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Stress and coping among gay older adults

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Stress and coping among gay older adults

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Content STRESS AND COPING AMONG
GAY OLDER ADULTS
by
Steven David
A Thesis Presented to the
FACULTY OF THE GRADUATE SCHOOL
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements of the Degree
MASTER OF ARTS
(PSYCHOLOGY)
August 2003
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UMI Number: 1417918
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UNIVERSITY O F S O U T H E R N CALIFORNIA
THE GRADUATE SCHOOL
UNIVERSITY PARK
LOS ANGELES. CALIFORNIA 9 0 0 0 7
T his thesis, w ritten by
S teven David
under the direction of h..iS....Thesis Committee,
and approved by all its members, has been pre
sented to and accepted by the Dean of The
Graduate School, in partial fulfillment of the
requirements for the degree of
Date.....Mms.%.llz.2mi
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ACKNOWLEDGMENTS
Special thanks to Gilbert Brown, whose interest in and generous support of
lesbian and gay aging research has enabled me to continue to expand this study.
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TABLE OF CONTENTS
Page
Acknowledgements..................................................................................................... ii
List of Tables ........................................... iv
List of Figures........................................................................................ v
Abstract .......................................................................................................... vi
Chapter
1. Background ........................................................................................... 1
Stigmatization ............................................................................. 1
Coping.................................................................................................... 4
Mental and Physical Health Outcomes.............................................. 7
Hypotheses ......................................................................................... 9
2. M ethod......................................................................................... .......... 11
Participants................. ........................................................................ 11
Measures............................................................................................... 13
3. Results........................................................................................................... 21
Demographic Characteristics............................................................. 21
Correlations.................................................................................. 24
Analyses for Total Sample .................................................... 29
Outcome Predictors ............................................................................ 33
Anxiety.................................................................................... 35
Depression................. ........................ ......................... 39
Physical Illness............................................. 44
Coping........................................................................... ........ 47
4. Discussion .............................................................................................. 49
Limitations ................................................................................ 55
Summary.............................................................................................. 57
References ........................................... ................................ ....................................... 59
Appendices................................. .............................................................................. 64
Appendix A - Study Questionnaire ....................................................... 64
iii
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LIST OF TABLES
Page
Table
1. Reliability of M easures.............. 15
2. Factor Loadings for Brief COPE Subscales.............. 19
3. Means and Standard Deviations for Total Sample ..... 23
4. Correlation Matrices for each Group....................................................... 25
a. Younger African American Group ................................. 25
b. Older African American Group.................. 26
c. Younger White Group .................... 27
d. Older White Group........................ 28
5. Hierarchical Regressions ................................ 37
a. Anxiety ............................. 37
b. Depression ..................................................................................... 41
c. Physical Illness................. 45
iv
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LIST OF FIGURES
Page
Figure
1. Interaction Effects .................. 30
a. Anxiety .......................... 30
b. Depression .......................... 31
c. Homonegativity................................................................................ 31
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ABSTRACT
STRESS AND COPING AMONG
GAY OLDER ADULTS
While White older adult gay men experience stigmatization due to their age
and sexual minority status, African American older adult gay men experience
additional stigmatization due to their ethnic minority status. The purpose of this
study was to determine if the experience of compounded stigmatization due to
multiple minority status would be associated with either negative mental and
physical health outcomes, or with more effective coping skills that would foster
crisis-competence. A sociocultural stress and coping model was adapted to explore
these outcomes among African American and White younger and older adult gay
men. A total of 253 participants were recruited for a 2 (Age group) x 2 (Ethnic
group) design. Stigmatization appraisals and coping styles were examined for
effects of ethnicity and age. Results showed that African American older adult gay
men experienced significantly higher levels o f perceived stigmatization than all other
groups. However, African American older adult gay men did not experience
significantly higher levels of negative mental or physical health outcomes, even
though these outcomes were predicted by perceived stigmatization in the other
groups. Coping style remained the greatest predictor of negative outcomes for
African American older adult gay men, providing possible support for crisis-
competence among African American older adult gay men.
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Chapter 1
Background
It has only been since the late 1970s that a specific focus on the needs of
older lesbians and gay men has begun to arise in the research community (Friend,
1987,1989,1990; Kimmel, 1978). Despite an abundance o f research on sexual
orientation in general, studies of gay older adults have been scarce and studies of
ethnic minority gay older adults even scarcer. The early research on gay older
adults is primarily descriptive in nature. Many of these studies examined stereotypes
held by the heterosexual population. These studies challenged assumptions about
gay older adults and have attempted to present a more complete view of aging and
adjustment processes experienced by this population (Berger, 1984, 1992;
Minnigerode, 1976; Minnigerode & Adelman, 1978). Some research on gay aging
has demonstrated the similarities in aging between the homosexual and heterosexual
population. For example, Berger (1984) found that many older adult gay men felt
that attitude about and adjustment to aging mattered more than issues related to their
sexuality. He also found that older homosexuals go through a life review process
that is similar to that of older heterosexuals. However, these studies primarily
involved white subjects with high socio-economic status.
