UC Irvine

In line with the minority stress model of psychopathology, research suggests that sexual minority individuals are at an increased risk for psychosis-spectrum experiences. Contextual social factors, such as stressful life events and discrimination, have been found to partially explain the relation between sexual minority status and psychosis-spectrum experiences. However, such research is limited, particularly in North American populations and individuals experiencing subclinical symptoms. We conducted a secondary data analysis aimed at understanding how contextual factors related to stress may differ based on sexual minority status and potentially mediate associations between sexual orientation and positive psychosis-spectrum symptomatology and functioning in a U.S. sample. Data were collected as part of the Computerized Assessment of Psychosis-Risk (CAPR) study. Participants in the study were 12–34-year-olds who self-reported sexual orientation (n heterosexual= 496, n sexual minority= 269), perceived stress, negative life events, experiences of everyday discrimination, and childhood trauma/abuse. Participants were assessed on the Structured Interview for Psychosis-Risk Syndromes and scales of global, social, and role functioning. Sexual minority participants were more likely to be at clinical-high risk for psychosis compared to their heterosexual counterparts. Sexual minority individuals also endorsed greater perceived stress and more frequent everyday discrimination, as well as more negative life events and types of childhood trauma. Sexual minority status was significantly associated with increased positive psychosis-spectrum symptom severity and decreased global, social, and role functioning. These associations were partly attributable to associations between sexual minority status and perceived stress and negative life events respectively. Study findings highlight the role of stress in informing the understanding and assessment of psychosis-risk in sexual minority populations. Future research would benefit from assessing sexual minority-specific mechanisms of stigma and incorporating considerations of intersectional marginalization and associated stressors.