7 - (IOP 26) Heterosexist Discrimination and Prospective Self-harm Among Sexual Minority Men: A Moderated Mediation Model

Self-harm (i.e., suicidal and non-suicidal self-injurious behavior) is a risk factor for death by suicide. Relative to heterosexual peers, sexual minority (SM) men are at increased risk for self-harm. Theory posits that living in a society that devalues sexual identities that are not exclusively heterosexual (i.e., heterosexist discrimination) contributes to aversive psychiatric symptoms, such as depressive symptoms (e.g., depressed mood, hopelessness). Individuals may subsequently engage in self-harm to end these aversive symptoms. Though depressive symptoms may mediate the relation between heterosexist discrimination and self-harm, this relation may not be uniform across all SM men. For instance, SM men with more (vs less) severe disordered eating symptoms (e.g., food restriction, purging) may experience cognitive-affective sequalae (e.g., decreased emotional control, cognitive rigidity) that impede effective coping with heterosexist discrimination, subsequently increasing risk for depressive symptoms, and ultimately, self-harm. To inform treatment targets for SM men, a group with disproportionate rates of disordered eating and self-harm, the current study examined a conditional process model underlying self-harm in this group, whereby baseline heterosexist discrimination predicted presence of 6-month self-harm via 3-month depressive symptoms. Moreover, this indirect path was hypothesized to be stronger among SM men reporting greater baseline levels of disordered eating symptoms.

The sample was 472 SM (42.2% gay, 44.3% bisexual, 6.8% pansexual, 6.8% other SM identity) men (Mage = 35.85, SD = 12.38; age range: 18-81; 41.0% non-White; 20.1% Hispanic/Latino/a/x; 13.3% transgender) recruited via Prolific. Participants were assessed at baseline, 3-, and 6-months using self-report measures. A single path model with Bayesian estimation was used to examine longitudinal relations among study variables. Covariates included baseline age and depressive symptoms as well as 3-month self-harm. The model, which fit the data well, accounted for a large amount variance in 6-month self-harm (R2 = .32, 95% credibility interval [0.21, 0.43]; f 2 = .47). Though baseline heterosexist discrimination did not directly predict 6-month self-harm (b = 0.05, 95% CI [-0.03, 0.12]), greater baseline heterosexist discrimination indirectly predicted 6-month self-harm via 3-month depressive symptoms among men reporting high baseline levels of disordered eating symptoms (b = 0.03, 95% CI [0.01, 0.07]).

Though results require replication with other SM populations (e.g., youth), results highlight the need for use of inclusive, evidence-based therapies that address sources, and sequelae, of heterosexist discrimination to reduce likelihood of self-harm, particularly among SM men with high levels of disordered eating.