Stigmatization
Research on gay aging has demonstrated some positive and negative effects
of aging as a gay man. Some gay men experienced the challenges o f coming to
terms with their publicly stigmatized sexual identity at a younger age. Some studies
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show that for White gay men, dealing with the effects of ageism may be less
difficult (Berger, 1996). Many White heterosexual men go through life experiencing
minimal discrimination. If they experience ageism in older adulthood, they are
forced for the first time to deal with stigmatization. Conversely, some gay White
men first experience the stigma o f being homosexual. In studies of these men, this
experience appears to have provided the necessary skills for some to overcome the
stigma o f aging through what may be described as a form of crisis-competence
(Berger, 1996; Kimmel, 1978). Men who have learned earlier in their lives to deal
successfully with discrimination and stereotypes experienced through sexual
minority status may have developed a greater self-acceptance that provides them
with skills to deal with ageism. However, further research is needed to verify the
presence or absence of these effects in ethnic minority older adult gay men and to
better understand mechanisms that underlie them.
In addition to the stigma experienced through sexual minority status and
older age, ethnic minority older adult gay men are subjected to the stressors that
accompany ethnic minority status. A few studies have explored the effects of ethnic
minority stigmatization on gay people (Chan, 1993; Manalansan, 1996; Meyer,
1995). Chan (1993) found that the extent to which a person identifies as Asian
American or gay can depend on his perceptions of homophobia and racism in the
Asian American and gay communities respectively. Manalansan (1996) asserts that
perceived stigmatization by men who have sex with men varies by ethnic group and
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leaves these men feeling multiply marginalized. The presence of a variety of
influences in areas such as mental and physical health is suggested.
One study o f younger African American gay men found that these men
perceived homosexuality as more highly stigmatized in the African American
community than in the White community and that this stigmatization led to
internalized negative attitudes and psychological distress (Stokes & Peterson, 1998).
Another study o f African American and White gay men found that African American
men experienced more stress associated with being gay and more negative attitudes
toward homosexuality than White men (Hayes, 1996). Other studies of African
American gay men have shown that men who had higher levels of negative
experiences o f ethnic minority status also had higher levels of negative experiences
o f sexual minority status (Crawford, Allison, Zamboni, & Soto, 2002). In addition to
experiences o f perceived stigmatization within ethnic group, other studies have been
previously cited in which ethnic minorities report experiences o f racism within the
gay community (Jones & Hill, 1996; Savin-Williams, 1999). Thus, if African
American men have been found to experience greater levels of homonegativity than
White men, if higher levels of homonegativity have been associated with higher
levels of negative ethnic minority status experiences, if racism and homonegativity
are compounded within the gay community, and if both have been associated with
psychological distress, this distress may be a manifestation o f multiple
marginalization.
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If this experience of multiple marginalization through sexual minority status
and ethnic minority status extends into older adulthood, the ethnic minority older
adult gay man may then have to contend with age status marginalization as well. If
so, the crisis-competence of dealing with sexual minority status at an early age that
some White older adult gay men may use to deal effectively with the stigma of older
age status may not be available to minority older adult gay men because their
multiple marginalization experience may cancel out these effects. Further research is
indicated to gain a better understanding of the effects of ethnic minority status on
gay older adults.
Coping
Over the past decade, theories of coping through crisis competence have been
developing in regard to lesbians and gay men (Adams & Kimmel, 1997; D'Augelli,
1994; Kimmel, 2002; Lackner, Joseph, Ostrow, Kessler, & et al., 1993; Quam,
1993). These theories assert that through unique developmental challenges
experienced by lesbians and gay men such as personal acceptance of one’s
homosexual identity and processing of personal and global homonegativity, one
develops a greater ability to cope and deal with crises as they occur. Several studies
point to this developmental phenomenon as particularly beneficial to the older adult
lesbian or gay man because she or he has had a substantial amount o f time to develop
this competence throughout her or his childhood, young adulthood, and middle
adulthood (Morrow, 2001; Pope & Schulz, 1990; Quam, 1993; Sharp, 1997).
Subjects in one study specifically reported evidence of adaptive coping mechanisms
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developed in response to what they viewed as an oppressive society regarding their
sexuality (Pope & Schulz, 1990). In a study of lesbian older adults, evidence was
found to suggest that the activity o f managing the stigma of lesbian sexuality at a
younger age had provided coping mechanisms employed by subjects when faced
with the stigma o f aging. Lesbians who had a stronger sense of sexual identity were
more likely to utilize lesbian and gay community groups for education and support
regarding concerns of aging. In addition to evidence supporting crisis competence
theory, studies of coping styles among lesbians and gay men have pointed to specific
mental health outcomes. Miranda and Storms (1989) found that active coping styles
in lesbians and gay men led to a positive sense o f sexual identity, which in turn led to
positive psychological adjustment.
