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Archives of Sexual Behavior

, Volume 44, Issue 7, pp 1843–1860 | Cite as

A Transdiagnostic Minority Stress Treatment Approach for Gay and Bisexual Men’s Syndemic Health Conditions

  • John E. Pachankis
Special Section: Sexual Health in Gay and Bisexual Men

Abstract

Developing and deploying separate treatments for separate conditions seems ill-suited to intervening upon the co-occurring, and possibly functionally similar, psychosocial conditions facing gay and bisexual men. This article argues for the need to create transdiagnostic interventions that reduce multiple syndemic conditions facing gay and bisexual men at the level of their shared source in minority stress pathways. This article first reviews psychosocial syndemic conditions affecting gay and bisexual men, then suggests pathways that might link minority stress to psychosocial syndemics based on recent advancements in emotion science, psychiatric nosology, and cognitive-affective neuroscience, and finally suggests cross-cutting psychosocial treatment principles to reduce minority stress−syndemic pathways among gay and bisexual men. Because minority stress serves as a common basis of all psychosocial syndemic conditions reviewed here, locating the pathways through which minority stress generates psychosocial syndemics and employing overarching treatment principles capable of simultaneously alleviating these pathways will ultimately create a transdiagnostic approach to improving gay and bisexual men’s health. Clinical research and training approaches are suggested to further validate the pathways suggested here, establish the efficacy of treatment approaches tied to those pathways, and generate effective methods for disseminating a transdiagnostic minority stress treatment approach for gay and bisexual men’s psychosocial syndemic health.

Keywords

Gay and bisexual men HIV prevention Syndemic Psychotherapy Mental health intervention Sexual orientation 

Notes

Acknowledgments

The preparation of this article was supported by a research grant from the National Institute of Mental Health (R34-MH096607; John E. Pachankis, Principal Investigator). The content is solely the responsibility of the author and does not necessarily represent the official views of the National Institutes of Health.

References

  1. Abramson, L. Y., Seligman, M. E., & Teasdale, J. D. (1978). Learned helplessness in humans: Critique and reformulation. Journal of Abnormal Psychology, 87(1), 49–74. doi: 10.1037/0021-843X.87.1.49.PubMedCrossRefGoogle Scholar
  2. Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review, 30(2), 217–237. doi: 10.1016/j.cpr.2009.11.004.PubMedCrossRefGoogle Scholar
  3. Austin, S. B., Ziyadeh, N., Kahn, J. A., Camargo, C. A., Colditz, G. A., & Field, A. E. (2004). Sexual orientation, weight concerns, and eating-disordered behaviors in adolescent girls and boys. Journal of the American Academy of Child and Adolescent Psychiatry, 43(9), 1115–1123. doi: 10.1097/01.chi.0000131139.93862.10.PubMedCrossRefGoogle Scholar
  4. Ayduk, O., Mendoza-Denton, R., Mischel, W., Downey, G., Peake, P. K., & Rodriguez, M. (2000). Regulating the interpersonal self: Strategic self-regulation for coping with rejection sensitivity. Journal of Personality and Social Psychology, 79(5), 776–792. doi: 10.1037/0022-3514.79.5.776.PubMedCrossRefGoogle Scholar
  5. Badgett, M. L. (1995). The wage effects of sexual orientation discrimination. Industrial and Labor Relations Review, 48, 726–739. doi: 10.2307/2524353.CrossRefGoogle Scholar
  6. Balsam, K. F., Rothblum, E. D., & Beauchaine, T. P. (2005). Victimizatino over the life span: A comparison of lesbian, gay, bisexual, and heterosexual siblings. Journal of Consulting and Clinical Psychology, 73(3), 477–487. doi: 10.1037/0022-006X.73.3.477.PubMedCrossRefGoogle Scholar
  7. Bancroft, J., Carnes, L., Janssen, E., Goodrich, D., & Long, J. S. (2005). Erectile and ejaculatory problems in gay and heterosexual men. Archives of Sexual Behavior, 34(3), 285–297. doi: 10.1007/s10508-005-3117-7.PubMedCrossRefGoogle Scholar
  8. Bandura, A. (1990). Perceived self-efficacy in the exercise of control over AIDS infection. Evaluation and Program Planning, 13(1), 9–17. doi: 10.1016/0149-7189(90)90004-G.CrossRefGoogle Scholar
  9. Barlow, D. H., Allen, L. B., & Choate, M. L. (2004). Toward a unified treatment for emotional disorders. Behavior Therapy, 35(2), 205–230. doi: 10.1016/S0005-7894(04)80036-4.CrossRefGoogle Scholar
  10. Barlow, D. H., Farchione, T. J., Fairholme, C. P., Ellard, K. K., Boisseau, C. L., Allen, L. B., & Ehrenreich-May, J. (2011). Unified protocol for transdiagnostic treatment of emotional disorders: Therapist guide. New York: Oxford University Press.Google Scholar
  11. Batten, S. V., Follette, V. M., & Aban, I. B. (2002). Experiential avoidance and high-risk sexual behavior in survivors of child sexual abuse. Journal of Child Sexual Abuse, 10(2), 101–120. doi: 10.1300/J070v10n02_06.CrossRefGoogle Scholar
  12. Baum, M. D., & Fishman, J. M. (1994). AIDS, sexual compulsivity, and gay men: A group treatment approach. In S. A. Cadwell, R. A. Burnham Jr, & M. Forstein (Eds.), Therapists on the front line: Psychotherapy with gay men in the age of AIDS (pp. 255–274). Arlington, VA: American Psychiatric Association.Google Scholar
  13. Baumeister, R. F. (1997). Esteem threat, self-regulatory breakdown, and emotional distress as factors in self-defeating behavior. Review of General Psychology, 1(2), 145–174. doi: 10.1037/1089-2680.1.2.145.CrossRefGoogle Scholar
  14. Baumeister, R. F., Heatherton, T. F., & Tice, D. M. (1994). Losing control: How and why people fail at self-regulation. San Diego, CA: Academic Press.Google Scholar
  15. Bickel, W. K., & Marsch, L. A. (2001). Toward a behavioral economic understanding of drug dependence: Delay discounting processes. Addiction, 96(1), 73–86. doi: 10.1046/j.1360-0443.2001.961736.x.PubMedCrossRefGoogle Scholar
  16. Borkovec, T. D., Ray, W. J., & Stöber, J. (1998). Worry: A cognitive phenomenon intimately linked to affective, physiological, and interpersonal behavioral processes. Cognitive Therapy and Rsearch, 22(6), 561–576. doi: 10.1023/A:1018790003416.CrossRefGoogle Scholar
  17. Bourdieu, P. (1990). The logic of practice. Stanford University Press.Google Scholar
  18. Brady, K. T., & Sinha, R. (2007). Co-occurring mental and substance use disorders: the neurobiological effects of chronic stress. FOCUS, 5(2), 229–239.CrossRefGoogle Scholar
  19. Bremner, J. D., Vermetten, E., Schmahl, C., Vaccarino, V., Vythilingam, M., … Charney, D. (2005). Positron emission tomographic imaging of neural correlates of a fear acquisition and extinction paradigm in women with childhood sexual-abuse-related post-traumatic stress disorder. Psychological Medicine, 35(6), 791–806. doi: 10.1017/S0033291704003290.
