Gay male sexual assault survivors: The relations among internalized homophobia, experiential avoidance, and psychological symptom severity

Gold, Sari D.; Marx, Brian P.; Lexington, Jennifer M.

doi:10.1016/j.brat.2006.05.006

Cited by 104Posttraumatic Stress Disorder ResearchSexual Assault and Victimization StudiesLGBTQ Health, Identity, and Policy

Gay male sexual assault survivors: The relations among internalized homophobia, experiential avoidance, and psychological symptom severity

Gold, Sari D., Marx, Brian P., Lexington, Jennifer M.·2007·Behaviour Research and Therapy

DOI 10.1016/j.brat.2006.05.006

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Abstract

This study explored the relations among internalized homophobia (IH), experiential avoidance, and psychological symptom severity in a community sample of 74 gay male sexual assault survivors. Results indicated that IH is associated with both depressive and posttraumatic stress disorder (PTSD) symptom severity. IH accounted for more variance than assault severity in predicting both PTSD and depression symptom severity. IH and experiential avoidance similarly predicted PTSD symptom severity. In comparison with IH, however, experiential avoidance is a stronger predictor of depression symptom severity. Results also showed that experiential avoidance partially mediated the relation between IH and both depressive and PTSD symptom severity. The implications of these findings are discussed and suggestions for future research are provided.

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From Health Anxiety and Mental Health Outcome During COVID-19 Lockdown in Italy: The Mediating and Moderating Roles of Psychological Flexibility (2020) · cites this paper as Gold et al., 2007

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Stressful or traumatic life events, post-traumatic stress disorder (PTSD) symptoms, and HIV sexual risk taking among men who have sex with men
Reisner, S. L., Mimiaga, M. J., Safren, S. A., & Mayer, K. H. (2009) · AIDS Care · doi:10.1080/09540120902893258 · Cited by 75 · see citing works
Measuring experiential avoidance in adults: the Avoidance and Fusion Questionnaire
Schmalz, J. E., & Murrell, A. R. (2010) · International Journal of Behavioral Consultation and Therapy · doi:10.1037/h0100908 · Cited by 65 · see citing works
Psychological inflexibility and stigma: A meta-analytic review
Krafft, J., Ferrell, J., Levin, M. E., & Twohig, M. P. (2018) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2017.11.002 · Cited by 76 · see citing works
“…Luoma et al., 2011; and Luoma et al., 2013), individuals with mental illness in Hong Kong (Chan & Mak, 2015); gay male sexual assault survivors (Gold et al., 2007); individuals with epilepsy (Heersink, Kocovski, MacKenzie, Denomme, & Macrodimitris, 2015); overweight/obese individuals (Lillis…”
BackgroundInfluential
Psychological Outcomes Among Lesbian Sexual Assault Survivors: An Examination of the Roles of Internalized Homophobia and Experiential Avoidance
Gold, S. D., Dickstein, B. D., Marx, B. P., & Lexington, J. M. (2009) · Psychology of Women Quarterly · doi:10.1111/j.1471-6402.2008.01474.x · Cited by 65 · see citing works
“Another contextual issue that was not examined here was the influence of the sexual perpetrator’s gender and sexual orientation on the relation between IH and symptom severity (Gold et al., 2007).”
BackgroundMethodResultInfluentialSelf-citation
Sexual assault, sense of belonging, depression and suicidality among LGBQ and heterosexual college students
Backhaus, I., Lipson, S. K., Fisher, L. B., Kawachi, I. I., & Pedrelli, P. (2019) · Journal of American College Health · doi:10.1080/07448481.2019.1679155 · Cited by 62 · see citing works
“Consistently, the minority stress theory also proposes stress–ameliorating factors, such as group cohesiveness and community connectedness, that may be protective and serve as buffers, thereby increasing one’s coping abilities and facilitating resilience against the negative effects of stressful life events.(19,20) As…”
Background
Sexual Assault Risks Among Gay and Bisexual Men
Hequembourg, A. L., Parks, K. A., Collins, R. L., & Hughes, T. L. (2014) · The Journal of Sex Research · doi:10.1080/00224499.2013.856836 · Cited by 61 · see citing works
“Gold, Marx, and Lexington (2007) identified a positive association between IH and negative psychological symptoms among gay male ASA survivors.”
