Predicting self-harm in an ethnically diverse sample of lesbian, gay and bisexual people in the United Kingdom

• Published in: International journal of social psychiatry Vol. 66; no. 4; pp. 349 - 360
• Main Authors: Rehman, Zaqia, Lopes, Barbara, Jaspal, Rusi
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.06.2020; Sage Publications Ltd
• Subjects: Adaptation, Psychological; Adolescent; Adult; Age differences; Behavior; Behavior problems; Bisexuality; Clinical psychology; Cognitive-behavioral factors; Coping strategies; Depression - epidemiology; Discrimination; Female; Gays & lesbians; Hate; Homophobia; Homophobia - psychology; Homosexuality; Humans; Indirect effects; Internalization; Lesbianism; Logistic Models; Low income groups; Male; Mental depression; Mental health; Mental Health - statistics & numerical data; Middle Aged; Original; Risk factors; Self destructive behavior; Self injury; Self-Injurious Behavior - epidemiology; Self-Injurious Behavior - psychology; Selfschemata; Sexual and Gender Minorities - psychology; Sexual orientation; Social Stigma; Stigma; Stress, Psychological - epidemiology; Surveys and Questionnaires; United Kingdom - epidemiology; Victimization; Women; Young Adult; United Kingdom; United Kingdom > UK; lesbian; internalized homophobia; Self-harm; bisexual; discrimination; victimization; gay
• ISSN: 0020-7640; 1741-2854
• DOI: 10.1177/0020764020908889

Background: Poor mental health is prevalent in lesbian, gay and bisexual (LGB) people due in part to social stigma. The social, psychological and clinical risk factors for self-harm among LGB people are unclear, which limits our ability to predict when and how this will occur and, crucially, how to prevent it. Aims: Drawing on the cognitive-behavioral approach in clinical psychology, this study identifies the predictors of self-harm in LGB people in the United Kingdom. Results: Women, lesbians, those with lower income and younger people were more likely to engage in self-harm. Self-harmers exhibited much more discrimination, LGB victimization and, thus, internalized homophobia and depressive symptomatology than non-self-harmers. The structural equation model showed direct effects of age and gender, and indirect effects of income and sexual orientation, on self-harm, through the mediating variables of discrimination, LGB victimization and internalized homophobia. Conclusions: Consistent with the cognitive-behavioral model, the results indicate that exposure to situational stressors can increase the risk of developing a self-hatred and depressive psychological self-schema, resulting in greater risk of self-harm as a maladaptive coping strategy. An integrative clinical intervention for enhancing psychological wellbeing in LGB people is proposed to mitigate the risk of self-harm in this population.