Despite the findings that support crisis competence theory and positive
outcomes of active coping in this population, Ehrenberg (1996) asserts that most of
these studies have failed to adequately represent the lesbian and gay older adult
population as a whole. In a study of younger Latina/o lesbians and gay men, Zea,
Reisen, and Poppen (1999) found that active coping styles were correlated with
decreased levels o f depression. Despite this one study, most research on this
population has focused on White, highly educated, affluent individuals who are able
to access high levels of instrumental support. Since accessing instrumental support
is considered an active coping style, it may be that White subjects have greater
resources to manifest this active coping style.
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A study of African American and White gay men found that African
American gay men were more likely to use emotion-focused coping styles than
White gay men (Hayes, 1996). Other studies have indicated and association between
experienced racism and emotion-focused coping (Clark, 1997; Lopez-Kinney, 2002).
Finally, in a small study of African American older adult gay men, Adams and
Kimmel suggest the presence of successful adaptations occurring within the
developmental context of this group in response to ethnic and sexual minority status
(Adams & Kimmel, 1997).
Further research is indicated that will examine these possible sociocultural
influences on stress appraisal and coping style among ethnic minority gay older
adults. In a study of African American and White caregivers, African American
participants employed emotion-focused coping styles which were associated with
increased emotional distress (Knight, Silverstein, McCallum, & Fox, 2000). In the
same study, a sociocultural stress and coping model was proposed that argued that
ethnicity implies cultural differences that affect the appraisal of stress and affects
other variables such as coping skills. The Knight et al. (2000) sociocultural stress
and coping model will be adapted for this study to examine how ethnic differences
affect coping style and perceived stigmatization among older and younger African
American and White gay men. This research may help answer questions about the
accuracy o f multiple-marginalization versus crisis-competence theories in issues of
age and ethnic group status among African American and White gay men.
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Mental and Physical Health Outcomes
Various studies have shown that the mental and physical health of gay people
can be influenced by sexual identity disclosure, homonegativity, and coping style.
Regarding sexual identity and stigmatization, Meyer (1995) found that stressors such
as internalized homophobia, expectations of rejection and discrimination, and actual
experiences o f discrimination and violence, were correlated with mental health
outcomes such as demoralization, guilt, suicidal ideation and suicidal behavior.
Cole, Kemeny, Taylor, and Visscher (1996) found that subjects who identified
negatively as gay and concealed their sexuality had a significantly higher incidence
of cancer and several infectious diseases. The authors did not propose a mechanism
for this relationship and indicated that further research is necessary to do so. In a
review o f the health behavior of gay men, Kauth and Prejean (1997) report several
studies showing that stigmatization related to sexual identity was correlated with
negative physical health outcomes. This stigmatization has been correlated with
lower levels o f sexual identity disclosure (Berger, 1992). Gray and Hedge (1999)
found that among partners o f gay men living with HIV and AIDS, those utilizing
more emotion-focused coping styles experienced higher levels of psychological
distress. A recent study of gay older adults (Grossman, D'Augelli, & O'Connell,
2001), found that higher levels o f sexual identity disclosure and lower levels of
homonegativity were associated with better mental health outcomes overall and
lower lifetime rates o f suicidal ideation.
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Finally, studies have shown lower levels of diagnosed depressive disorders
in the general older adult population and it is important to note the proposed
theoretical perspective o f the life-span diathesis-stress model (Gatz, 2000; Gatz,
Kasl-Godley, & Karel, 1996; Kasl-Godley, Gatz, & Fiske, 1998). Gatz (2000)
suggests that in addition to the developmental trajectory o f the disorder and diatheses
among older adults, protective factors such as such coping styles may also have a
developmental trajectory in which they increase with maturity. These increases
would lend support for crisis-competence theory concerning depression in older
adults. Further research is indicated to clarify the effects o f perceived stigmatization
and coping style on the mental and physical health of gay older adults.
Based on this literature, the current investigation examines the effects of
stress, as appraised by forms o f perceived stigmatization, and varying coping styles
on mental and physical health outcomes among younger and older African American
and White gay men. Similar studies of lesbian women and o f other ethnicities are
indicated for future research.
In this study, young and old groups were divided at age 55 in order to
account for considerations o f possible “accelerated aging”(Friend, 1987). Some
studies have shown that the phenomenon of accelerated aging, in which one
perceives oneself as older at a younger chronological age than others the same age
do, may occur among gay men more frequently than among heterosexual men.
Other studies on accelerated aging have produced conflicting results (Friend, 1987).
In order to gauge more accurately the possible perceptions of accelerated aging
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among potential participants for this study, informal adult and older adult gay male
discussion groups were attended at which the issue of accelerated aging was raised.
Evidence from the literature, coupled with information gained through discussion
groups, led to the 5 5-year-old dividing line for younger and older groups.