Background
Psychological Flexibility and Self-Compassion in Gay and Heterosexual Men: How They Relate to Childhood Memories, Shame, and Depressive Symptoms
Matos, M., Carvalho, S. A., Cunha, M., Galhardo, A., & Sepodes, C. (2017) · Journal of LGBT Issues in Counseling · doi:10.1080/15538605.2017.1310007 · Cited by 55 · see citing works
“…avoidance—which is theoretically the opposite of acceptance (Hayes, Luoma, Bond, Masuda, & Lillis, 2006)—is a stronger predictor of depression symptom severity than internalized homophobia and mediates the relationship of internalized homophobia and depressive symptoms severity (Gold & Marx, 2007).”
Background
Internalized Homonegativity, Sense of Belonging, and Depressive Symptoms Among Australian Gay Men
Davidson, K. B., McLaren, S., Jenkins, M., Corboy, D., Gibbs, P. M., & Molloy, M. (2016) · Journal of Homosexuality · doi:10.1080/00918369.2016.1190215 · Cited by 46 · see citing works
“Previous research has demonstrated a direct relationship between internalized homonegativity and depression among gay men (Gold et al., 2007; Igartua et al., 2003; Morandini et al., 2015; see Newcomb & Mustanski, 2010, for a review).”
Background
Sexual minority status and interpersonal victimization in college men.
Anderson, R. E., Wandrey, R. L., Klossner, S. C., Cahill, S. P., & Delahanty, D. L. (2016) · Psychology of Sexual Orientation and Gender Diversity · doi:10.1037/sgd0000204 · Cited by 46 · see citing works
Sexual Violence in LGBTQ Communities
Messinger, A. M., & Koon‐Magnin, S. (2019) · Springer eBooks · doi:10.1007/978-3-030-23645-8_39 · Cited by 46 · see citing works
A social ecological approach to understanding correlates of lifetime sexual assault among sexual minority women in Toronto, Canada: results from a cross-sectional internet-based survey
Logie, C. H., Alaggia, R., & Rwigema, M.-J. (2014) · Health Education Research · doi:10.1093/her/cyt119 · Cited by 45 · see citing works
“Internalized homophobia was associated with PTSD among gay male [26] and lesbian [27] sexual assault survivors.”
Intersection of Trauma and Identity
Alessi, E. J., & Martin, J. I. (2017) · Springer eBooks · doi:10.1007/978-3-319-54509-7_1 · Cited by 42 · see citing works
‘Our life is pointless … ’: Exploring discrimination, violence and mental health challenges among sexual and gender minorities from Brazil
Malta, M., de Jesus, J. G., LeGrand, S., Seixas, M., Benevides, B., Silva, M. D. D., Lana, J. S., Huynh, H. V., Belden, C. M., & Whetten, K. (2020) · Global Public Health · doi:10.1080/17441692.2020.1767676 · Cited by 46 · see citing works
Posttraumatic Stress Symptoms and its Association with Rumination, Thought Suppression and Experiential Avoidance: a Systematic Review and Meta-Analysis
Miethe, S., Wigger, J., Wartemann, A., Fuchs, F. O., & Trautmann, S. (2023) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-023-10022-2 · Cited by 55 · see citing works
Religious Attitudes, Homophobia, and Professional Counseling
Bowers, R., Minichiello, V., & Plummer, D. (2010) · Journal of LGBTQ Issues in Counseling · doi:10.1080/15538605.2010.481961 · Cited by 41 · see citing works
“The Gay, Lesbian, and Straight Education Network ( GLSEN, 2003 ) conducted a National School Climate Survey of gay, lesbian, bisexual, and transgendered students in the United States.”