  20. Brennan, D. J., Craig, S. L., & Thompson, D. E. A. (2012). Factors associated with a drive for muscularity among gay and bisexual men. Culture Health and Sexuality, 14(1), 1–15. doi: 10.1080/13691058.2011.619578.CrossRefGoogle Scholar
  21. Brubaker, M. D., Garrett, M. T., & Dew, B. J. (2009). Examining the relationship between internalized heterosexism and substance abuse among lesbian, gay, and bisexual individuals: A critical review. Journal of LGBT Issues in Counseling, 3(1), 62–89. doi: 10.1080/15538600902754494.CrossRefGoogle Scholar
  22. Bydlowski, S., Corcos, M., Jeammet, P., Paterniti, S., Berthoz, S., Laurier, C., et al. (2005). Emotion-processing deficits in eating disorders. International Journal of Eating Disorders, 37(4), 321–329. doi: 10.1002/eat.20132.PubMedCrossRefGoogle Scholar
  23. Cacioppo, J. T., Ernst, J. M., Burleson, M. H., McClintock, M. K., Malarkey, W. B., Hawkley, L. C., … Berntson, G. G. (2000). Lonely traits and concomitant physiological processes: The MacArthur social neuroscience studies. International Journal of Psychophysiology, 35(2–3), 143–154. doi: 10.1016/s0167-8760(99)00049-5.
  24. Carter, P. L., & Reardon, S. F. (2014). Inequality matters: A William T. Grant Foundation inequality paper. New York, NY: William T. Grant Foundation.Google Scholar
  25. Carvalho, A. F., Lewis, R. J., Derlega, V. J., Winstead, B. A., & Viggiano, C. (2011). Internalized sexual minority stressors and same-sex intimate partner violence. Journal of Family Violence, 26(7), 501–509. doi: 10.1007/s10896-011-9384-2.CrossRefGoogle Scholar
  26. Centers for Disease Control and Prevention. (2013). HIV and AIDS among gay and bisexual men. Atlanta, GA: Centers for Disease Control and Prevention. doi: 10.1007/978-1-4614-5283-6_17.Google Scholar
  27. Chorpita, B. F., & Barlow, D. H. (1998). The development of anxiety: The role of control in the early environment. Psychological Bulletin, 124(1), 3–21. doi: 10.1037/0033-2909.124.1.3.PubMedCrossRefGoogle Scholar
  28. Cochran, S. D. (2001). Emerging issues in research on lesbians’ and gay men’s mental health: Does sexual orientation really matter? The American Psychologist, 56(11), 931–947. doi: 10.1037/0003-066x.56.11.931.PubMedCrossRefGoogle Scholar
  29. Cochran, S. D., Grella, C. E., Mays, V., et al. (2012). Do substance use norms and perceived drug availability mediate sexual orientation differences in patterns of substance use? Results from the California Quality of Life Survey II. Journal of Studies on Alcohol and Drugs, 73(4), 675–685.PubMedCentralPubMedCrossRefGoogle Scholar
  30. Cole, S. W., Kemeny, M. E., & Taylor, S. E. (1997). Social identity and physical health: accelerated HIV progression in rejection-sensitive gay men. Journal of Personality and Social Psychology, 72(2), 320–335. doi: 10.1037/0022-3514.72.2.320.PubMedCrossRefGoogle Scholar
  31. Cook, J. E., Purdie-Vaughns, V., Meyer, I. H., & Busch, J. T. (2014). Intervening within and across levels: A multilevel approach to stigma and public health. Social Science and Medicine, 103, 101–109. doi: 10.1016/j.socscimed.2013.09.023.PubMedCrossRefGoogle Scholar
  32. Corley, M. D., & Kort, J. (2006). The sex addicted mixed-orientation marriage: Examining attachment styles, internalized homophobia, and viability of marriage after disclosure. Sexual Addiction and Compulsivity, 13, 167–193. doi: 10.1080/10720160600870737.CrossRefGoogle Scholar
  33. Courtenay, W. H. (2000). Constructions of masculinity and their influence on men’s well-being: A theory of gender and health. Social Science and Medicine, 50(10), 1385–1401. doi: 10.1016/s0277-9536(99)00390-1.PubMedCrossRefGoogle Scholar
  34. Crocker, J., & Major, B. (1989). Social stigma and self-esteem: The self-protective properties of stigma. Psychological Review, 96, 608–630. doi: 10.1037/0033-295X.96.4.608.CrossRefGoogle Scholar
  35. Dantzer, R., O’Connor, J. C., Freund, G. G., Johnson, R. W., & Kelley, K. W. (2008). From inflammation to sickness and depression: when the immune system subjugates the brain. Nature Reviews Neuroscience, 9(1), 46–56. doi: 10.1038/nrn2297.PubMedCentralPubMedCrossRefGoogle Scholar
  36. D’Augelli, A. R. (1998). Developmental implications of victimization of lesbian, gay, and bisexual youths. In G. M. Herek (Ed.), Stigma and sexual orientation: Understanding prejudice against lesbians, gay men, and bisexuals (pp. 187–210). Thousand Oaks, CA: Sage.CrossRefGoogle Scholar
  37. Dawe, S., & Loxton, N. J. (2004). The role of impulsivity in the development of substance use and eating disorders. Neuroscience and Biobehavioral Reviews, 28(3), 343–351. doi: 10.1016/j.neubiorev.2004.03.007.PubMedCrossRefGoogle Scholar
  38. Derks, B., Inzlicht, M., & Kang, S. (2008). The neuroscience of stigma and stereotype threat. Group Processes and Intergroup Relations, 11(2), 163–181. doi: 10.1177/1368430207088036.CrossRefGoogle Scholar
  39. Diaz, R. M., Ayala, G., Bein, E., Henne, J., & Marin, B. V. (2001). The impact of homophobia, poverty, and racism on the mental health of gay and bisexual Latino men: Findings from 3 U.S. cities. American Journal of Public Health, 91(6), 927–932. doi: 10.2105/ajph.91.6.927.PubMedCentralPubMedCrossRefGoogle Scholar
  40. DiClemente, C. C., Fairhurst, S. K., & Piotrowski, N. A. (1995). Self-efficacy and addictive behaviors. In J. E. Maddux (Ed.), Self-efficacy, adaptation, and adjustment: Theory, research, and application (pp. 109–141). New York, NY: Plenum Press.CrossRefGoogle Scholar
  41. Dohrenwend, B. P. (2000). The role of adversity and stress in psychopathology: Some evidence and its implications for theory and research. Journal of Health and Social Behavior, 41, 1–19.PubMedCrossRefGoogle Scholar
  42. Downey, G., & Feldman, S. I. (1996). Implications of rejection sensitivity for intimate relationships. Journal of Personality and Social Psychology, 70(6), 1327–1343. doi: 10.1037/0022-3514.70.6.1327.PubMedCrossRefGoogle Scholar
  43. Edwards, K. M., & Sylaska, K. M. (2013). The perpetration of intimate partner violence among LGBTQ college youth: The role of minority stress. Journal of Youth and Adolescence, 42(11), 1721–1731. doi: 10.1007/s10964-012-9880-6.PubMedCrossRefGoogle Scholar
  44. Egan, J. E., Frye, V., Kurtz, S. P., Latkin, C., Chen, M., Tobin, K., … Koblin, B. A. (2011). Migration, neihborhoods, and networks: Approaches to understanding how urban environmental conditions affect syndemic adverse health outcomes among gay, bisexual, and other men who have sex with men. AIDS and Behavior, 15(Suppl. 1), S35–S50. doi: 10.1007/s10461-011-9902-5.
