Mental health promotion and suicide prevention among sexually and gender diverse adults

Sexual and gender minority (SGM; e.g., lesbian, gay, bisexual, transgender) individuals are recognized as a health disparity population due to the undue burden of mental and physical health disorders among this population. The National Institutes of Health Sexual and Gender Minority Research Office (NIH-SGMRO) generated a social-ecological research framework for SGM health disparity research, articulating need for further research in the areas of (a) minority stress, (b) resilience, (c) violence and discrimination, and (d) intersecting identities. Informed by this research framework, the current dissertation contains three studies attending to these four research areas. Study one is a grounded theory of SGM suicide; 30 interviews with SGM adults in the United States lead to the co-construction of the SGM Suicide Risk and Protection (SuRAP) which outlines the impact of minority stress on suicide outcomes for SGM adults. Study two is a psychometric evaluation of the Brief Resilience Scale (BRS) among a sample of alternative sexuality community members (e.g., persons engaging in non-monogamy and kink), validating use of the BRS in future resilience-based research among this population. Study three is an examination of the mental health outcomes of sexual harassment, using a Psychological Mediation Framework to assess the ways in which social support, emotion regulation, and internalized minority stress explain the sexual harassment-mental health linkage among trauma-exposed sexual minority women. Taken together, findings indicate that therapeutic modalities such as Affirmative Dialectical Behavior Therapy may be of clinical utility.