Background
Process-based functional analysis can help behavioral science step up to novel challenges: COVID - 19 as an example
Hayes, S. C., Hofmann, S. G., & Stanton, C. E. (2020) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2020.08.009 · Cited by 39 · see citing works
Gender, Sexual Orientation, and Rape Myth Acceptance: Preliminary Findings From a Sample of Primarily LGBQ-Identified Survey Respondents
Schulze, C., & Koon‐Magnin, S. (2017) · Violence and Victims · doi:10.1891/0886-6708.vv-d-15-00017 · Cited by 31 · see citing works
The Experience of Sexual Stigma and the Increased Risk of Attempted Suicide in Young Brazilian People from Low Socioeconomic Group
Costa, Â. B., Pasley, A., Machado, W. D. L., Portalino, E. A., Dutra-Thomé, L., & Koller, S. H. (2017) · Frontiers in Psychology · doi:10.3389/fpsyg.2017.00192 · Cited by 31 · see citing works
“Non-heterosexuals (or those perceived to be non-heterosexual) are often subject to a slew of prejudice and discrimination such as bullying (Poteat and Espelage, 2005), physical abuse (Saewyc et al., 2004), sexual abuse (Gold and Marx, 2007), and violence (Gruenewald, 2012).”
Background
Minority Stress Theory and Internalized Homophobia among LGB Sexual Assault Survivors: Implications for Posttraumatic Adjustment
Binion, K., & Gray, M. J. (2020) · Journal of Loss and Trauma · doi:10.1080/15325024.2019.1707987 · Cited by 31 · see citing works
“This assessment could orient clinicians to potential cognitive distortions (Jackson et al., 2017), experiential avoidance (Gold et al., 2009), and risk factors that may be adversely impacting psychological functioning (Gold et al., 2007).”
Background
Future directions in studies of trauma among ethnoracial and sexual minority samples: Commentary.
Triffleman, E., & Pole, N. (2010) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0020225 · Cited by 30 · see citing works
Mental health during the COVID-19 pandemic: exploring the role of psychological flexibility and stress-related variables.
Prudenzi, A., Graham, C. D., Rogerson, O., & O’Connor, D. B. (2023) · Psychology & Health · doi:10.1080/08870446.2021.2020272 · Cited by 27 · see citing works
“…at times of great difficulty, such as wars (Tol et al., 2020), school shootings, devastating storms, or violent crime (e.g. Brockman et al., 2016; Gold & Marx 2007; Kumpula et al., 2011), higher psychological flexibility can help people function effectively even when experiencing strong emotions…”
BackgroundResult
Internalized transphobia, nondisclosure of gender identity, and life satisfaction among transgender and non-binary adults: The moderating roles of psychological flexibility and inflexibility
Flynn, M. K., & Bhambhani, Y. (2021) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2021.04.008 · Cited by 29 · see citing works
Cognitive-Behavioral Erectile Dysfunction Treatment for Gay Men
Hart, T. A., & Schwartz, D. R. (2010) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2009.04.009 · Cited by 26 · see citing works
Relationship Between Childhood Sexual Abuse and HIV-Related Risks Among Men Who Have Sex with Men: Findings from Mainland China
Xu, W., Zheng, L., Song, J., Zhang, X., Zhang, X., & Zheng, Y. (2017) · Archives of Sexual Behavior · doi:10.1007/s10508-017-1104-4 · Cited by 26 · see citing works
“Additionally, researchers could examine trauma-relatedprocesses (e.g., experiential avoidanceand internalized homophobia) (Fortier et al., 2009; Gold & Marx, 2007; Rosenthal et al., 2005) as possible mediators underlying the associations between CSA and mentalhealth (e.g., psychological…”
Background
Sexual minority status and trauma symptom severity in men living with HIV/AIDS
Kamen, C. S., Flores, S., Taniguchi, S., Khaylis, A., Lee, S. S., Koopman, C., & Gore-Felton, C. E. (2011) · Journal of Behavioral Medicine · doi:10.1007/s10865-011-9329-5 · Cited by 25 · see citing works
“For example, one study showed that internalized homophobia was a stronger predictor of traumarelated symptoms than assault severity in gay-identified men who have survived sexual assault ( Gold et al. 2007 ).”
