A minority stress—emotion regulation model of sexual compulsivity among highly sexually active gay and bisexual men.
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OBJECTIVE: Sexual compulsivity represents a significant public health concern among gay and bisexual men, given its co-occurrence with other mental health problems and HIV infection. The purpose of this study was to examine a model of sexual compulsivity based on minority stress theory and emotion regulation models of mental health among gay and bisexual men. METHOD: Gay and bisexual men in New York City reporting at least nine past-90-day sexual partners (n = 374) completed measures of distal minority stressors (i.e., boyhood gender nonconformity and peer rejection, adulthood perceived discrimination), hypothesized proximal minority stress mediators (i.e., rejection sensitivity, internalized homonegativity), hypothesized universal mediators (i.e., emotion dysregulation, depression, and anxiety), and sexual compulsivity. RESULTS: The hypothesized model fit the data well (RMSEA = 0.05, CFI = 0.98, TLI = 0.95, SRMR = 0.03). Distal minority stress processes (e.g., adulthood discrimination) were generally found to confer risk for both proximal minority stressors (e.g., internalized homonegativity) and emotion dysregulation. Proximal minority stressors and emotion dysregulation, in turn, generally predicted sexual compulsivity both directly and indirectly through anxiety and depression. CONCLUSIONS: The final model suggests that gay-specific (e.g., internalized homonegativity) and universal (e.g., emotion dysregulation) processes represent potential treatment targets to attenuate the impact of minority stress on gay and bisexual men's sexual health. Tests of interventions that address these targets to treat sexual compulsivity among gay and bisexual men represent a promising future research endeavor.
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Difficulties in emotion regulation contribute to and maintain mental health issues such as depression and anxiety, as well as maladaptive coping behaviors among sexual minority men, including alcohol and substance use and sexual compulsivity.
“Difficulties in emotion regulation contribute to and maintain mental health issues (depression and anxiety) as well as maladaptive coping behaviors among sexual minority men including alcohol and substance use and sexual compulsivity (Pachankis et al., 2014).”
From Mindfulness for Reducing Minority Stress and Promoting Health Among Sexual Minority Men: Uncovering Intervention Principles and Techniques (2022) · cites this paper as Pachankis et al., 2014
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Experimental — accuracy not yet measuredPeer rejection significantly correlated with rejection sensitivity in two measurements.
“Peer rejection was measured twice and each found a significant correlation (Pachankis et al., 2015;Rosenbach & Renneberg, 2014).”
From The link between rejection sensitivity and borderline personality disorder: A systematic review and meta-analysis (2019) · cites this paper as Pachankis et al., 2015
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Daily minority stress and affect among gay and bisexual men: A 30-day diary study
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Gender Minority Stress and Depressive Symptoms in Transitioned Swiss Transpersons
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Self-citationGay-Related Rejection Sensitivity as a Risk Factor for Condomless Sex
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Self-citationHacking Stigma by Loving Yourself: a Mediated-Moderation Model of Self-Compassion and Stigma
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A biopsychosocial framework for understanding sexual and gender minority health: A call for action
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Self-citationDepression and Associated Factors Among Gay and Heterosexual Male University Students in Nigeria
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The Relationship Between Emotion Regulation and Sexual Function and Satisfaction: A Scoping Review
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Substance Use Stigma, Avoidance Coping, and Missed HIV Appointments Among MSM Who Use Substances
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Self-citationAcculturative stress, emotion regulation, and affective symptomology among Latino/a college students
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Self-citationHughto, J. M. W., Pachankis, J. E., & Reisner, S. L. (2018) · Psychology of Sexual Orientation and Gender Diversity · doi:10.1037/sgd0000296 · Cited by 57 · see citing works
Self-citationCohen, J. M., Feinstein, B. A., Rodriguez-Seijas, C. A., Taylor, C. B., & Newman, M. G. (2016) · Psychology of Sexual Orientation and Gender Diversity · doi:10.1037/sgd0000170 · Cited by 54 · see citing works
Rooney, B. M., Tulloch, T. G., & Blashill, A. J. (2018) · Archives of Sexual Behavior · doi:10.1007/s10508-017-1032-3 · Cited by 52 · see citing works
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Self-citationA Psychometric Review of Measures Assessing Discrimination Against Sexual Minorities
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Self-citationA Moderated Mediation Test of Minority Stress
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Hollinsaid, N. L., Pachankis, J. E., Bränström, R., & Hatzenbuehler, M. L. (2023) · Clinical Psychological Science · doi:10.1177/21677026231159050 · Cited by 45 · see citing works
Self-citationDevelopmental Cognitive Neuroscience of Adolescent Sexual Risk and Alcohol Use
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What is the role of the community? Examining minority stress processes among gay and bisexual men.
