195514 Impact of discriminatory laws on psychopathology in LGB populations: A prospective study

Monday, November 9, 2009: 10:30 AM

Mark Hatzenbuehler, MS, MPhil , Department of Psychology, Yale University, New Haven, CT
Katie A. McLaughlin, PhD , Department of Health Care Policy; School of Public Health, Harvard University, Boston, MA
Katherine Keyes, MPH , Columbia University/New York State Psychiatric Institute, New York, NY
Background: Policy debates regarding lesbian, gay and bisexual (LGB) populations are center stage in the public discourse in countries across the world. Few studies, however, have empirically examined the extent to which such policies impact the mental health of LGB individuals, and none have used general population data or detailed measurement of DSM-IV diagnoses. The present study examined associations between the passage of discriminatory laws during the 2004 election and changes in the prevalence of psychiatric disorders among LGB respondents assessed prior and subsequent to the change in law.

Methods: Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (N=34,653), a longitudinal nationally representative study of non-institutionalized U.S. adults, conducted in 2001-2005.

Results: A significant increase in mood disorders (36.6%), generalized anxiety disorder (248.2%), alcohol use disorder (41.9%) and psychiatric comorbidity (36.3%) was observed among LGB respondents living in states that passed anti-gay marriage amendments, relative to LGB respondents living in states that did not change their marriage laws (mood disorder: 23.6% decrease; generalized anxiety disorder: 48% increase; alcohol use disorder: 28.9% increase; comorbidity: 8.5% increase). Results were consistent for comparisons between LGB respondents and heterosexuals living in states passing these amendments. Controlling for multiple sociodemographic factors did not attenuate these relationships.

Conclusions: This study provides the strongest empirical evidence to date demonstrating that discriminatory policies may have pernicious consequences for the mental health of LGB populations. These results lend timely scientific support for recent efforts that aim to overturn these policies.

Learning Objectives:
1. Describe the unique mental health issues confronting lesbian, gay, bisexual, and transgendered (LGBT) populations, including increased rates of psychopathology relative to heterosexuals. 2. Identify risk factors for these mental health disparities, including exposure to discrimination. 3. Evaluate the impact of institutional forms of discrimination (i.e., state-level anti-marriage amendments) on prevalence of psychiatric disorders in LGBT populations, using data from a prospective, nationally representative study. 4. Discuss policy initiatives and prevention interventions that may reduce mental health disparities among LGBT populations.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have published five peer-reviewed articles and book chapters on the topic of LGBT mental health. My research on mental health disparities in LGBT populations, including the work for this abstract, has been supported by grants and awards from the National Institutes of Mental Health (National Research Service Award), the American Psychological Association (Division 44 Maylon-Smith Dissertation Award), and the Williams Institute at the UCLA School of Law (Small Grant Research Program Award).
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.