Background
Investigating the role of psychological inflexibility, mindfulness, and self-compassion in PTSD
Cheng, Z. H., Lozier, C. C., Lewis, M. M., O'Neil, M. E., Luoma, J. B., & Morasco, B. J. (2021) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2021.10.004 · Cited by 22 · see citing works
Towards a more integrated and gender-sensitive care delivery for victims of sexual assault: key findings and recommendations from the Belgian sexual assault care centre feasibility study
Hendriks, B., Vandenberghe, A., Peeters, L., Roelens, K., & Keygnaert, I. (2018) · International Journal for Equity in Health · doi:10.1186/s12939-018-0864-3 · Cited by 22 · see citing works
Methamphetamine addiction: biological foundations, psychological factors, and social consequences
(2009) · Choice Reviews Online · doi:10.5860/choice.47-0902 · Cited by 22 · see citing works
The effects of sexual and gender minority stress on relationship functioning: A meta‐analysis
Bresin, K., Nicholas, J. K., Cowand, A., Alacha, H. F., Rodriguez, A. M., & Parrott, D. J. (2023) · Personal Relationships · doi:10.1111/pere.12511 · Cited by 21 · see citing works
Child sexual abuse/exploitation and LGBTQI+ children: Context, links, vulnerabilities, gaps, challenges and priorities
Capaldi, M. P., Schatz, J., & Kavenagh, M. (2024) · Child Protection and Practice · doi:10.1016/j.chipro.2024.100001 · Cited by 23 · see citing works
Diskriminierung von Lesben, Schwulen und Bisexuellen
Steffens, M. C., & Wagner, C. (2009) · VS Verlag für Sozialwissenschaften eBooks · doi:10.1007/978-3-531-91621-7_12 · Cited by 20 · see citing works
Needs of Male Sexual Assault Victims in the U.S. Armed Forces
Matthews, M., Farris, C. A., Tankard, M. E., & Dunbar, M. S. (2018) · Rand health quarterly · doi:10.7249/rhq-08-02-07 · Cited by 17 · see citing works
Lesbian, Gay, and Bisexual Identity as a Moderator of Relationship Functioning After Sexual Assault
Gemberling, T. M., Cramer, R. J., Miller, R. S., Stroud, C. H., Noland, R. M., & Graham, J. M. (2014) · Journal of Interpersonal Violence · doi:10.1177/0886260514563834 · Cited by 17 · see citing works
“The results of Hypothesis 2 are in line with the limited literature (e.g., Coxell & King, 2010; Gold et al., 2009; Gold et al., 2007) connecting sexual assault victimization and LGB identity components.”
Result
Minority stress and mental health in lesbian, gay, bisexual, transgender, and queer survivors of sexual assault
Bedford, C. E., Trotter, A. M., Potter, M. R., & Schmidt, N. B. (2023) · Journal of Traumatic Stress · doi:10.1002/jts.22970 · Cited by 15 · see citing works
An Exploration of Factors that Mediate the Relationship Between Adverse Childhood Experiences and Sexual Assault Victimization Among LGBTQ+ College Students
Sutton, T. E., Edwards, K. M., Siller, L., & Shorey, R. C. (2021) · Child Maltreatment · doi:10.1177/10775595211041970 · Cited by 13 · see citing works
La otra migración. Historias de discriminación de personas que vivieron con VIH en México
Martínez, D. H.-R. (2008) · LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) · Cited by 13 · see citing works
Adverse Childhood Experiences, Suicidal/Self-Harming Thoughts, and Suicide Attempts Among LGB and Heterosexual Utahns
McGraw, J. S., McManimen, S. L., Chinn, J., Angoff, H. D., Docherty, M., & Mahoney, A. (2021) · Journal of Homosexuality · doi:10.1080/00918369.2021.1909396 · Cited by 12 · see citing works
“Similarly, Gold, Marx, and Lexington (2007) found that gay male sexual assault survivors reported higher levels of negative feelings about their sexual orientation than community samples of gay men.”
