THE MEDIATING ROLE OF MENTAL HEALTH IN THE RELATIONSHIP BETWEEN DISCRIMINATION AND RISKY BEHAVIORS IN LGBT ADULTS IN LATIN AMERICA

THE MEDIATING ROLE OF MENTAL HEALTH IN THE RELATIONSHIP BETWEEN DISCRIMINATION AND RISKY BEHAVIORS IN LGBT ADULTS IN LATIN AMERICA By Annie E. Rabinovitch, M.A., M.S. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University Virginia Commonwealth University, 2017 Major Director: Paul B. Perrin, Associate Professor. Psychology Department This study explored relationships among discrimination experiences, mental health (i.e., anxiety symptoms, depression symptoms), risky behaviors (i.e., suicidal ideation, illicit substance use use), religiosity, and social support in LGBT adults residing in Latin America. First, multiple regression analyses were conducted to identify patterns of connections among discrimination, mental health, suicidal ideation, and illicit substance use in sexual and gender minority adults from Latin America. Harassment/Rejection discrimination, but neither Work/School nor Other discrimination predicted suicidal ideation. None of the three discrimination subscales predicted illicit substance use. Work/School discrimination predicted mental health problems (Anxiety and Depression subscales of the HSCL-25 combined), while Harassment/Rejection and Other discrimination did not. Depression predicted suicidal ideation, but failed to predict illicit substance use, and anxiety symptoms alone neither uniquely predicted suicidal ideation nor illicit substance use. Subsequently, separate mediational models were conducted to examine whether depression mediated relationships between Work/School discrimination and suicidal ideation, as well as Harassment/Rejection discrimination and suicidal ideation. Depression was a significant mediator of both of these relationships. To assess whether the relationships among discrimination, depression symptoms, and suicidal ideation varied as a function of religiosity and social support, the two mediation models were expanded to six moderated mediations. Depression symptoms mediated the effects of Work/School and Harassment/Rejection discrimination on suicidal ideation when participants had low to moderate levels of social support, but not high social support. Depression symptoms also mediated the effects of Work/School discrimination on suicidal ideation when participants had low to moderate levels of both Interpersonal and Intrapersonal Religiosity, but not when participants had high levels. Finally, Depression symptoms mediated the effect of Harassment/Rejection discrimination on suicidal ideation when participants had low to moderate levels of Intrapersonal Religiosity, but not when participants had high levels; depression symptoms mediated the effect of Harassment/Rejection discrimination on suicidal ideation at all levels of Interpersonal Religiosity. Limitations to the current study include a homogenous sample with respect to country of residence, education level, and socioeconomic status, with participants primarily residing in Mexico, having high levels of education, and being primarily middle class. These drawbacks limit generalizability of study findings to sociodemographically and demographically diverse samples of LGBT adults in Latin America. Nevertheless, results from this study indicate that high, but not low or moderate levels of social support and religiosity seem to buffer LGBT adults in Latin America against discrimination, specifically by weakening links among discrimination, depression symptoms, and suicidal ideation. Clinical intervention research with LGBT adults in Latin America should focus on increasing social support networks for this population and on helping LGBT adults reconcile conflicts between religious identities and sexual or gender minority identities, as religiosity may serve as a protective factor against mental health problems generally, and suicidal ideation specifically.