Differences in forms of perceived stigmatization, coping styles, and mental
and physical health outcomes were examined by ethnicity and age. Perceived
stigmatization was evaluated through measures of homonegativity, sexual identity
disclosure, ageism, and racism. Emotional distress was evaluated through depression
and anxiety measures and physical health was evaluated through measures of
perceived physical health. The aims of this investigation were: (a) to determine
whether there are mean differences between gay African Americans and Whites in
both process and outcome variables o f stress and coping that are due to ethnicity and
age (as main effects) or to differences in the ways in which African Americans and
Whites experience age status (Ethnicity x Age Status interaction); and (b) to
determine whether mean differences in outcome variables are related to effects of
coping style or perceived stigmatization.
Hypotheses
The overall objective o f this research investigation is to test for ethnic and
age differences in coping styles, perceived stigmatization, and mental and physical
health outcomes between gay African American and White younger and older adults.
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Specifically,
1. Regarding Multiplicative Marginalization, the African American older adult
group will have higher perceived stigmatization and higher negative mental
and physical health outcomes than all other groups.
2. Regarding Crisis-Competence, the White older adult group will have lower
negative mental and physical health outcomes than older African American
men and lower negative mental health outcomes than younger White group.
3. In support o f previous findings on mental and physical health outcomes,
active coping will be associated with positive outcomes, emotion-focused
coping will be associated with negative outcomes, and greater perceived
stigmatization will be associated with negative outcomes.
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Chapter 2
Method
Participants
Samples o f gay younger and older adults were recruited through agencies,
organizations, and businesses that provide social and recreational services and
programs to gay men in the Los Angeles area. The primary recruitment focus for
this study was on African American and White gay men. A total o f 253 participants
were recruited for a 2 (Age group) x 2 (Ethnic group) design, resulting in group
totals of 61 younger African American men, 62 younger White men, 61 older
African American men, and 69 older White men. The age distribution o f recruited
participants was continuous. Participants were divided into younger (under 55) and
older (over 55) age groups in order to obtain groups sizes that would provide good
statistical power.
The organizations through which the participants were recruited were
identified through networks of professionals who work with such agencies and
through leaders in the gay community. In order to maximize the diversity of the
sample along lines of socioeconomic status and varying levels of involvement with
the gay community, participant recruitment was distributed across a range of sources.
These ranged from visibly gay organizations and businesses to non-gay identified
organizations privately known to have contact with African American and White gay
men who may not be involved with the gay community. Contact persons at each
location were identified and utilized to facilitate recruitment. In addition, classified
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advertisements ran in local gay newspapers and magazines in an effort to recruit
participants. These ads stated that African American and White gay men would
receive a $10 honorarium for participating in a questionnaire study of stress and
coping. Interested participants were instructed to call, email, or write to request a
questionnaire. Questionnaire packets were given or mailed to interested participants
to be completed and returned by mail in a stamped envelope that was provided. To
further increase the general diversity of the sample, a snowball approach was used.
Organization and business contact persons, as well as participants, were asked to
recruit participants that were not affiliated with their group and were not members of
the same household.
Participants who completed and returned questionnaires and payment forms
were mailed $10.00 each for their participation. An information sheet that assured
the participant that his payment form would be filed separately from his
questionnaire and that his questionnaire would contain no identifying labels, was
provided with each packet. If a participant chose to remain anonymous, he had the
option to forego the $10.00 and not return the payment form with his identifying
information. A response rate could not be calculated because the number of
participants available to complete the questionnaire could not be determined.
However, over a six-month period, 257 questionnaires were returned. Of the 257
questionnaires returned, 4 were identified as not qualified due to 3 ethnic identities
and 1 gender identity not covered in the current study. This resulted in a final
sample size o f 253.
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While there are several previous studies of gay men with similar sample
sizes, it appears that this study is the first to include African American older adult
gay men with samples of this size and the first to compare African American and
White gay men across younger and older adult age groups.
Measures
Participants provided information concerning their age, years of education,
ethnic identity, sexual identity, and annual income. The following ranges for annual
income were used: (1) below $20,000; (2) $20,000-39,999; (3) $40,000-59,999; (4)
$60,000-79,999; (5) $80,000-99,999; (6) $100,000 and above.
Perceived stigmatization The Revised Homosexuality Attitude Inventory
(RHAI;(Shidlo, 1994) was used to measure personal and global homonegativity.
Participants are asked to statements that relate to being gay and circle the best
answer from 1 {Strongly Disagree) to 4 {Strongly Agree). Several items on each
subscale are designed with reverse scoring and are recoded so that higher totals on
subscales indicate higher levels of homonegativity. The personal homonegativity
subscale o f the RHAI consists of fifteen items that assess personal homonegativity in
terms of the participant’s attitudes regarding their own homosexuality. Examples of
personal homonegativity items include I am glad to be gay (reverse scored) and
Whenever I think a lot about being gay, Ifeel critical o f myself In a study of
lesbian, gay, and bisexual older adults (D'Augelli, Grossman, Hershberger, &
O'Connell, 2001) the coefficient a for personal homonegativity as assessed by this
scale was .82.