Background
Childhood Sexual Abuse and Associated Suicidal Ideation and Attempts Among Gay and Bisexual Men in China: A Moderated Mediation Model
Xue, S., & Xu, W. (2022) · Journal of Interpersonal Violence · doi:10.1177/08862605221104528 · Cited by 10 · see citing works
ACEs, sexual violence, and sexual health
Wekerle, C., Hébert, M., Daigneault, I., Fortin-Langelier, E., & Smith, S. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-816065-7.00006-9 · Cited by 9 · see citing works
Psychosocial and Behavioral Correlates of Internalized Homonegativity in Midlife and Older Gay and Bisexual Men
Jacobs, R. J., Kane, M. N., & Sklar, E. M. (2019) · Journal of Applied Gerontology · doi:10.1177/0733464819843057 · Cited by 9 · see citing works
Giftedness, Gender Identities, and Self-Acceptance: A Retrospective Study on LGBTQ+ Postsecondary Students
Lo, C. O., Hu, S., Sungur, H., & Lin, C.-H. (2021) · Gifted Child Quarterly · doi:10.1177/00169862211029681 · Cited by 10 · see citing works
“When this belief is indoctrinated into the LGBTQ+ mind, it can lead to self-loathing and selfbelittling thoughts and behaviors (McDermott et al., 2008; Meyer & Dean, 1998), which may further result in psychopathological symptoms (Amadio, 2006; Gold & Marx, 2007).”
Background
Internalised homonegativity and depressive symptoms: a meta-analysis
Mercan, M. N., Güvenç, İ. B., & Cingöz-Ulu, B. (2024) · Psychology and Sexuality · doi:10.1080/19419899.2024.2400187 · Cited by 7 · see citing works
Does sexual orientation moderate the relationship between posttraumatic cognitions and mental health outcomes following sexual assault?
Newins, A. R., Wilson, L. C., & Kanefsky, R. Z. (2020) · Psychology and Sexuality · doi:10.1080/19419899.2020.1729846 · Cited by 7 · see citing works
“These beliefs may also stem from internalised homophobia, which has been linked to sexual minority survivors believing they deserved to victimised or were targeted because of their sexual orientation (Dillon, 2001, as cited in Gold et al., 2007).”
Background
Chronic Stress, Regulation of Emotion, and Functional Activity of the Brain
Ragen, B., Roach, A. E., & Chollak, C. (2016) · Elsevier eBooks · doi:10.1016/b978-0-12-800951-2.00029-7 · Cited by 8 · see citing works
Male Survivors of Sexual Assault: To tell or not to tell?
Pitfield, C. (2013) · UEL Research Repository (University of East London) · doi:10.15123/pub.3442 · Cited by 7 · see citing works
Sexual Minority Status and Psychotic Experiences Among Young Adult College Students in the United States
Oh, H. Y., Jacob, L., Smith, L., Leaune, É., Zhou, S., Shin, J. I., & Koyanagi, A. (2022) · Journal of Homosexuality · doi:10.1080/00918369.2022.2132582 · Cited by 6 · see citing works
“Moreover, our study did not examine other linkages or explanatory factors (e.g., rejection sensitivity (Anglin et al., 2016), internalized homophobia (Gold et al., 2009; Gold & Marx, 2007), which may have resulted in omitted variable bias.”
Background
Perceptions of sexual violence among men who have sex with men and individuals on the trans-feminine spectrum in Mongolia
Peitzmeier, S. M., Stephenson, R. B., Delegchoimbol, A., Dorjgotov, M., & Baral, S. (2015) · Global Public Health · doi:10.1080/17441692.2015.1114133 · Cited by 5 · see citing works
“Homophobia may still be an issue impacting experiences and perceptions of rape in these populations, as internalised homophobia among gay male rape survivors has been shown to be more predictive of PTSD and depressive symptoms after an assault than assault severity (Gold et al., 2007).”
BackgroundInfluential
The Role of Experiential Avoidance in Trauma, Substance Abuse, and Other Experiences
Pepper, S. E. (2012) · doi:10.12794/metadc149651 · Cited by 5 · see citing works
Rejoinder and an Update
Szymanski, D. M., & Kashubeck‐West, S. (2008) · The Counseling Psychologist · doi:10.1177/0011000008320078 · Cited by 4 · see citing works
The Moderation Effect of Generation on the Relationship between Psychological Flexibility and Covid-19 Preventive Behaviour among Females
Kotta, I. (2020) · The Proceedings of the International Conference on Humanities, Psychology and Social Sciences. · doi:10.33422/11th.hpsconf.2020.12.94 · Cited by 4 · see citing works
“Lower psychological flexibility has been found to predict trauma and mental health problems in the context of natural disasters, school shootings, and violent crimes (e.g., Gold et al., 2007; Kumpula et al., 2011; Marshall and Brockman, 2016).”