  45. Ellard, K. K., Fairholme, C. P., Boisseau, C. L., Farchione, T. J., & Barlow, D. H. (2010). Unified protocol for the transdiagnostic treatment of emotional disorders: Protocol development and initial outcome data. Cognitive and Behavioral Practice, 17(1), 88–101. doi: 10.1016/j.cbpra.2009.06.002.CrossRefGoogle Scholar
  46. Eshel, N., & Roisere, J. P. (2010). Reward and punishment processing in depression. Biological Psychiatry, 68(2), 118–124. doi: 10.1016/j.biopsych.2010.01.027.PubMedCrossRefGoogle Scholar
  47. Etkin, A., & Wager, T. D. (2007). Functional neuroimaging of anxiety: A meta-analysis of emotional processing in PTSD, social anxiety disorder, and specific phobia. American Journal of Psychiatry, 164(10), 1476–1488. doi: 10.1176/appi.ajp.2007.07030504.PubMedCentralPubMedCrossRefGoogle Scholar
  48. Fairburn, C. G., Shafran, R., & Cooper, Z. (1999). A cognitive behavioural theory of anorexia nervosa. Behaviour Research and Therapy, 37(1), 1–13. doi: 10.1016/s0005-7967(98)00102-8.PubMedCrossRefGoogle Scholar
  49. Farchione, T. J., Fairholme, C. P., Ellard, K. K., Boisseau, C. L., Thompson-Hollands, J., Carl, J. R., … Barlow, D. H. (2012). Unified protocol for transdiagnostic treatment of emotional disorders: A randomized controlled trial. Behavior Therapy, 43(3), 666–678. doi: 10.1016/j.beth.2012.01.001.
  50. Feinstein, B. A., Goldfried, M. R., & Davila, J. (2012). The relationship between experiences of discrimination and mental health among lesbians and gay men: An examination of internalized homonegativity and rejection sensitivity as potential mechanisms. Journal of Consulting and Clinical Psychology, 80(5), 917–927. doi: 10.1037/a0029425.PubMedCrossRefGoogle Scholar
  51. Feldman, M. B., & Meyer, I. H. (2007). Eating disorders in diverse lesbian, gay, and bisexual populations. International Journal of Eating Disorders, 40(3), 218–226. doi: 10.1002/eat.20360.PubMedCentralPubMedCrossRefGoogle Scholar
  52. Felson, R. B., & Outlaw, M. C. (2007). The control motive and marital violence. Violence and Victims, 22(4), 387–407. doi: 10.1891/088667007781553964.PubMedCrossRefGoogle Scholar
  53. Foa, E. B., & Kozak, M. J. (1986). Emotional processing of fear: Exposure to corrective information. Psychological Bulletin, 99(1), 20–35. doi: 10.1037/0033-2909.99.1.20.PubMedCrossRefGoogle Scholar
  54. Folkman, S., Chesney, M., Collette, L., Boccellari, A., & Cooke, M. (1996). Postbereavement depressive mood and its prebereavement predictors in HIV + and HIV− gay men. Journal of Personality and Social Psychology, 70(2), 336–348. doi: 10.1037/0022-3514.70.2.336.PubMedCrossRefGoogle Scholar
  55. Fox, H. C., Bergquist, K. L., Gu, P., & Sinha, R. (2010). Interactive effects of cumulative stress and impulsivity on alcohol consumption. Alcoholism: Clinical and Experimental Research, 34(8), 1376–1385. doi: 10.1111/j.1530-0277.2010.01221.x.Google Scholar
  56. Fresco, D. M., Frankel, A. N., Mennin, D. S., Turk, C. L., & Heimberg, R. G. (2002). Distinct and overlapping features of rumination and worry: The relationship of cognitive production to negative affective states. Cognitive Therapy and Research, 26(2), 179–188. doi: 10.1023/A:1014517718949.CrossRefGoogle Scholar
  57. Friedman, M. S., Marshal, M. P., Stall, R., Cheong, J., & Wright, E. R. (2008). Gay-related development, early abuse and adult health outcomes among gay males. AIDS and Behavior, 12(6), 891–902. doi: 10.1007/s10461-007-9319-3.PubMedCentralPubMedCrossRefGoogle Scholar
  58. Frost, D. M., & Meyer, I. H. (2009). Internalized homophobia and relationship quality among lesbians, gay men, and bisexuals. Journal of Counseling Psychology, 56(1), 97–109. doi: 10.1037/a0012844.PubMedCentralPubMedCrossRefGoogle Scholar
  59. Gailliot, M. T., & Baumeister, R. F. (2007). Self-regulation and sexual restraint: Dispositionality and temporarily poor self-regulatory abilities contribute to failures at restraining sexual behavior. Personality and Social Psychology Bulletin, 33(2), 173–186. doi: 10.1177/0146167206293472.PubMedCrossRefGoogle Scholar
  60. Gardner, K. L., Thrivikraman, K. V., Lightman, S. L., Plotsky, P. M., & Lowry, C. A. (2005). Early life experience alters behavior during social defeat: Focus on serotonergic systems. Neuroscience, 136(1), 181–191. doi: 10.1016/j.neuroscience.2005.07.042.PubMedCrossRefGoogle Scholar
  61. Goldfried, M. R. (1980). Toward the delineation of therapeutic change principles. American Psychologist, 35(11), 991–999. doi: 10.1037/0003-066X.35.11.991.PubMedCrossRefGoogle Scholar
  62. Goldfried, M. R. (2013). What should we expect from psychotherapy? Clinical Psychology Review, 33(7), 862–869. doi:10.1016j/j.cpr.2013.05.003.PubMedCrossRefGoogle Scholar
  63. Goldfried, M. R., & Wolfe, B. E. (1996). Psychotherapy practice and research: Repairing a strained relationship. American Psychologist, 51(10), 1007–1016. doi: 10.1037/0003-066X.51.10.1007.PubMedCrossRefGoogle Scholar
  64. Goldman, M. S. (2002). Expectancy and risk for alcoholism: The unfortunate exploitation of a fundamental characteristic of neurobehavioral adaptation. Alcoholism: Clinical and Experimental Research, 26(5), 737–746. doi: 10.1111/j.1530-0277.2002.tb02599.x.CrossRefGoogle Scholar
  65. Gratz, K. L., Bornovalova, M. A., Delany-Brumsey, A., Nick, B., & Lejuez, C. W. (2007). A laboratory-based study of the relationship between childhood abuse and experiential avoidance among inner-city substance users: The role of emotional nonacceptance. Behavior Therapy, 38(3), 256–268. doi: 10.1016/j.beth.2006.08.006.PubMedCrossRefGoogle Scholar
