In the following section, preliminary evidence for each of these hypotheses is reviewed, with particular attention paid to research on depression, anxiety, and alcohol use disorders, which are all elevated among LGB individuals according to a recent meta-analysis (Meyer, 2003). Although the minority stress theory makes predictions that are general and uniform across types of disorder (Meyer, 2003), the processes through which minority stress contributes to psychopathology may differ by disorder. Research on general psychological processes related to the development of psychopathology provides evidence in support of this position. For example, psychiatric and substance use disorders differ in symptoms, etiologic pathways, and the types of treatment that are appropriate, suggesting that they should be considered separately. Thus, although stigma-related stress is an important aspect of the integrative framework for all forms of psychopathology, discussion of the framework is organized around outcome to account for the different psychological processes through which this distal predictor is associated with clinical outcomes. Mental disorders are increasingly separated into “internalizing” and “externalizing” domains (e.g., Krueger, 1999). Thus, internalizing disorders (i.e., depression and anxiety) are discussed first, followed by externalizing disorders (i.e., alcohol use disorders).