Background
Cognitive behaviour therapy
Stallard, P. (2014) · Routledge eBooks · doi:10.4324/9780203098714-6 · Cited by 4 · see citing works
Sexual orientation and health : general and minority stress factors explaining health differences between lesbian, gay, bisexual and heterosexual individuals
Kuyper, L. (2011) · Data Archiving and Networked Services (DANS) · Cited by 3 · see citing works
Masculinity matters: Perceptions of one's own gender status and the effects on psychosocial well being among gay men
Whicker, D. R. (2016) · e-Publications@Marquette (Marquette University) · Cited by 3 · see citing works
The Relationship Between Posttraumatic Stress Disorder and Alcohol Misuse and Smoking Among Aging Men Who Have Sex With Men: No Evidence of Exercise or Volunteering Impact
Barrett, B. W., Meanley, S., Brennan‐Ing, M., Haberlen, S., Ware, D. P., Detels, R., Friedman, M. R., & Plankey, M. W. (2023) · Journal of Aging and Health · doi:10.1177/08982643231215475 · Cited by 2 · see citing works
“We selected covariates in this analysis based on a literature review (Desrichard et al., 2018; DiGrande et al., 2008; Frazier et al., 2018; Gold & Marx, 2007; McMillan et al., 2020; Regan et al., 2016; Ursoiu et al., 2018; Williamson, 2000) and expert knowledge, with covariates chosen to minimize…”
Sexual Orientation and Health
Frost, D. M. (2019) · Cited by 2 · see citing works
Interpersonal trauma in gay men: A systematic review of post-aggression risk and protective factors for PTSD
Lépine, O., Brillon, P., & Lebel, S. (2023) · Journal of Gay & Lesbian Mental Health · doi:10.1080/19359705.2023.2239740 · Cited by 2 · see citing works
“Finally, experiential avoidance did not significantly mediate the association between childhood physical abuse and PTSD symptoms (Gold et al., 2007).”
Influential
HIV-Related Post-Traumatic Stress Disorder: Psychological distress among a sample of individuals recently diagnosed with HIV
Martin, L. I. (2008) · SUNScholar (Stellenbosch University) · Cited by 2 · see citing works
Correlates of Well-Being Following Anti-LGBT Trauma or Discrimination
Wootten, S. E. (2018) · TSpace (University of Toronto) · Cited by 2 · see citing works
Posttraumatic stress symptoms and its association with rumination, thought suppression and experiential avoidance: A systematic review and meta-analysisPreprint
Miethe, S., Wigger, J., Wartemann, A., & Trautmann, S. (2022) · doi:10.31234/osf.io/egv6t · Cited by 2 · see citing works
An Internet-Based Intervention to Increase the Ability of Lesbian, Gay, and Bisexual People to Cope With Adverse Events: Single-Group Feasibility Study
Isbășoiu, A. B., Sava, F. A., Larsen, T. M. B., Anderssen, N., Rotaru, T.-S., Rusu, A., Sălăgean, N., & Tulbure, B. T. (2024) · JMIR Formative Research · doi:10.2196/56198 · Cited by 1 · see citing works
“It also mediates the relationship between internalized homophobia and the severity of depressive symptoms [19].”
Background
Exploring the Increased Risk of Post-Traumatic Stress Following a Sexual Assault: Implications for Individuals Who Identify as a Sexual Minority
Murphy-Oikonen, J., Vis, J., & Egan, R. (2023) · Trauma Care · doi:10.3390/traumacare3040029 · Cited by 1 · see citing works
“These messages lead to devaluation and poor self-regard in the individual and have been linked to shame, psychological distress, loneliness, lower self-esteem, and greater substance use [15,66].”
BackgroundInfluential
Culture, Sexual Orientation, and Distress Among LGBQ Asian and Pacific Islander Individuals
Kase, C. A., Chong, E. S. K., & Mohr, J. J. (2024) · The Counseling Psychologist · doi:10.1177/00110000241305649 · Cited by 1 · see citing works
“For example, perfectionism may play a role in the development of both norm conformity (Wang, 2010) and internalized homonegativity (Gold & Marx, 2007).”
