Scheer, J.R., Harney, P., Esposito, J., & Woulfe, J.M. (2019). Self-reported mental and physical health symptoms and potentially traumatic events among lesbian, gay, bisexual, transgender, and queer individuals: The role of shame. Psychology of Violence. Advance online publication. http://dx.doi.org/10.1037/vio0000241
This study examined the effects of potentially traumatic events exposure and shame on the mental and physical health of LGBTQ individuals. Previous research indicates that people exposed to interpersonal forms of trauma report greater shame-proneness (Andrews, Brewin, Rose & Kirk, 2000). With this in mind, the researchers sought to determine whether shame mediates the relationship between exposure to potentially traumatic events and negative mental and physical health symptoms in LGBTQ individuals.
The study defines shame as “feelings of inferiority and powerlessness that are directly tied to social ostracism and trauma” (Taylor, 2015). It also differentiates between impersonal and interpersonal trauma, such as natural disasters versus intimate partner violence respectively.
Participants were recruited from more than 100 LGBTQ-specific, trauma-specific, or combination listservs and included 218 self-identified LGBTQ adults ages 18–78 who reported having experienced at least one potentially traumatic event in their lifetime. Of the participants, 40% identified as people of color, 40% identified as transgender and/or gender-nonconforming (TGNC), and 64% identified as nonmonosexual (queer, bisexual, pansexual, etc.).
Along with demographic information, participants reported on their lifetime exposure to potentially traumatic events (both impersonal and interpersonal), their depression symptoms over the past two weeks, posttraumatic stress disorder (PTSD) symptoms over the past month, substance use in the past six months, sexual risk behavior over the past month, chronic health conditions over the past year, and somatic symptoms over the past week. Shame over the past year was also measured by the Shame subscale of the Personal Feelings Questionaaire-2.
Results indicated that exposure to both impersonal and interpersonal potentially traumatic events were positively correlated with shame, depression symptoms, PTSD symptoms, substance use, chronic health conditions, and somatic symptoms. Impersonal, but not interpersonal, potentially traumatic events exposure was positively correlated with sexual risk behavior. Shame was also positively correlated with depression symptoms, PTSD symptoms, substance use, sexual risk behavior, and somatic symptoms.
The researchers found that participants who identified as people of color reported greater exposure to interpersonal potentially traumatic events and shame than White participants. TGNC participants reported greater exposure to both interpersonal and impersonal potentially traumatic events, along with greater somatic and depressive symptoms than cisgender participants.
Finally, further analyses found that shame partially mediated the relationship between exposure to potentially traumatic events and negative mental and physical health symptoms. This indicates that exposure to such events is associated with greater levels of shame, and that greater levels of shame in turn is associated with worse mental and physical health symptoms.
The authors specifically suggest that cognitive behavioral therapy-based interventions targeting internalized discrimination or group therapy focused on building a sense of community can be especially beneficial to patients struggling with shame or negative beliefs about LGBTQ identity.