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The global homonegativity subscale of the RHAI consists o f nine items that
assess homonegativity in terms o f the participant’s attitudes regarding homosexuality
in general. Examples o f global homonegativity items include Homosexuality is not
as satisfying as heterosexuality and Homosexuality is a natural expression of
sexuality in humans (reverse scored). In this study, the coefficient a’s for personal
homonegativity and global homonegativity ranged from .71 to .87 across the four
groups. In addition, these subscales were highly correlated across all groups, ranging
from .67 to .79. As such, the subscales were combined into a 24 item measure and a
total RHAI score was used to measure total homonegativity, with a possible range of
scores from 24 to 96. The coefficient a ’s for total homonegativity as assessed by the
RHAI scale ranged from .75 to .89 across all groups and are listed in Table 1.
As a measure of sexual identity disclosure, each participant was asked to
indicate what percentage of people who currently know the participant, are aware of
his sexual identity. Responses were coded as 1 for less than 25%, 2 for 25% to 50%,
3 for 51% to 75%, and 4 for more than 75%.
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Table 1
Reliability of Measures
African-American White
Measure
Younger
(n = 61)
Older
(n = 61)
Younger
(n = 62)
Older
(n = 69)
Anxiety .95 .94 .95 .93
Depression .94 .94 .94 .88
Emotion-focused
Coping
.80 .77 .86 .70
Active Coping .87 .88 .85 .72
Homonegativity .76 .89 .85 .75
Racism .84 .89 - —
Ageism — .88 — .77
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The Index of Race-Related Stress-Brief Version (IRRS-B; Utsey, 1999) was
used to measure experiences of racism in African American participants. The IRRS-
B is a 22-item measure of the race-related stress experienced by African Americans
as a result o f their encounters with racism. Each item consists o f a statement
indicating either personally experienced or observed racism. African American
participants are asked to rate each item as 0 {This never happened to me) to 4 {This
event happened and I was extremely upset) with no reverse scored items and a total
possible range o f scores from 0 to 88. Examples of items include While shopping at
a store, or when attempting to make a purchase, you were ignored as if you were not
a serious customer or did not have any money and You have been subjected to racist
jokes by Whites/non-Blacks in positions o f authority and you did not protest for fear
they might have held it against you. Higher total scores indicate higher levels of
race-related stress. The coefficient a’s on the IRRS-B for the African American
groups in this study ranged were .84 for the younger African American group and
.89 for the older African American group and are listed in table 1.
The Ageism Survey (Palmore, 2001) was used to measure experiences of
ageism in older adult participants. This Ageism Survey is a 20-item instrument for
measuring prevalence and type of ageism experienced by older adults. The survey
asks participants to circle a number from 0 {Never) to 2 {More than once) showing
how often the participant has experienced the event listed in each item. Examples of
items include I was called an insulting name because o f my age and I was patronized
to talked down to because o f my age. In a study of older adults, the coefficient a for
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the survey was .81 (Palmore, 2001). In this study, the coefficient a ’s for the older
African American group and the older White group were .88 and .77 respectively,
and are listed in Table 1.
Coping style Coping styles were assessed using the Brief COPE scale
(Carver, 1997). This measure is an abbreviated form of the COPE inventory (Carver
& Scheier, 1994; Carver, Scheier, & Weintraub, 1989). The Brief COPE reduces the
full COPE instrument from 60 to 28 items that measure ways o f coping with
stressors. The scale is designed to measure both active coping and emotion-focused
coping styles. These styles of coping include specific coping activities such as self
distraction, active coping, denial, substance use, use of emotional support, use of
instrumental support, behavioral disengagement, venting, positive reframing,
planning, humor, acceptance, religion, and self-blame. The 14 activities represent
the 14 2-item subscales of the Brief COPE. Participants are asked to rate each item
from 1 (/ usually don’ t do this at all) to 4 (I usually do this a lot) according to how
they usually respond to difficult or stressful events in their lives. Examples of items
include I turn to work or other activities to take my mind off things on the Self
distraction subscale and I get comfort and understanding from someone on the use of
emotional support subscale. Reports on the reliability and validity o f the COPE have
shown that it possesses good psychometric properties (Carver et al., 1989).
Reliability analyses o f the Brief Cope indicated that reliabilities for all of its scales
met or exceeded the minimally acceptable value of .50 and most exceeded .60
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(Carver, 1997). Factor structures were similar to those originally reported for the
full COPE inventory (Carver, 1997).