Trauma Treatment Considerations for Sexual Minoritized Veterans
Taylor, L. M., Davis, B. C., & Bannister, J. A. (2025) · Journal of LGBTQ Issues in Counseling · doi:10.1080/26924951.2024.2439596 · Cited by 1 · see citing works
The role of queer people of colour identity affirmation on psychological flexibility amid everyday discrimination among Black sexual and gender minority adults
Keene, L. C., Maglalang, D. D., Yoo, N., & Deulofeutt, S. R. (2026) · Psychology and Sexuality · doi:10.1080/19419899.2026.2663547 · Cited by 1 · see citing works
Resilience Through Relational Connection: A Relational Model to Sexual Minority Mental and Physical Health
Mereish, E. H. (2014) · Cited by 1 · see citing works
The rape and sexual assault of men - a review of the
Burrowes, N., & Horvath, T. (2013) · Cited by 1 · see citing works
Exploring the Relationship between Social Support, Academic Performance, and Measures of Well-Being of LGBTQIA2S+ College Students at a Midwestern University
Lee, B., & Paliliunas, D. (2024) · Behavior and Social Issues · doi:10.1007/s42822-024-00176-3 · Cited by 1 · see citing works
“Research has suggested that experiential avoidance may mediate the relationship between experiences of internalized homophobia and depression (Gold & Marx, 2007).”
Acceptance and commitment therapy and depression: the development of a depression specific process measure
Cooper, E. (2009) · Research Online (University of Wollongong) · Cited by 1 · see citing works
Evaluating Process Variables in Acceptance and Commitment Therapy
Lugt, A. A. V. (2011) · doi:10.12794/metadc84296 · Cited by 1 · see citing works
Development and Validation of a Measure of Religious and Spiritual Flexibility
Schmalz, J. E. (2014) · doi:10.12794/metadc700031
Investigating constructions of masculinity in men's talk of male rape.
Field, S. A. (2010) · University of the Witwatersrand, Johannesburg Institutional Repository on DSpace (University of the Witwatersrand, Johannesburg)
The impact of verbal victimization on psychopathology in LGB youths who have experienced trauma : the roles of self-criticism and internalized homophobia.
Armelie, A. P. (2009) · OhioLink ETD Center (Ohio Library and Information Network)
Rate at Which Lesbian, Gay, and Bisexual Citizens Are Victims of Physical Assaults Due to Their Sexual Orientation
Jones, J. R. (2015)
Mock Juror Effects of Blame and Conviction in Rape Cases: Do Attitudes, Beliefs, and Contact with Homosexuals Matter?
Hurst-McCaleb, D. (2016) · doi:10.12794/metadc849652
Mental Health, Identity and Coping Following Hate Crime Victimization
Wootten, S. E. (2012) · TSpace (University of Toronto)
Self murder: suicide and the intolerable state of a fragmented self.
Chamberlain, P. (2011) · Adelaide Research & Scholarship (AR&S) (University of Adelaide)
Paranoia and Sexual Orientation: A Hermeneutic Literature Review
Wilson, P. M. (2017) · Tuwhera (Auckland University of Technology) · doi:10.13140/rg.2.2.36620.49286
It's About Survivors, Not Sex: Exploring Future Aspirations of Undergraduate Survivors of Sexual Assault
Podarita, I., & Scott, C. L. (2025) · Contemporary perspectives on family research · doi:10.1108/s1530-353520250000030004
Internalized homophobia, alcohol use, and risky sexual behaviors : the buffering role of DBT coping skills
Worhach, M. J. (2016) · doi:10.54014/8pw9-eth0
Differential Effects of Anxiety Sensitivity and Attitudes Toward Violence on Posttraumatic Stress Symptoms Between Interpersonal Trauma Types
Quiles, J. R. G., Morabito, D. M., Potter, M. R., & Schmidt, N. B. (2025) · Journal of Interpersonal Violence · doi:10.1177/08862605251384901
Exploring associations between sexual orientation, substance use, loneliness, and sense of belonging in a large college sample
Lippi, S. L. P., Witherell, S. M., Minnigh, T. L., & Lipson, S. K. (2026) · Journal of American College Health · doi:10.1080/07448481.2026.2678238
“Mental health difficulties (e.g., depression, anxiety) are common among college students, especially those with a lower sense of belonging, 33,34,65,66 and during the transition to college and throughout the first year of college.”
