Date of Award


Document Type

Campus Access Dissertation

Degree Name

Doctor of Philosophy (PhD)


Clinical Psychology

First Advisor

Heidi M. Levitt

Second Advisor

Sharon G. Horne

Third Advisor

Sarah Hayes-Skelton


Internalized heterosexism refers to the development of a negative view of one's own and others' sexual minority identities as a product of living within a heterosexist society. Various negative mental health outcomes have been associated with internalized heterosexism (IH), such as anxiety, depression, and suicidality. However, little is known about the actual processes through which these outcomes take place. The current study examined the role of self-criticism (a psychological process), connectedness with other sexual minorities (a social process), and decentering (a potential coping strategy wherein someone is able to detach from their thoughts and view them as events instead of truth about themselves) in explaining the relation between IH and psychological distress. Data were collected via an online survey and analyzed using structural equation modeling (SEM) with latent variables for most study constructs. Results supported previous research, showing a significant direct relation between IH and psychological distress. In addition, higher self-criticism and lower connectedness with sexual minorities mediated this relation. The model fit for the final model which included both mediators was a significant improvement from the initial model with only the direct relation between IH and psychological distress and accounted for a significant amount of the variance in psychological distress (64.3%). In addition, decentering significantly moderated the relation between IH and psychological distress. At low levels of IH, decentering did not appear to impact the relation with psychological distress. However, at high levels of IH, high decentering was associated with lower psychological distress for participants who had lower scores on decentering. Correlational analyses also revealed that high decentering was associated with less self-criticism and more community connectedness. Most participants reported having various types of connections to other sexual minorities, with the mean being 3.49 different forms of community connections. The findings of this study revealed underlying processes that explain a significant amount of variance in the relation between IH and psychological distress. Both self-criticism and connectedness to a sexual minority community are mechanisms that could be targeted within therapy when working to improve the mental health of clients with high IH. Limitations and directions for future research are presented.


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