Discrimination, Coming-Out, and Self-Esteem as Predictors of Depression and Anxiety in the

144 Pages·2017·0.72 MB·English

Walden University
ScholarWorks
Walden Dissertations and Doctoral Studies
Walden Dissertations and Doctoral Studies
Collection
2017
Discrimination, Coming-Out, and Self-Esteem as
Predictors of Depression and Anxiety in the
Lesbian Community
Adrien Purvis
Walden University
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Walden University

College of Social and Behavioral Sciences

This is to certify that the doctoral dissertation by

Adrien Purvis

has been found to be complete and satisfactory in all respects,
and that any and all revisions required by
the review committee have been made.

Review Committee
Dr. Tracy Masiello, Committee Chairperson, Psychology Faculty
Dr. Stephen Rice, Committee Member, Psychology Faculty
Dr. Neal McBride, University Reviewer, Psychology Faculty

Chief Academic Officer
Eric Riedel, Ph.D.

Walden University
2017
Abstract
Discrimination, Coming-Out, and Self-Esteem as Predictors of Depression and Anxiety
in the Lesbian Community
by
Adrien Purvis

MS, University of Phoenix, 2009
BA, Brooklyn College, 1998

Proposal Submitted in Partial Fulfillment
of the Requirements for the Degree of
Doctor of Philosophy
Clinical Psychology

Walden University
June 2017
Abstract
Mixed findings in the research on mental health issues in the lesbian community have
resulted in conflicting conclusions as to whether the prevalence rate of generalized
anxiety disorders and depression in the lesbian population differs from that of non-
lesbians. The variability of findings may be due to factors such as discrimination,
coming-out, and self-esteem. Using the minority stress model a framework, the purpose
of this quantitative survey study was to examine whether perceptions of discrimination,
coming-out, and self-esteem levels predict lesbians’ anxiety and depression. Participants
anonymously completed online measures of the Outness Inventory, the Schedule of
Sexually Discriminatory Events, the State-Trait Anxiety Inventory, the Beck Depression
Inventory-II, and the Rosenberg Self-Esteem Scale. The snowball sample consisted of
105 self-identified lesbian women from the United States. Hierarchical regression was
used to test the hypotheses. According to study results, frequency and stressfulness of
sexual discrimination, coming-out, and self-esteem levels predicted depression and
anxiety, with low self-esteem as the only significant predictor of depression and anxiety.
The findings were only partially consistent with the minority stress model because
perceived discrimination did not predict depression or anxiety. This study facilitates
positive social change by pointing out and focusing on the need for mental health
interventions specific to the stresses that lesbians face pertaining to low self-esteem, as
that predicts their anxiety and depression.
Discrimination, Coming-Out, and Self-Esteem as Predictors of Depression and Anxiety
in the Lesbian Community
by
Adrien Purvis

MS, University of Phoenix, 2009
BA, Brooklyn College, 1998

Proposal Submitted in Partial Fulfillment
of the Requirements for the Degree of
Doctor of Philosophy
Clinical Psychology Program

Walden University
June 2017
Dedication
I dedicate this dissertation to my mother, the late Doristene Angelina Purvis for
all of her guidance and for teaching me that failure is not an option. Next, I would like to
dedicate my dissertation to my family, friends and colleagues. They extended
unconditional support and patience throughout this process. I thank everyone for being a
part of this positive and productive educational life journey.
Acknowledgments
I would like to thank my dissertation chairperson, Dr. Tracy Masiello, who
provided support, encouragement, patience and guidance during this process. I would
also like to extend my thanks to my committee member, Dr. Stephen, for his support and
guidance. You have both helped to develop my skills as a researcher.
Table of Contents
List of Tables ....................................................................................................................... i
List of Figures .................................................................................................................... iv
Chapter 1: Introduction to the Study ....................................................................................1
Introduction ....................................................................................................................1
Background ....................................................................................................................2
Problem Statement .........................................................................................................5
Purpose of the Study ......................................................................................................7
Research Questions and Hypotheses .............................................................................7
Theoretical Framework ..................................................................................................9
Nature of Study ............................................................................................................12
Definition of Terms......................................................................................................12
Assumptions .................................................................................................................14
Scope and Delimitations ..............................................................................................14
Limitations ...................................................................................................................15
Significance..................................................................................................................16
Summary ......................................................................................................................17
Chapter 2: Literature Review .............................................................................................18
Introduction ..................................................................................................................18
Literature Search Strategy............................................................................................19
Theoretical Foundation ................................................................................................19
Literature Review Related to Key Variables ...............................................................23
i
The Lesbian Experience ........................................................................................ 23
Sexual Minority Status and Mental Health ........................................................... 27
Lesbian Status and Mental Health ........................................................................ 34
Sexual Minority Status and Positive Mental Health Outcomes ............................ 36
Sexual Minority Status and Physical Health ......................................................... 41
Sexual Minority Status and Stigma....................................................................... 45
Sexual Minority Status and Discrimination .......................................................... 47
Sexual Minority Status, Self Esteem, and Coming Out ........................................ 51
Summary and Conclusions ..........................................................................................55
Chapter 3: Research Method ..............................................................................................57
Introduction ..................................................................................................................57
Research Design and Rationale ...................................................................................57
Population ............................................................................................................. 59
Sampling and Sampling Procedures ..................................................................... 60
Procedures for Recruitment .................................................................................. 61
Data Collection ..................................................................................................... 62
Instrumentation and Operationalization of Constructs ......................................... 62
Data Analysis ........................................................................................................ 67
Threats to Validity and Reliability ...............................................................................69
Ethical Procedures .......................................................................................................70
Chapter 4: Results ..............................................................................................................72
Chapter 5: Discussion, Conclusions, and Recommendations ............................................85
ii
References ........................................................................................................................108
Appendix A: Self-Esteem Scale .......................................................................................121
Appendix B: Consent Form .............................................................................................122
Appendix C: Outness Inventory .......................................................................................124
Appendix D: Beck Depression Inventory – II .................................................................125
Appendix E: Schedule of Sexually Discriminatory Events .............................................128
Appendix F: Demographic Questionnaire .......................................................................128
Appendix G: State Trait Anxiety Inventory.....................................................................128
iii