  66. Green, K. E., & Feinstein, B. A. (2012). Substance use in lesbian, gay, and bisexual populations: An update on empirical research and implications for treatment. Psychology of Addictive Behaviors, 26(2), 265–278. doi: 10.1037/a0025424.PubMedCentralPubMedCrossRefGoogle Scholar
  67. Green, R., & Mitchell, V. (2002). Gay and lesbian couples in therapy: Homophobia, relational ambiguity, and social support. In A. S. Gurman & N. S. Jacobson (Eds.), Clinical handbook of couple therapy (3rd ed., pp. 546–568). New York, NY: Guilford Press.Google Scholar
  68. Greenan, D. E., & Tunnell, G. (2003). Couple therapy with gay men. New York, NY: Guilford Press.Google Scholar
  69. Greenberg, L. S., & Pascual-Leone, A. (2006). Emotion in psychotherapy: A practice-friendly research review. Journal of Clinical Psychology, 62(5), 611–630. doi: 10.1002/jclp.20252.PubMedCrossRefGoogle Scholar
  70. Hains, A. B., & Arnsten, A. F. T. (2008). Molecular mechanisms of stress-induced prefrontal cortical impairment: Implications for mental illness. Learning and Memory, 15(8), 551–564. doi: 10.1101/lm.921708.PubMedCrossRefGoogle Scholar
  71. Halkitis, P. N. (2010). Reframing HIV prevention for gay men in the United States. American Psychologist, 65(8), 752–763.Google Scholar
  72. Halkitis, P. N. (2013). The AIDS generation: Stories of survival and resilience. New York, NY: Oxford University Press.CrossRefGoogle Scholar
  73. Hamilton, C. J., & Mahalik, J. R. (2009). Minority stress, masculinity, and social norms predicting gay men’s health risk behaviors. Journal of Counseling Psychology, 56(1), 132–141. doi: 10.1037/a0014440.CrossRefGoogle Scholar
  74. Hart, T. A., & Heimberg, R. G. (2005). Social anxiety as a risk factor for unprotected intercourse among gay and bisexual male youth. AIDS and Behavior, 9(4), 505–512. doi: 10.1007/s10461-005-9021-2.PubMedCrossRefGoogle Scholar
  75. Hatzenbuehler, M. L. (2009). How does sexual minority stigma “get under the skin”? A psychological mediation framework. Psychological Bulletin, 135(5), 707–730. doi: 10.1037/a0016441.PubMedCentralPubMedCrossRefGoogle Scholar
  76. Hatzenbuehler, M. L. (2010). Social factors as determinants of mental health disparities in LGB populations: Implications for public policy. Social Issues and Policy Review, 4(1), 31–62. doi: 10.1111/j.1751-2409.2010.01017.x.CrossRefGoogle Scholar
  77. Hatzenbuehler, M. L., Corbin, W. R., & Fromme, K. (2008a). Trajectories and determinants of alcohol use among LGB young adults and their heterosexual peers: Results from a prospective study. Developmental Psychology, 44(1), 81–90. doi: 10.1037/0012-1649.44.1.81.PubMedCentralPubMedCrossRefGoogle Scholar
  78. Hatzenbuehler, M. L., McLaughlin, K. A., & Nolen-Hoeksema, S. (2008b). Emotion regulation and internalizing symptoms in a longitudinal study of sexual minority and heterosexual adolescents. Journal of Child Psychology and Psychiatry, 49, 1270–1278. doi: 10.1111/j.1469-7610.2008.01924.x.PubMedCentralPubMedCrossRefGoogle Scholar
  79. Hatzenbuehler, M. L., Nolen-Hoeksema, S., & Dovidio, J. (2009). How does stigma “get under the skin”? The mediating role of emotion regulation. Psychological Science, 20(10), 1282–1289. doi: 10.1111/j.1467-9280.2009.02441.x.PubMedCentralPubMedCrossRefGoogle Scholar
  80. Hatzenbuehler, M. L., Nolen-Hoeksema, S., & Erickson, S. J. (2008c). Minority stress predictors of HIV risk behavior, substance use, and depressive symptoms: Results from a prospective study of bereaved gay men. Health Psychology, 27(4), 455–462. doi: 10.1037/0278-6133.27.4.455.PubMedCrossRefGoogle Scholar
  81. Heatherton, T. F., & Wagner, D. D. (2011). Cognitive neuroscience of self-regulation failure. Trends in Cognitive Sciences, 15(3), 132–139. doi: 10.1016/j/tics.2010.12.005.PubMedCentralPubMedCrossRefGoogle Scholar
  82. Heim, C., Owens, M. J., Plotsky, P. M., & Nemeroff, C. B. (1997). Persistent change in corticotropin-releasing factor systems due to early life stress: Relationship to the pathophysiology of major depression and post-traumatic stress disorder. Psychopharmacology Bulletin, 33(2), 185–192.PubMedGoogle Scholar
  83. Hellman, R. E., & Klein, E. (2004). A program for lesbian, gay, bisexual, and transgender individuals with major mental illness. Journal of Gay & Lesbian Psychotherapy, 8(3–4), 67–82.Google Scholar
  84. Herek, G. M. (2004). Beyond “homophobia”: Thinking about sexual prejudice and stigma in the twenty-first century. Sexuality Research and Social Policy, 1(2), 6–24. doi: 10.1525/srsp.2004.1.2.6.CrossRefGoogle Scholar
  85. Herrick, A. L., Stall, R., Goldhammer, H., Egan, J. E., & Mayer, K. H. (2014). Resilience as a research framework and as a cornerstone of prevention research for gay and bisexual men: Theory and evidence. AIDS and Behavior, 18, 1–9. doi: 10.1007/s10461-012-0384-x.PubMedCrossRefGoogle Scholar
  86. Hershberger, S. L., & D’Augelli, A. R. (1995). The impact of victimization on the mental health and suicidality of lesbian, gay, and bisexual youths. Developmental Psychology, 31(1), 65–74. doi: 10.1037/0012-1649.31.1.65.CrossRefGoogle Scholar
  87. Hershenberg, R., & Goldfried, M. R. (in press). Implications of RDoC for the research and practice of psychotherapy. Behavior Therapy. doi: 10.1016/j.beth.2014.09.014.
