Date of Award


Document Type

Campus Access Dissertation

Degree Name

Doctor of Philosophy (PhD)


Clinical Psychology

First Advisor

Heidi M. Levitt

Second Advisor

Sarah Hayes-Skelton

Third Advisor

Sharon G. Horne


Emotion regulation and defense mechanisms are theoretically similar constructs that impact mental health. Despite their similarities, they are not often studied in the same projects or academic subdisciplines because of their separate conceptual origins in behavioral health and psychoanalytic theory, respectively. Both have been found to partially account for the link between psychological distress and the experience of sexual minority stressors in the lesbian, gay, bisexual, and queer (LGBQ+) population and thus represent potential targets for therapeutic intervention. The current study tested a mediation model exploring emotion regulation and defense style as mechanisms through which sexual minority stress impacts psychological outcomes, as well as explored the relative contribution of each respective construct to the full model. The current study also details the initial development of a novel process measure of how LGBQ+ people respond to heterosexist experiences which was used as one of several outcomes. Results show that difficulties with emotion regulation and immature/non-adaptive defenses were both significant mediators, implying that patterns of non-adaptive emotional processing partially explain why some people experience heightened internalizing symptoms and exhibit less adaptive responses after being exposed to heterosexism. Clinical implications of the results are presented, including a reframing of the idea that developing emotion regulation skills is an ideal focus of psychotherapy and a discussion of the importance of theoretical integration.


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