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Self-regulation as a promotive and protective factor of mental health in gender and sexual orientation diverse emerging adults
Dissertation   Open access

Self-regulation as a promotive and protective factor of mental health in gender and sexual orientation diverse emerging adults

Hana-May Eadeh
University of Iowa
Doctor of Philosophy (PhD), University of Iowa
Summer 2023
DOI: 10.25820/etd.007216
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Abstract

Background. Gender and Sexual Orientation Diverse (GSD) individuals face higher levels of oppression, discrimination, and generally negative socio-environmental contexts. These negative experiences contribute to GSD individuals experiencing mental health problems at two to four times the rate of their peers. Further, GSD individuals are at risk of experiencing greater and more severe social rejection than their non-GSD peers, particularly during emerging adulthood, and face increased barriers to receiving appropriate and affirming therapeutic and medical services.Method. The specific aims of the proposed research were to determine how self-regulation promotes well-being and reduces mental health symptoms by protecting against the risks associated with (1) poor social support, and (2) lack of access to affirming health care service use. 114 GSD emerging adults completed self-report, behavioral, and physiological indices of self-regulation as well as reliable and valid interviews and self-report ratings regarding social support, service use, and mental health symptoms. Structural equation modeling examined (1) the direct effects of social support, service use, and self-regulation on mental health and (2) the extent to which self-regulation moderates the effect of social support (Aim 1) and service use (Aim 2) on multiple dimensions of mental health functioning. It was hypothesized that better self-regulation would enhance the protective benefits of health service use and social support (or mitigate the risk of low levels of support and service use) on mental health. Exploratory analyses examined effects of the number of marginalized identities and discrimination on mental health outcomes. Results. There were direct effects of social support, service use, and self-regulation (self-report measures and RSA reactivity) for both well-being and psychopathology. There was little evidence that self-regulation moderated these effects, with only one significant moderation found (between service use and well-being, with self-reported self-regulation). Self-regulation indexed via cognitive tasks was unrelated to psychopathology and well-being in the primary analyses. For exploratory analyses, having multiple marginalized identities (specifically, three) was associated with lower social support, worse self-reported self-regulation, lower performance on cognitive tasks, and higher levels of psychopathology and discrimination. Discussion. Together these results indicate that social support, service use, and self-regulation may be independently important protective factors for GSD individuals, and these three factors will be important to continue exploring to understand how to best adapt interventions for GSD individuals. This sample was likely underpowered to detect some effects, which may have contributed to the lack of moderation found. However, there has also been very little research evaluating the interaction of self-regulation and protective factors within GSD individuals and more work is needed to elucidate these associations. In terms of research, important next steps include validating measures and tasks within GSD populations to ensure constructs are being adequately captured for these individuals while taking their unique lived experiences into account.
 Mental Health emotion regulation gender and sexual minority LGBTQ respiratory sinus arrythmia self regulation

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