Term of Award

Fall 2022

Degree Name

Doctor of Psychology in Clinical Psychology (Psy.D.)

Document Type and Release Option

Dissertation (open access)

Copyright Statement / License for Reuse

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


Department of Psychology

Committee Chair

Jeff Klibert

Committee Member 1

Stacy Smallwood

Committee Member 2

Brandon Weiss


As mental health disparities and discrimination facing the LGB (sexual minority) community continues to come into public focus, researchers and clinicians are moving toward identifying LGB-specific mental health interventions to support well-being efforts within this population. Furthermore, much of the current literature on sexual minority mental health is focused on predominantly urban samples failing to consider the sociocultural impacts of living in low resourced and geographically isolated regions of the United States (US). To this end, social support is a promising prevention factor, but few studies to date examine its influence on different minority stress models. As such, the current study sought to answer the following questions: a) do reports of social support, internalized homophobia, and mental health distress vary by rural groups?, b) do self-reports of internalized homophobia correlate with mental health distress?, c) do indices of support moderate the relationship between internalized homophobia and mental health distress?, and d) does rurality moderate the relationship between internalized homophobia and mental health distress? The study utilized a cross-sectional and correlational design, whereby participants completed an online survey to answer questions related to their rural status, experiences with internalized homophobia, overall social support, LGB-peer support, and mental health distress. Online survey data were collected from a community sample of 494 adults who self-identified as a sexual minority. A MANOVA was analyzed to determine any significant rural differences on the main variables. Results indicated non-rural and rural sexual minorities report comparable levels of internalized homophobia, social support, and distress. Bivariate correlations indicated that higher self-reported internalized homophobia was significantly correlated with poorer mental health outcomes. Regarding path analytic models, neither social support indices or rurality were found to significantly moderate the relationship between internalized homophobia and mental health outcomes. Overall, these findings reinforce the negative psychological effects of internalized discrimination on distress. The merits of employing social support interventions as a prevention to approach to manage minority stress is also discussed. Finally, the results emphasize the need for additional research into significant moderators of the relationship between discrimination and mental health distress.

Research Data and Supplementary Material