  88. Huebner, D. M., & Davis, M. C. (2005). Gay and bisexual men who disclose their sexual orientations in the workplace have higher workday levels of salivary cortisol and negative affect. Annals of Behavioral Medicine, 30(3), 260–267. doi: 10.1207/s15324796abm3003_10.PubMedCrossRefGoogle Scholar
  89. Huebner, D. M., Davis, M. C., Nemeroff, C. J., & Aiken, L. S. (2002). The impact of internalized homophobia on HIV preventive interventions. American Journal of Community Psychology, 30(3), 327–348. doi: 10.1023/A:1015325303002.PubMedCrossRefGoogle Scholar
  90. Hyman, S. E., Malenka, R. C., & Nestler, E. J. (2006). Neural mechanisms of addiction: The role of reward-related learning and memory. Annual Review of Neuroscience, 29, 565–598. doi: 10.1146/annurev.neuro.29.051605.113009.PubMedCrossRefGoogle Scholar
  91. Insel, T., Cuthbert, B., Garvey, M., Heinssen, R., Pine, D. S., Quinn, K., ... Wang, P. (2010). Research domain criteria (RDoC): Toward a new classification framework for research on mental disorders. American Journal of Psychiatry, 167(7), 748–751.Google Scholar
  92. Inzlicht, M., McKay, L., & Aronson, J. (2006). Stigma as ego-depletion: How being the target of prejudice affects self-control. Psychological Science, 17(3), 262–269. doi: 10.1111/j.1467-9280.2006.01695.x.PubMedCrossRefGoogle Scholar
  93. Kassel, J. D., Wardle, M., & Roberts, J. E. (2007). Adult attachment security and college student substance use. Addictive Behaviors, 32(6), 1164–1176. doi: 10.1016/j.addbeh.2006.08.005.PubMedCrossRefGoogle Scholar
  94. Kernis, M. H. (1995). Efficacy, agency, and self-esteem. New York, NY: Plenum Press.CrossRefGoogle Scholar
  95. Kimmel, S. B., & Mahalik, J. R. (2005). Body image concerns of gay men: The roles of minority stress and conformity to masculine norms. Journal of Consulting and Clinical Psychology, 73(6), 1185–1190. doi: 10.1037/0022-006X.73.6.1185.PubMedCrossRefGoogle Scholar
  96. Klostermann, K., Kelley, M. L., Milletich, R. J., & Mignone, T. (2011). Alcoholism and partner aggression among gay and lesbian couples. Aggression and Violent Behavior, 16(2), 115–119. doi: 10.1016/j.avb.2011.01.002.CrossRefGoogle Scholar
  97. Krueger, R. F., Watson, D., & Barlow, D. H. (2005). Introduction to the special section: Toward a dimensionally based taxonomy of psychopathology. Journal of Abnormal Psychology, 114(4), 491–493. doi: 10.1037/0021-843X.114.4.491.PubMedCentralPubMedCrossRefGoogle Scholar
  98. Kubicek, K., Beyer, W. J., Weiss, G., Iverson, E., & Kipke, M. D. (2010). In the dark: Young men’s stories of sexual initiation in the absence of relevant sexual health information. Health Education and Behavior, 37(2), 243–263. doi: 10.1177/1090198109339993.PubMedCentralPubMedCrossRefGoogle Scholar
  99. Lange, A. J., Jakubowski, P., & McGovern, T. V. (1976). Responsible assertive behavior: Cognitive/behavioral procedures for trainers. Champaign, IL: Research Press.Google Scholar
  100. LaSala, M. C. (2000). Lesbians, gay men, and their parents: Family therapy for the coming-out crisis. Family Process, 39(1), 67–81. doi: 10.1111/j.1545-5300.2000.39108.x.PubMedCrossRefGoogle Scholar
  101. Li, C. R., & Sinha, R. (2008). Inhibitory control and emotional stress regulation: Neuroimaging evidence for frontal-limbic dysfunction in psycho-stimulant addiction. Neuroscience and Biobehavioral Reviews, 32(3), 581–597. doi: 10.1016/j.neubiorev.2007.10.003.PubMedCrossRefGoogle Scholar
  102. Lin, Y., & Israel, T. (2012). A computer-based intervention to reduce internalized heterosexism in men. Journal of Counseling Psychology, 59(3), 458–464. doi: 10.1037/a0028282.PubMedCrossRefGoogle Scholar
  103. Linehan, M. M. (1993). Cognitive behavioral treatment of borderline personality disorder. New York, NY: Guilford Press.Google Scholar
  104. MacKinnon, D. P. (2008). Introduction to statistical mediation analysis. New York, NY: Taylor & Francis Group/Lawrence Erlbaum Associates.Google Scholar
  105. Major, B., & O’Brien, L. T. (2005). The social psychology of stigma. Annual Review of Psychology, 56, 393–421. doi: 10.1146/annurev.psych.56.091103.070137.PubMedCrossRefGoogle Scholar
  106. Marlatt, G. A., & Donovan, D. M. (2005). Relapse prevention: Maintenance strategies in the treatment of addictive behaviors (2nd ed.). New York, NY: Guilford Press.Google Scholar
  107. Martin, A. D., & Hetrick, E. S. (1988). The stigmatization of the gay and lesbian adolescent. Journal of Homosexuality, 15(1–2), 163–183. doi: 10.1300/J082v15n01_12.PubMedCrossRefGoogle Scholar
  108. Marx, B. P., & Sloan, D. M. (2002). The role of emotion in the psychological functioning of adult survivors of childhood sexual abuse. Behavior Therapy, 33(4), 563–577. doi: 10.1016/S0005-7894(02)80017-X.CrossRefGoogle Scholar
  109. Mays, V. M., & Cochran, S. D. (2001). Mental health correlates of perceived discrimination among lesbian, gay, and bisexual adults in the United States. American Journal of Public Health, 91(11), 1869–1876. doi: 10.2105/AJPH.91.11.1869.PubMedCentralPubMedCrossRefGoogle Scholar
  110. McKenry, P. C., Serovich, J. M., Mason, T. L., & Mosack, K. (2006). Perpetration of gay and lesbian partner violence: A disempowerment perspective. Journal of Family Violence, 21(4), 233–243. doi: 10.1007/s10896-006-9020-8.CrossRefGoogle Scholar
  111. McLaughlin, K. A., Hatzenbuehler, M. L., & Hilt, L. M. (2009). Emotion dysregulation as a mechanism linking peer victimization to internalizing symptoms in adolescents. Journal of Consulting and Clinical Psychology, 77(5), 894–904. doi: 10.1037/a0015760.PubMedCentralPubMedCrossRefGoogle Scholar
  112. Mennin, D., & Farach, F. (2007). Emotion and evolving treatments for adult psychopathology. Clinical Psychology: Science and Practice, 14(4), 329–352. doi: 10.1111/j.1468-2850.2007.00094.x.Google Scholar
  113. Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674–697. doi: 10.1037/0033-2909.129.5.674.PubMedCentralPubMedCrossRefGoogle Scholar
  114. Meyer, I. H., Schwartz, S., & Frost, D. M. (2008). Social patterning of stress and coping: Does disadvantaged social statuses confer more stress and fewer coping resources? Social Science and Medicine, 67, 368–379.PubMedCentralPubMedCrossRefGoogle Scholar
  115. Michael, R. (1990). A preliminary investigation of alexithymia in men with psychoactive substance dependence. American Journal of Psychiatry, 147, 1228–1230.CrossRefGoogle Scholar
  116. Mineka, S., Watson, D., & Clark, L. A. (1998). Comorbidity of anxiety and unipolar mood disorders. Annual Review of Psychology, 49, 377–412. doi: 10.1146/annurev.psych.49.1.377.PubMedCrossRefGoogle Scholar
  117. Mineka, S., & Zinbarg, R. (2006). A contemporary learning theory perspective on the etiology of anxiety disorders: It’s not what you thought it was. American Psychologist, 61(1), 10–26. doi: 10.1037/0003-066X.61.1.10.PubMedCrossRefGoogle Scholar
  118. Missildine, W., Feldstein, G., Punzalan, J. C., & Parsons, J. T. (2005). S/he loves me, s/he loves me not: Questioning heterosexist assumptions of gender differences for romantic and sexually motivated behaviors. Sexual Addiction and Compulsivity, 12(1), 65–74. doi: 10.1080/10720160590933662.CrossRefGoogle Scholar
  119. Miyake, Y., Okamoto, Y., Onoda, K., Shirao, N., Okamoto, Y., Otagaki, Y., & Yamawaki, S. (2010). Neural processing of negative word stimuli concerning body image in patients with eating disorders: An fMRI study. Neuroimage, 50(3), 1333–1339. doi: 10.1016/j.neuroimage.2009.12.095.PubMedCrossRefGoogle Scholar
  120. Mohr, J. J., & Fassinger, R. E. (2003). Self-acceptance and self-disclosure of sexual orientation in lesbian, gay, and bisexual adults: An attachment perspective. Journal of Counseling Psychology, 50(4), 482–495. doi: 10.1037/0022-0167.50.4.482.CrossRefGoogle Scholar
  121. Muraven, M., & Baumeister, R. F. (2000). Self-regulation and depletion of limited resources: Does self-control resemble a muscle? Psychological Bulletin, 126(2), 247–259. doi: 10.1037/0033-2909.126.2.247.PubMedCrossRefGoogle Scholar
  122. Mustanski, B., Garofalo, R., Herrick, A., & Donenberg, G. (2007). Psychosocial health problems increase risk for HIV among urban young men who have sex with men: Preliminary evidence of a syndemic in need of attention. Annals of Behavioral Medicine, 34(1), 37–45.Google Scholar
  123. Mustanski, B., Greene, G. J., Ryan, D., & Whitton, S. W. (2014). Feasibility, acceptability, and initial efficacy of an online sexual health promotion program for LGBT youth: The Queer Sex Ed intervention. Journal of Sex Research,. doi: 10.1080/00224499.2013.867924.Google Scholar
  124. National Institute of Mental Health (NIMH). (2008a). The National Institute of Mental Health Strategic Plan (NIH Publication No. 08-6368). Retrieved from http://www.nimh.nih.gov/about/strategic-planning-reports/index.shtml.