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Sexual Desire and Fantasies in the LGBT+ Community: Focus on Lesbian Women and Gay Men
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Toward Formulating Evidence-Based Principles of LGB-Affirmative Psychotherapy
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Self-citationDiversity and the Hierarchical Taxonomy of Psychopathology (HiTOP)
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Cain, D. N., Mirzayi, C. A., Rendina, H. J., Ventuneac, A., Grov, C., & Parsons, J. T. (2017) · LGBT Health · doi:10.1089/lgbt.2017.0002 · Cited by 35 · see citing works
Self-citationSexual orientation and sex-related substance use: The unexplored role of bisexuality
Taggart, T. C., Rodriguez-Seijas, C. A., Dyar, C., Elliott, J. C., Thompson, R. G., Hasin, D. S., & Eaton, N. R. (2018) · Behaviour Research and Therapy · doi:10.1016/j.brat.2018.12.012 · Cited by 33 · see citing works
Burton, C. L., Wang, K., & Pachankis, J. E. (2018) · Clinical Psychological Science · doi:10.1177/2167702618755321 · Cited by 31 · see citing works
Self-citationRodriguez-Seijas, C. A., Morgan, T. A., & Zimmerman, M. (2021) · Assessment · doi:10.1177/1073191121991922 · Cited by 31 · see citing works
Yi, M., Li, X., Chiaramonte, D., Sun, S., Pan, S., Soulliard, Z., Eisenstadt, B. E., Ljótsson, B., Hagaman, A., & Pachankis, J. (2024) · Behaviour Research and Therapy · doi:10.1016/j.brat.2024.104605 · Cited by 31 · see citing works
Self-citationDifficulties in Emotion Regulation and Problematic Pornography Use: The Mediating Role of Loneliness
Cardoso, J., Ramos, C., Brito, J., & Almeida, T. C. (2023) · International Journal of Sexual Health · doi:10.1080/19317611.2023.2224807 · Cited by 29 · see citing works
Experiential Avoidance and Emotion Dysregulation as Mediators in the LGBTQ Minority Stress Model
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Association between gender nonconformity and victimization: a meta-analysis
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Is “Coming Out” Still Relevant? Social Justice Implications for LGB‐Membered Families
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Adam, B. D., Hart, T. A., Mohr, J., Coleman, T. A., & Vernon, J. R. G. (2017) · Culture Health & Sexuality · doi:10.1080/13691058.2017.1309461 · Cited by 27 · see citing works
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Sun, S., Guy, A. A., Zelaya, D. G., & Operario, D. (2022) · Mindfulness · doi:10.1007/s12671-022-01973-w · Cited by 25 · see citing works
“Psychological distress, sexual risk, and service avoidance are responses driven by external and internal identity-based minority stressors (Pachankis et al., 2014, 2018, 2015a, 2015b; Storholm et al., 2016), yet psychosocial-based interventions for HIV/ STI prevention in this group have been…”
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Self-citationBisexual men’s sexual health: A test of minority stress theory.
Polihronakis, C. J., Velez, B. L., & Brewster, M. E. (2020) · Psychology of Men & Masculinity · doi:10.1037/men0000304 · Cited by 23 · see citing works
Syndemic Profiles and Sexual Minority Men’s HIV-Risk Behavior: A Latent Class Analysis
Scheer, J. R., Clark, K. A., Maiolatesi, A. J., & Pachankis, J. E. (2021) · Archives of Sexual Behavior · doi:10.1007/s10508-020-01850-4 · Cited by 22 · see citing works
Self-citationCOVID-19 health behaviors in a sexual minority sample: The impact of internalized stigma.
Solomon, D. T., Morey, K. E., Williams, C. J., Grist, C. L., & Malesky, L. A. (2021) · Psychology of Sexual Orientation and Gender Diversity · doi:10.1037/sgd0000466 · Cited by 21 · see citing works
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The role of bisexual-specific minority stressors in sexual compulsivity among bisexual men
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Abboud, S., Seal, D. W., Pachankis, J. E., Khoshnood, K., Khouri, D., Fouad, F. M., & Heimer, R. (2023) · Social Science & Medicine · doi:10.1016/j.socscimed.2023.116248 · Cited by 16 · see citing works
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Parmenter, J. G., Crowell, K. A., & Galliher, R. V. (2019) · Sex Roles · doi:10.1007/s11199-019-01067-3 · Cited by 16 · see citing works
LGBQ-affirming clinical recommendations for compulsive sexual behavior disorder
Jennings, T. L., Gleason, N., Pachankis, J. E., Bőthe, B., & Kraus, S. W. (2024) · Journal of Behavioral Addictions · doi:10.1556/2006.2024.00012 · Cited by 16 · see citing works
Self-citationThe relation of perceived social support to compulsive sexual behavior