As in Carver’s study, analyses in this study indicated that reliabilities for all
subscales met or exceeded the minimally acceptable value o f .50 and most exceeded
.60. Using principle components analysis, subscales were combined into two higher
ordered factors o f Emotion-focused Coping and Active Coping consisting of 6 and 8
subscales respectively for both African American and White participants. Factor
loadings for all subscales are listed by ethnicity in Table 2. Unlike previous studies,
in this study the humor subscale loaded on Active Coping instead of Emotion-
focused coping. The Active Coping factor included the eight subscales o f use o f
emotional support, use o f instrumental support, active coping, positive reframing,
planning, humor, acceptance, and religion. The Emotion-focused Coping factor
included the six subscales of self-distraction, denial, substance use, behavioral
disengagement, venting, and self-blame. Cronbach a’s for Emotion-focused Coping
and Active Coping ranged from .70 to .86 across groups and are listed in Table 1.
Emotional distress Mental health outcomes or emotional distress was
measured with two widely used scales. Depression was measured using the Center
for Epidemiological Studies Depression Scale (CES-D; Radloff, 1977). The CES-D
scale is a 20-item self-report measure developed to screen for depressive
symptomolgy in the general population. Total scores range from 0 to 60 with higher
scores indicating more depressive symptomology. The corrected split-halves
correlation and coefficient a were satisfactorily high (.85 to .92) (Radloff, 1977).
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Table 2
Factor Loadings for Brief COPE Subscales
African-American White
(n=122) (n=131)
Active Emotion- Active Emotion-
Focused Focused
Use of emotional
Support
.53 .27 .60 .30
Use of instrumental
Support
.59 -.15 .55 -.02
Active coping .73 -.07 .62 -.28
Positive reframing .68 .28 .60 .11
Planning .82 .13 .65 -.21
Humor .55 .23 .49 .18
Acceptance .59 .19 .66 -.05
Religion .65 .17 .43 .19
Self-distraction -.04 .60 -.10 .56
Denial -.31 .65 -.42 .55
Substance use .10 .48 -.27 .53
Behavioral
disengagement
-.47 .62 -.43 .51
Venting .15 .52 .39 .54
Self-blame -.50 .59 -.38 .56
% variance explained 33 29 31 25
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An analysis of studies that used the CES-D with older adults found that the
scale is as good or better with older adults as it is with younger adults (Radloff &
Teri, 1986). Cronbach a ’s on the CES-D are reported for all groups in this study in
Table 1. Anxiety was measured by the Trait Anxiety Scale from the Spielberger
State-Trait Anxiety Inventory (Spielberger, 1985). The STAI-Trait (STAI-T) is a 20
item self-report scale that measures general anxiety level. Total scores for trait
anxiety range from 20 to 80, with higher scores indicating more anxiety. The overall
median alpha coefficient for the Trait anxiety scale in normative samples was .92.
Studies have shown the STAI to be a good measure of anxiety in older adults
(Patterson, 1980). Cronbach a ’s on the STAI-T are reported for all groups in this
study in Table 1.
Physical Health Drawing upon the work of Liang (1986) self-reported
physical health was measured as participants were asked to report their current health
status by responding “yes” or “no” to a list of 9 health problems and illnesses. Items
were scored as 1 if endorsed and 0 if not endorsed with a possible total range o f 0 to
9. Examples o f items include Respiratory problems/illnesses? and Digestive/internal
problems/illnesses ?
20
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Chapter 3
Results
Demographic Characteristics Demographic data characterizing the four
groups on variables o f age, years of education, and annual income are presented in
Table 3. The younger African American group ranged in age from 18 to 54 with a
mean age of 33.9. The younger White group also ranged in age from 18 to 54 and
had a mean age of 34.9. The older African American group ranged in age from 55 to
83 with a mean age o f 65.7 while the older White group ranged in age from 55 to 90
with a mean age o f 69.1. The younger African American and White groups had
14.6 and 15.6 mean years of education respectively. The older African American
and White groups had 14.8 and 15.8 mean years of education respectively. The
younger African American and White groups had 2.0 and 2.6 mean annual income
ratings respectively. The older African American and White groups had 2.1 and 2.7
mean annual income ratings respectively. This placed the means of all groups within
the $20,000 to $39,999 annual income range.
Comparisons of the four groups on the variables of age, years of education,
and annual income were conducted using a 2 (Younger, Older) x 2 (African
American, White) multivariate analysis of variance (MANOVA). Mean age did not
differ significantly between the two younger groups or between the two older groups.
Both education and income variables varied significantly as a function of ethnic
group. Significant main effects were found for education F(l,57) = 8.1, p< .05 and
annual income F(l,22) = 13.23, p<.001 with White participants having more years of
21
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education and higher levels of income than African American participants. No
significant interaction effects were found. Mean levels of education and income for
this sample appear to be similar to those in previous studies o f gay men. Means and
standard deviations are shown in Table 3.