  125. National Institute of Mental Health (NIMH). (2008b). The National Institute of Mental Health Strategic Plan (NIH Publication No. 08-6368). Retrieved July 9, 2014 from NIHM website: http://www.nimh.nih.gov/about/strategic-planning-reports/nimh-strategic-plan-2008.pdf.
  126. National Institute of Mental Health. (2011). Research domain criteria (RDoC). Retrieved from http://www.nimh.nih.gov/research-priorities/rdoc/nimh-research-domain-criteria-rdoc.shtml.
  127. Newcomb, M. E., & Mustanski, B. (2010). Internalized homophobia and internalizing mental health problems: A meta-analytic review. Clinical Psychology Review, 30(8), 1019–1029. doi: 10.1016/j.cpr.2010.07.003.PubMedCrossRefGoogle Scholar
  128. Nijm, J., & Jonasson, L. (2009). Inflammation and cortisol response in coronary artery disease. Annals of Medicine, 41(3), 224–233. doi: 10.1080/07853890802508934.PubMedCrossRefGoogle Scholar
  129. Ostafin, B. D., & Marlatt, G. A. (2008). Surfing the urge: Experiential acceptance moderates the relation between automatic alcohol motivation and hazardous drinking. Journal of Social and Clinical Psychology, 27(4), 404–418. doi: 10.1521/jscp.2008.27.4.404.CrossRefGoogle Scholar
  130. Pachankis, J. E. (2007). The psychological implications of concealing stigma: A cognitive- affective-behavioral model. Psychological Bulletin, 133(2), 328–345. doi: 10.1037/0033-2909.133.2.328.PubMedCrossRefGoogle Scholar
  131. Pachankis, J. E. (2009). The use of cognitive-behavioral therapy to promote authenticity. Pragmatic Case Studies in Psychotherapy, 5(4), 28–38. doi: 10.14713/pcsp.v5i4.997.CrossRefGoogle Scholar
  132. Pachankis, J. E. (2014). Uncovering clinical principles and techniques to address minority stress, mental health, and related health risks among gay and bisexual men. Clinical Psychology, 21, 313–330.PubMedPubMedCentralGoogle Scholar
  133. Pachankis, J. E., & Goldfried, M. R. (2006). Social anxiety in young gay men. Journal of Anxiety Disorders, 20, 996–1015. doi: 10.1016/j.janxdis.2006.01.001.PubMedCrossRefGoogle Scholar
  134. Pachankis, J. E., & Goldfried, M. R. (2007a). An integrative, principle-based approach to psychotherapy. In S. G. Hofmann & J. Weinberger (Eds.), The art and science of psychotherapy (pp. 49–68). New York, NY: Routledge/Taylor & Francis Group.Google Scholar
  135. Pachankis, J. E., & Goldfried, M. R. (2007b). On the next generation of process research. Clinical Psychology Review, 27(6), 760–768. doi: 10.1016/j.cpr.2007.01.009.PubMedCrossRefGoogle Scholar
  136. Pachankis, J. E., Goldfried, M. R., & Ramrattan, M. E. (2008). Extension of the rejection sensitivity construct to the interpersonal functioning of gay men. Journal of Consulting and Clinical Psychology, 76(2), 306–317. doi: 10.1037/0022-006X.76.2.306.PubMedCrossRefGoogle Scholar
  137. Pachankis, J. E., & Hatzenbuehler, M. L. (2013). The social development of contingent self-worth in sexual minority young men: An empirical investigation of the “Best Little Boy in the World” hypothesis. Basic and Applied Social Psychology, 35(2), 176–190. doi: 10.1080/01973533.2013.764304.CrossRefGoogle Scholar
  138. Pachankis, J. E., Hatzenbuehler, M. L., Rendina, H. J., Safren, S. A., & Parsons, J. T. (2015). Cognitive behavior therapy for young adult gay and bisexual men’s mental health and related health risks: A randomized controlled trial of a transdiagnostic minority stress approach. Unpublished manuscript, Yale School of Public Health, Yale University, New Haven, CT.Google Scholar
  139. Pachankis, J. E., Hatzenbuehler, M. L., Schmidt, A. J., Hickson, F., Weatherburn, P., Berg, R., & Marcus, U. (2014a). Hidden from health: Structural stigma, sexual orientation concealment, and HIV across 38 countries in the European MSM Internet Survey (EMIS). Unpublished manuscript, Yale University.Google Scholar
  140. Pachankis, J. E., Hatzenbuehler, M. L., & Starks, T. J. (2014b). The influence of structural stigma and rejection sensitivity on young sexual minority men’s daily tobacco and alcohol use. Social Science and Medicine, 103, 67–75. doi: 10.1016/j.socscimed.2013.10.005.PubMedCrossRefGoogle Scholar
  141. Pachankis, J. E., Lelutiu-Weinberger, C., Golub, S. A., & Parsons, J. T. (2013). The development of an online risk-reduction intervention for young gay and bisexual men using social networking technology. AIDS and Behavior, 17, 2986–2998.PubMedCrossRefGoogle Scholar
  142. Pachankis, J. E., Newcomb, M. E., Feinstein, B. A., & Bernstein, L. B. (2014c). Young gay and bisexual men’s stigma experiences and mental health: A five-year longitudinal study. Unpublished manuscript, Yale School of Public Health, Yale University, New Haven.Google Scholar
  143. Pachankis, J. E., Rendina, H. J., Restar, A., Ventuneac, A., Grov, C., & Parsons, J. T. (in press). A minority stress-emotion regulation model of sexual compulsivity among highly sexually active gay and bisexual men. Health Psychology. doi: 10.1037/hea0000180.