Wizła, M., Glica, A., Gola, M. K., & Lewczuk, K. (2022) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2022.10.021 · Cited by 15 · see citing works
Compulsive Sexual Behavior Disorder and Problematic Pornography Use in the Context of Social Ties
Wizła, M., & Lewczuk, K. (2024) · Current Addiction Reports · doi:10.1007/s40429-024-00550-6 · Cited by 14 · see citing works
Rendina, H. J., López-Matos, J., Wang, K., Pachankis, J. E., & Parsons, J. T. (2018) · The Journal of Sex Research · doi:10.1080/00224499.2018.1453042 · Cited by 15 · see citing works
Self-citationWang, J., & Zheng, L. (2021) · Archives of Sexual Behavior · doi:10.1007/s10508-021-02039-z · Cited by 14 · see citing works
McCabe, C. J., Hipwell, A. E., Keenan, K. E., Stepp, S. D., Chung, T. A., & King, K. M. (2021) · Clinical Psychological Science · doi:10.1177/2167702621999359 · Cited by 13 · see citing works
Cienfuegos-Szalay, J., Moody, R. L., Talan, A. J., Grov, C., & Rendina, H. J. (2021) · The Journal of Sex Research · doi:10.1080/00224499.2021.1963649 · Cited by 13 · see citing works
Self-citationMaiolatesi, A. J., Wang, K., Burton, C. L., Harkness, A., Esserman, D. A., Safren, S., & Pachankis, J. (2022) · Self and Identity · doi:10.1080/15298868.2022.2125062 · Cited by 12 · see citing works
Self-citationPsychosocial Factors and HIV Prevention for Gay, Bisexual, and Other Men Who Have Sex with Men
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Duncan, D. T., Ransome, Y., Park, S. H., Jackson, S. D., Kawachi, I. I., Branas, C. C., Knox, J., Al‐Ajlouni, Y. A., Mountcastle, H., Miles, C. H., et al. (2021) · Social Science & Medicine · doi:10.1016/j.socscimed.2021.113913 · Cited by 13 · see citing works
Wang, K., Maiolatesi, A. J., Burton, C. L., Scheer, J. R., & Pachankis, J. E. (2021) · Psychology of Sexual Orientation and Gender Diversity · doi:10.1037/sgd0000503 · Cited by 13 · see citing works
Self-citationTrombetta, T., & Rollè, L. (2023) · Journal of Interpersonal Violence · doi:10.1177/08862605231201822 · Cited by 12 · see citing works
Abboud, S., Chaudhry, A. B., Taweh, O., & Pachankis, J. E. (2024) · SSM - Qualitative Research in Health · doi:10.1016/j.ssmqr.2024.100393 · Cited by 13 · see citing works
Self-citationPisula, E., Płatos, M., Banasiak, A., Danielewicz, D., Gosztyła, T., Podgórska-Jachnik, D., Pyszkowska, A., Rumińska, A., & Winczura, B. (2024) · Oficyna Wydawnicza "Impuls" eBooks · doi:10.62634/9788382943139 · Cited by 13 · see citing works
Huțul, T., Karner‐Huțuleac, A., Huțul, A., & Popescu, A. (2024) · International Journal of Sexual Health · doi:10.1080/19317611.2024.2329973 · Cited by 12 · see citing works
Hollinsaid, N. L., Pachankis, J. E., Mair, P., & Hatzenbuehler, M. L. (2023) · Emotion · doi:10.1037/emo0001198 · Cited by 12 · see citing works
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Peng, H., Su, Y., & Zheng, Y. (2024) · Sexuality Research and Social Policy · doi:10.1007/s13178-024-01028-w · Cited by 12 · see citing works
Morrison, S. A., Yoong, D., Hart, T. A., MacPherson, P. A., Bogoch, I. I., Sivarajah, V., Gough, K. A., Naccarato, M., & Tan, D. H. S. (2018) · PLoS ONE · doi:10.1371/journal.pone.0197998 · Cited by 12 · see citing works
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Self-citation
- Authors
- Pachankis, J. E., Rendina, H. J., Restar, A., Ventuneac, A., Grov, C., & Parsons, J. T.
- ORCID
- Venue
- Health Psychology
- Published
- 2015-08
- Volume
- 34
- Issue
- 8
- Pages
- 829-840
- ISSN
- 0278-6133 (ISSN-L)
- 1930-7810
- PMC
- PMC4476950
- OpenAlex
- W2333398650
- Cited by
- 185
- References
- 87
- Citations by year
- 2026: 16 · 2025: 12 · 2024: 26 · 2023: 20 · 2022: 13 · 2021: 19 · 2020: 12 · 2019: 12 · 2018: 19 · 2017: 18 · 2016: 7 · 2015: 9 · 2014: 1
- FWCI
- 17.31
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Health Psychology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01-MH087714, F31-MH095622)
- Topics
- Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
- Social Sciences › Psychology › Clinical Psychology › Sexuality, Behavior, and Technology
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- compulsive sexual behavior, minority stress, emotion regulation, gay men, bisexual men, internalized homophobia, rejection sensitivity, perceived discrimination, emotional dysregulation, depression, anxiety, sexual health, HIV risk
- MeSH terms
- Adolescent, Adult, Aged, Bisexuality, Compulsive Behavior, Emotions, Follow-Up Studies, Humans, Longitudinal Studies, Male, Men, Middle Aged, Minority Groups, Models, Psychological, New York City, Sexual Behavior, Sexual Partners, Stress, Psychological, Homosexuality, Male, Young Adult
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