2 2
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Table 3
Means and Standard Deviations fo r the Total Sample
African-American White
Younger Older Younger Older
v o
I I
V O
l i
&
(n=62) (n = 69)
Variable M SD M SD M SD M SD
Age 33.9,, 9.7 65.7a 8.7 34.9b 8.9 69. la 7.8
Years of education 1 4 4 2.1 14.8^ 2.8 15-6a 2.7
CO
hn
3.0
Annual income
(1-6)
2 .0 b 1 .2 2.1b
1.0 2 -6 a 1.3 2.7a 1 .6
Anxiety
(20-80)
37.7b 12.7 36.9b 1 2 .2 43.2a 13.3 33.5b 11.2
Depression
(0-60)
13-7ab
11.9 13.9^ 12.7 17.9a 13.2 11.7b 1 0 .0
Physical Illness
(0-9)
l-lb
1.4
2 .2 a
1.5 1 .0 b 1.1 2-4a 1.5
Emotion-focused
Coping (16-48)
26.5a 6.0 26.9a 8.2 25.4a 5.4
23.1b
6 . 0
Active Coping
(12-64)
45.6 8.0 44.3 10.7 44.1 7.5 43.5 1 0 .2
Homonegativitv
(24-96)
4 3 4 9.4 47.6a 1 1 .0 43.0b 9.3 40.7b 7.5
Sexual Identity
Disclosure (1-4)
3 .0 b 1 .0 2.2C 1 .2
3 4 1 .0 3 .0 b 1 .1
Racism
(0-88)
3 7 .9 b 19.8 5 3 .1 a 22.8 ““
...
—
Ageism
(0-40)
13.8* 8 .2 8.5b 5 .2
Note. Means with different subscripts differ (p < .05) on the basis of post hoc t tests. Double
subscripts are used when a middle score falls between two significantly different means and
does not differ significantly from either.
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Correlations
Correlation matrices for all dependent and independent variables for each
group can be found in Tables 4a, 4b, 4c, and 4d. The matrices show no evidence of
multicolinearity, as none o f the independent variables are correlated more than .5.
The anxiety (STAI-T) and depression (CES-D) measures were highly correlated
across all groups, indicating that these measures are not independent of each other.
However, analyses o f mean differences showed patterns of significant differences
across groups that varied by each measure and as such, a decision was made to use
both scales.
Generally, measures o f stigmatization appear to correlate significantly with
mental health outcomes across all groups and with physical illness in the White older
adult group. Higher levels of homonegativity, experienced racism, and experienced
ageism, were associated with higher levels o f anxiety and in some cases, depression.
Higher levels o f stigmatization were also associated with higher levels o f physical
illness in the White older adult group. In addition, in most groups, emotion-focused
coping correlated significantly with negative mental health outcomes with more
emotion-focused coping associated with higher levels of anxiety and in some cases,
depression. In all groups except for the White older adult group, active coping was
negatively correlated with mental health outcomes, with higher levels o f active
coping associated with lower levels o f anxiety and depression.
24
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Table 4a
Correlation Matrix fo r Younger African-American Group
Variable VI V2 V3 V4 V5 V6 V7 V8 V9 V10 V I1
V 1 Education 1.00
V2 Income .46” 1.00
V3 Anxiety -.24 -.24 1.00
(STAIT)
V4 Depression -.19 -.17 .82” 1.00
(CES-D)
V5 Physical -.03 -.16 .24 .32* 1.00
Illness
V6 Emotion-focused -.07 -.11 .47" .53’ .10 1.00
Coping (COPE)
V7 Active Coping .12 .11 -.54” -.38” -.06 -.06 1.00
(COPE)
V8 Homonegativity -.13 -.33” .33” .22 .02 .03 -.32* 1.00
(RHAI)
V9 Sexual Identity .09 .07 -.34" -.20 -.02 .04 .23 -.42” 1.00
Disclosure
V I0 Racism -.10 -.24 .50" .46” .22 .24 -.09 .10 -.30’ 1.00
(IRRS-B)
V I1 Ageism
(Ageism Survey)
"Correlation is significant at the .01 level (2-tailed).
’Correlation is significant at the .05 level (2-tailed).
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Table 4b
Correlation Matrix fo r Older African-American Group
Variable VI V2 V3 V4 V5 V6 V7 V8 V9 V10 V ll
VI Education 1.00
V2 Income .53** 1.00
V3 Anxiety -.22 -.08 1.00
(STAIT)
V4 Depression -.22 -.13 .92** 1.00
(CES-D)
V5 Physical -.22 -.29* -.08 -.01 1.00
Illness
V6 Emotion-focused
1
00
«
-.20 .38* .33** .31* 1.00
Coping (COPE)
V7 Active Coping .22 .03 -.32" -.36" .04 -.12 1.00
(COPE)
V8 Homonegativity -.45** -.25 .23 .11 .11 .43" -.19 1.00
(RHAI)
V9 Sexual Identity .54** .37" -.09 -.02 -.26* -.45" .14 -.25 1.00
Disclosure
V 10 Racism -.12 -.19 .23 .25 .18 .36" -.10 .41** -.43** 1.00
(IRRS-B)
V I 1 Ageism -.37" -.22 .42** .39** .23 .70" -.18 .55" -.53" .61" 1.00
(Ageism Survey)
**Correlation is significant at the .01 level (2-tailed).
♦Correlation is significant at the .05 level (2-tailed).
