other anxiety disorders (Borkovec, Alcaine & Behar, 2004).

Individuals most prone to developing GAD may lack safety signals or indicators telling them when

negative events are unlikely to occur, causing a constant state of vig

THE ROLE OF SCHOOL-BASED SUPPORT AND COPING SKILLS IN THE DEVELOPMENT OF ANXIETY IN LGBTQ YOUNG ADULTS

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