Violence on the self: Exploring the intersection of trauma and identity among sexual and gender minorities from a neurobiological and developmental perspective to advance our understanding of PTSD, moral injury, and dissociation symptoms
Nicholson, A. A., Siegel, M., Villeneuve, A. H., Angeletti, L. L., Fani, N., Hatchard, T., Northoff, G., Lanius, R. A., Pichtikova, M., Hosseini‐Kamkar, N., et al. (2026) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2026.106841 · Cited by 1 · see citing works

Psychological Outcomes Among Lesbian Sexual Assault Survivors: An Examination of the Roles of Internalized Homophobia and Experiential Avoidance
Gold, S. D., Dickstein, B. D., Marx, B. P., & Lexington, J. M. (2009) · Psychology of Women Quarterly · doi:10.1111/j.1471-6402.2008.01474.x · Cited by 65 · see citing works
Self-citation
Internalized Homophobia: A Factor in Depression, Anxiety, and Suicide in the Gay and Lesbian Population
Igartua, K. J., Gill, K. J., & Montoro, R. (2003) · Canadian Journal of Community Mental Health · doi:10.7870/cjcmh-2003-0011 · Cited by 207 · see citing works
Internalized Homophobia and Psychosexual Adjustment among Gay Men
Dupras, A. (1994) · Psychological Reports · doi:10.2466/pr0.1994.75.1.23 · Cited by 73 · see citing works
10. Internalized Homophobia, Pathological Grief, and High Risk Sexual Behavior in a Gay Man with Multiple Psychiatric Disorders
(2008) · Columbia University Press eBooks · doi:10.7312/frie12056-014
Childhood physical abuse, internalized homophobia, and experiential avoidance among lesbians and gay men.
Gold, S. D., Feinstein, B. A., Skidmore, W. C., & Marx, B. P. (2010) · Psychological Trauma Theory Research Practice and Policy · doi:10.1037/a0020487 · Cited by 43 · see citing works
Self-citation

Authors: Gold, S. D., Marx, B. P., & Lexington, J. M.
Affiliations: Temple University (US)
Corresponding author: Marx, Brian P.
ORCID: Marx, Brian P.
Venue: Behaviour Research and Therapy
Publisher: Elsevier BV
Published: 2007-03
Volume: 45
Issue: 3
Pages: 549-562
ISSN: 0005-7967 (ISSN-L)
DOI: 10.1016/j.brat.2006.05.006
OpenAlex: W2072218636
Cited by: 104
References: 73
Citations by year: 2026: 5 · 2025: 3 · 2024: 5 · 2023: 7 · 2022: 4 · 2021: 5 · 2020: 11 · 2019: 4 · 2018: 3 · 2017: 8 · 2016: 7 · 2015: 3 · 2014: 8 · 2013: 3 · 2012: 3
FWCI: 6.52
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Behaviour Research and Therapy (publishedVersion)
PubMed (publishedVersion)
Funders: Temple University
Topics: Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Social Sciences › Gender Studies › Sexual Assault and Victimization Studies
Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
Keywords: internalized homophobia, experiential avoidance, post-traumatic stress disorder, depression, mediation, sexual minority mental health
MeSH terms: Adaptation, Psychological, Adolescent, Adult, Aged, Mental Disorders, Defense Mechanisms, Depressive Disorder, Homosexuality, Humans, Identification, Psychological, Life Change Events, Male, Middle Aged, Prejudice, Self Concept, Severity of Illness Index, Sex Offenses, Social Identification, Socioeconomic Factors, Stress Disorders, Post-Traumatic, Violence, Survivors, Crime Victims

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Gay male sexual assault survivors: The relations among internalized homophobia, experiential avoidance, and psychological symptom severity

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