  144. Pachankis, J. E., Westmaas, J. L., & Dougherty, L. R. (2011). The influence of sexual orientation and masculinity on young men’s tobacco smoking. Journal of Consulting and Clinical Psychology, 79(2), 142–152. doi: 10.1037/a0022917.PubMedCrossRefGoogle Scholar
  145. Parsons, J. T., Grov, C., & Golub, S. A. (2012). Sexual compulsivity, co-occurring psychosocial health problems, and HIV risk among gay and bisexual men: Further evidence of a syndemic. American Journal of Public Health, 10(1), 156–162. doi: 10.2105/AJPH.2011.300284.CrossRefGoogle Scholar
  146. Parsons, J. T., Kelly, B. C., Bimbi, D. S., Muench, F., & Morgenstern, J. (2007). Accounting for the social triggers of sexual compulsivity. Journal of Addictive Diseases, 26(3), 5–16. doi: 10.1300/J069v26n03_02.PubMedCrossRefGoogle Scholar
  147. Paul, J. P., Catania, J., Pollack, L., & Stall, R. (2001). Understanding childhood sexual abuse as a predictor of sexual risk-taking among men who have sex with men: The Urban Men’s Health Study. Child Abuse and Neglect, 25(4), 557–584. doi: 10.1016/S0145-2134(01)00226-5.PubMedCrossRefGoogle Scholar
  148. Plöderl, M., & Fartacek, R. (2005). Suicidality and associated risk factors among lesbian, gay, and bisexual compared to heterosexual Austrian adults. Suicide and Life-Threatening Behavior, 35(6), 661–670. doi: 10.1521/suli.2005.35.6.661.PubMedCrossRefGoogle Scholar
  149. Ratti, R., Bakeman, R., & Peterson, J. L. (2000). Correlates of high-risk sexual behavior among Canadian men of South Asian and European origin who have sex with men. AIDS Care, 12(2), 193–202. doi: 10.1080/09540120050001878.PubMedCrossRefGoogle Scholar
  150. Reid, R. C., Carpenter, B. N., Spackman, M., & Willes, D. L. (2008). Alexithymia, emotional instability, and vulnerability to stress proneness in patients seeking help for hypersexual behavior. Journal of Sex and Marital Therapy, 34(2), 133–149. doi: 10.1080/00926230701636197.PubMedCrossRefGoogle Scholar
  151. Roemer, L., Orsillo, S. M., & Salters-Pedneault, K. (2008). Efficacy of an acceptance-based behavior therapy for generalized anxiety disorder: Evaluation in a randomized controlled trial. Journal of Consulting and Clinical Psychology, 76(6), 1083–1089. doi: 10.1037/a0012720.PubMedCentralPubMedCrossRefGoogle Scholar
  152. Rosario, M., Schrimshaw, E. W., & Hunter, J. (2009). Disclosure of sexual orientation and subsequent substance use and abuse among lesbian, gay, and bisexual youths: Critical role of disclosure reactions. Psychology of Addictive Behaviors, 23(1), 175–184. doi: 10.1037/a0014284.PubMedCentralPubMedCrossRefGoogle Scholar
  153. Russell, C. J., & Keel, P. K. (2002). Homosexuality as a specific risk factor for eating disorders in men. International Journal of Eating Disorders, 31(3), 300–306. doi: 10.1002/eat.10036.PubMedCrossRefGoogle Scholar
  154. Russell, S. T., Ryan, C., Toomey, R. B., Diaz, R. M., & Sanchez, J. (2011). Lesbian, gay, bisexual, and transgender adolescent school victimization: Implications for young adult health and adjustment. The Journal of School Health, 81(5), 223–230. doi: 10.1111/j.1746-1561.2011.00583.x.PubMedCrossRefGoogle Scholar
  155. Safren, S. A., Blashill, A., & O’Cleirigh, C. (2011). Promoting the sexual health of MSM in the context of comorbid mental health problems. AIDS and Behavior, 15, S30–S34.PubMedCentralPubMedCrossRefGoogle Scholar
  156. Safren, S. A., & Heimberg, R. G. (1999). Depression, hopelessness, suicidality, and related factors in sexual minority and heterosexual adolescents. Journal of Consulting and Clinical Psychology, 67(6), 859–866. doi: 10.1037/0022-006X.67.6.859.PubMedCrossRefGoogle Scholar
  157. Safren, S. A., Reisner, S. A., Herrick, A., Mimiaga, M. J., & Stall, R. (2010). Mental health and HIV risk in men who have sex with men. Journal of AIDS, 55, S74–S77.PubMedCentralPubMedGoogle Scholar
  158. Sanislow, C. A., Pine, D. S., Quinn, K. J., Kozak, M. J., Garvey, M. A., … Cuthbert, B. N. (2010). Developing constructs for psychopathology research: Research domain criteria. Journal of Abnormal Psychology, 119(4), 631–639. doi: 10.1037/a0020909.
  159. Sherry, A. (2007). Internalized homophobia and adult attachment: Implications for clinical practice. Psychotherapy, 44(2), 219–225. doi: 10.1037/0033-3204.44.2.219.PubMedCrossRefGoogle Scholar
  160. Shin, L. M., & Liberzon, I. (2010). The neurocircuitry of fear, stress, and anxiety disorders. Neuropsychopharmacology, 35(1), 169–191. doi: 10.1038/npp.2009.83.PubMedCentralPubMedCrossRefGoogle Scholar
  161. Siegel, S., & Lowe, E. (1994). Uncharted lives: Understanding the life passages of gay men. New York, NY: Plume.Google Scholar
  162. Sikkema, K. J., Kochman, A., DiFranceisco, W., Kelly, J. A., & Hoffmann, R. G. (2003). AIDS- related grief and coping with loss among HIV-positive men and women. Journal of Behavioral Medicine, 26(2), 165–181. doi: 10.1023/A:1023086723137.PubMedCrossRefGoogle Scholar
  163. Singer, M. C., Erickson, P. I., Badiane, L., Diaz, R., Ortiz, D., … Nicolaysen, A. M. (2006). Syndemics, sex and the city: Understanding sexually transmitted diseases in social and cultural context. Social Science and Medicine, 63(8), 2010–2021. doi: 10.1016/j.socscimed.2006.05.012.
