There appear to be multiple pathways through which stigma-related stress ultimately influences the pathogenesis of mental health and alcohol use disorders among sexual minorities (see Table 2). In the domain of internalizing psychopathology, the data point to specific coping/emotion regulation (rumination), social/interpersonal (low social support), and cognitive (hopelessness, pessimism, negative self-schemas) processes that may account for increased rates of mood and anxiety disorders within LGB populations. In the area of alcohol use disorders, the results also indicate emotion regulation/coping (drinking to cope), social/interpersonal (social norms), and cognitive (alcohol expectancies) processes initiated by stigma-related stress that could explain increased rates of alcohol use disorders among sexual minorities.