  164. Sinha, R. (2008). Chronic stress, drug use, and vulnerability to addiction. In G. R. Uhl (Ed.), Addiction reviews 2008 (pp. 105–130). Malden: Blackwell Publishing.Google Scholar
  165. Slavich, G. M., Way, B. M., Eisenberger, N. I., & Taylor, S. E. (2010). Neural sensitivity to social rejection is associated with inflammatory responses to social stress. PNAS Proceedings of the National Academy of Sciences of the United States, 107(33), 14917–14927. doi: 10.1073/pnas.1009164107.Google Scholar
  166. Stall, R., Friedman, M., & Catania, J. A. (2008). Interacting epidemics and gay men’s health: a theory of syndemic production among urban gay men. In R. J. Wolitski, R. Stall, & R. O. Valdiserri (Eds.), Unequal opportunity: Health disparities affecting gay and bisexual men in the United States (pp. 251–274). New York, NY: Oxford University Press.Google Scholar
  167. Stall, R., & Purcell, D. W. (2000). Intertwining epidemics: A review of research on substance use among men who have sex with men and its connection to the AIDS epidemic. AIDS and Behavior, 4(2), 181–192. doi: 10.1023/A:1009516608672.CrossRefGoogle Scholar
  168. Stapinski, L. A., Abbott, M. J., & Rapee, R. M. (2010). Evaluating the cognitive avoidance model of generalized anxiety disorder: Impact of worry on threat appraisal, perceived control and anxious arousal. Behaviour Research and Therapy, 48(10), 1032–1040. doi: 10.1016/j.brat.2010.07.005.PubMedCrossRefGoogle Scholar
  169. Strauman, T. J. (2002). Self-regulation and depression. Self and Identity, 1(2), 151–157. doi: 10.1080/152988602317319339.CrossRefGoogle Scholar
  170. Taywaditep, K. J. (2001). Marginalization among the marginalized: Gay men’s anti-effeminacy attitudes. Journal of Homosexuality, 42(1), 1–28. doi: 10.1300/J082v42n01_01.PubMedCrossRefGoogle Scholar
  171. Teicher, M. H., Andersen, S. L., Polcari, A., Anderson, C. M., Navalta, C. P., & Kim, D. M. (2003). The neurobiological consequences of early stress and childhood maltreatment. Neuroscience and Biobehavioral Reviews, 27(1), 33–44. doi: 10.1016/S0149-7634(03)00007-1.PubMedCrossRefGoogle Scholar
  172. Tharinger, D., & Wells, G. (2000). An attachment perspective on the developmental challenges of gay and lesbian adolescents: The needs for continuity of caregiving from family and schools. School Psychology Review, 29(2), 158–172.Google Scholar
  173. Tilcsik, A. (2011). Pride and prejudice: Employment discrimination against openly gay men in the United States. American Journal of Sociology, 117(2), 586–626. doi: 10.1086/661653.CrossRefGoogle Scholar
  174. Tjaden, P., Thoennes, N., & Allison, C. J. (1999). Comparing violence over the life span in samples of same-sex and opposite-sex cohabitants. Violence and Victims, 14(4), 413–425.PubMedGoogle Scholar
  175. Trapence, G., Collins, C., Avrett, S., Carr, R., Sanchez, H., Ayala, G., … Baral, S. D. (2012). From personal survival to public health: Community leadership by men who have sex with men in the response to HIV. Lancet, 380(9839), 400–410. doi: 10.1016/S0140-6736(12)60834-4.
  176. Walkup, J., Blank, M. B., Gonzalez, J. S., Safren, S., Schwartz, R., Brown, L., … Schumacher, J. E. (2008). The impact of mental health and substance abuse factors on HIV prevention and treatment. JAIDS Journal of Acquired Immune Deficiency Syndromes, 47, S15–S19. doi: 10.1097/QAI.0b013e3181605b26.
  177. Ward, A., Ramsay, R., & Treasure, J. (2000). Attachment research in eating disorders. British Journal of Medical Psychology, 73(1), 35–51. doi: 10.1348/000711200160282.PubMedCrossRefGoogle Scholar
  178. Webb, T. L., Miles, E., & Sheeran, P. (2012). Dealing with feeling: A meta-analysis of the effectiveness of strategies derived from the process model of emotion regulation. Psychological Bulletin, 138(4), 775–808. doi: 10.1037/a0027600.PubMedCrossRefGoogle Scholar
  179. Weeks, J., Heaphy, B., & Donovan, C. (2001). Same sex intimacies: Families of choice and other life experiments. London: Routledge.CrossRefGoogle Scholar
  180. West, C. M. (2012). Partner abuse in ethnic minority and gay, lesbian, bisexual, and transgender populations. Partner Abuse, 3(3), 336–357. doi: 10.1891/1946-6560.3.3.336.CrossRefGoogle Scholar
  181. Westen, D., Novotny, C. M., & Thompson-Brenner, H. (2004). The empirical status of empirically supported therapies: Assumptions, findings, and reporting in controlled clinical trials. Psychological Bulletin, 130(4), 631–663. doi: 10.1037/0033-2909.130.4.631.PubMedCrossRefGoogle Scholar
  182. Wilamowska, Z. A., Thompson-Hollands, J., Fairholme, C. P., Ellard, K. K., Farchione, T. J., & Barlow, D. H. (2010). Conceptual background, development, and preliminary data from the unified protocol for transdiagnostic treatment of emotional disorders. Depression and Anxiety, 27(10), 882–890. doi: 10.1002/da.20735.PubMedCrossRefGoogle Scholar
  183. Williams, J. L., & Lierle, D. M. (1986). Effects of stress controllability, immunization, and therapy on the subsequent defeat of colony intruders. Animal Learning and Behavior, 14(3), 305–314. doi: 10.3758/BF03200072.CrossRefGoogle Scholar
  184. Wilson, W. J. (2010). Why both social structure and culture matter in a holistic analysis of inner-city poverty. Annals of the American Academy of Political and Social Science, 629(1), 200–219. doi: 10.1177/0002716209357403.CrossRefGoogle Scholar
  185. Wilton, L. (2009). A preliminary study of body image and HIV sexual risk behavior in black gay and bisexual men: Implications for HIV prevention. Journal of Gay and Lesbian Social Services, 21(4), 309–325. doi: 10.1080/10538720802497829.CrossRefGoogle Scholar
  186. Winters, J., Clift, R. J., & Dutton, D. G. (2004). An exploratory study of emotional intelligence and domestic abuse. Journal of Family Violence, 19(5), 255–267. doi: 10.1023/B:JOFV.0000042076.21723.f3.CrossRefGoogle Scholar
  187. World Health Organization. (2006). Defining sexual health. Report of a technical consultation on sexual health, January 2002. Geneva: World Health Organization.Google Scholar
  188. Yehuda, R., Bierer, L. M., Schmeidler, J., Aferiat, D. H., Breslau, I., & Dolan, S. (2000). Low cortisol and risk for PTSD in adult offspring of Holocaust survivors. American Journal of Psychiatry, 157(8), 1252–1259. doi: 10.1176/appi.ajp.157.8.1252.PubMedCrossRefGoogle Scholar
  189. Yi, H., Sandfort, T. G., & Shidlo, A. (2010). Effects of disengagement coping with HIV risk on unprotected sex among HIV-negative gay men in New York City. Health Psychology, 29(2), 205–214. doi: 10.1037/a0017786.PubMedCentralPubMedCrossRefGoogle Scholar
  190. Zakalik, R. A., & Wei, M. (2006). Adult attachment, perceived discrimination based on sexual orientation, and depression in gay males: Examining the mediation and moderation effects. Journal of Counseling Psychology, 53(3), 302–313. doi: 10.1037/0022-0167.53.3.302.CrossRefGoogle Scholar
  191. Zamboni, B. D., & Crawford, I. (2007). Minority stress and sexual problems among African- American gay and bisexual men. Archives of Sexual Behavior, 36(4), 569–578. doi: 10.1007/s10508-006-9081-z.PubMedCrossRefGoogle Scholar
  192. Zapf, J. L., Greiner, J., & Carroll, J. (2008). Attachment styles and male sex addiction. Sexual Addiction and Compulsivity, 15(2), 158–175. doi: 10.1080/10720160802035832.CrossRefGoogle Scholar

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© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Social and Behavioral Sciences Division, Department of Chronic Disease Epidemiology, Yale School of Public HealthYale UniversityNew HavenUSA

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