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Table 4c
Correlation Matrix fo r Younger White Group
Variable VI V2 V3 V4 V5 V6 V7 V8 V9 V10 V I1
V 1 Education 1.00
V2 Income .54*” 1.00
V3 Anxiety -.20 -.22 1.00
(STAIT)
V4 Depression -.21 -.14 .84” 1.00
(CES-D)
V5 Physical -.04 -.11 .39” .34** 1.00
Illness
V6 Emotion-focused -.40” -.34” .38" .37” .21 1.00
Coping (COPE)
V7 Active Coping -.14 -.08 -.52” -.53” -.18 -.07 1.00
(COPE)
V8 Homonegativity -.24 -.10 .49” .45” .01 .23 -.33”
(RHAI)
V9 Sexual Identity .06 -.08 -.17 -.27* .05 -.10 .14
Disclosure
V10 Racism
(IRRS-B)
V I1 Ageism
(Ageism Survey)
♦♦Correlation is significant at the .01 level (2-tailed).
♦Correlation is significant at the .05 level (2-tailed).
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Table 4d
Correlation Matrix fo r Older White Group
Variable VI V2 V3 V4 V5 V6 V7 V8 V9 V10 V I1
VI Education 1.00
V2 Income .40" 1.00
V3 Anxiety -.12 -.19 1.00
(STAIT)
V4 Depression -.19 -.27* .81" 1.00
(CES-D)
V5 Physical -.14 -.01 .23* .40" 1.00
Illness
V6 Emotion-focused -.07 -.08 .33" .51" .28* 1.00
Coping (COPE)
V7 Active Coping -.04 -.17 -.10 -.08 .17 -.33" 1.00
(COPE)
V8 Homonegativity -.09 -.08 .54” .49” .27* .24* -.21 1.00
(RHAI)
V9 Sexual Identity .13 .04 -.15 -.06 .25* .04 .19 -.18 1.00
Disclosure
V I0 Racism
(IRRS-B)
V 11 Ageism -.15 .08 .31" .33" .46" .22 .18 .19 -.03 1.00
(Ageism Survey)
“ Correlation is significant at the .01 level (2-tailed).
‘ Correlation is significant at the .05 level (2-tailed).
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Analyses for Total Sample A multivariate analysis o f variance (MANOVA)
was performed using a 2 (Age group) x 2 (Ethnic group) between subjects design for
the variables o f depression, anxiety, physical illness, homonegativity, sexual identity
disclosure, emotion-focused coping, and active coping. This analysis revealed a
significant multivariate main effect for ethnic group [Wilks’s A = .213, F(7,245) =
2.09,p < .05], no significant multivariate main effect for age group [Wilks’s A =
.951, F(7,245) = 1.52, p < .16], and a significant multivariate age group x ethnic
group interaction effect [Wilks’s A = .924, F(7,245) = 2.44, p < .05]. Subsequent
multiple univariate analyses were performed. Significant main effects by ethnicity
were found for sexual identity disclosure F (1,249) = 20.36, p < .001, MSE - 1.18;
emotion-focused coping F(l,249) = 8.94, p < .01, MSE = 41.59; and homonegativity
F( 1,249) = 9.25, p < .01, MSE = 87.65. White participants had higher levels of
sexual identity disclosure, lower levels of emotion-focused coping, and lower levels
o f homonegativity than African American subjects, as hypothesized. While these
results support the hypothesis that African American participants would have higher
levels of emotion-focused coping than White participants would, they do not support
the hypothesis that African American participants would have lower levels of active
coping than White participants would. In addition, the hypothesis that older
participants would have higher levels of active coping than younger participants was
not supported. Significant interaction effects of ethnicity by age group were found
for anxiety F(l,249) = 7.78, p < .01, MSE = 153.35; depression F(l,249) = 4.13,p <
.05, MSE = 142.81; and homonegativity F{1,249) = 6.80, p < .05, MSE = 87.65.
29
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Interaction effects are shown in Figures la, lb, and lc. These results reflected
higher levels o f anxiety and depression for younger White participants, and higher
levels o f homonegativity for older African American participants. These results
supported the hypotheses that older White participants would experience the lowest
levels o f emotional distress and older African American participants would
experience the highest levels of homonegativity. These results did not support the
hypothesis that significant interaction effects would be found with older African
American participants reporting the lowest levels of sexual identity disclosure.
Means and standard deviations are shown in Table 3.
Figure la
Anxiety
42-
40-
t r
Age Group
34 -
18 to 54
55 +
African-American White
Ethnicity
30
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Figure lb
Depression
Q 16-
(O
m
o 1 5 .
c
JB
05
5 14.
Age Group
18 to 54
55 +
African-American White
Ethnicity
Figure lc
Homonegativity
46-
<
I
D C
c
s
5
44-
Age Group
42-
18 to 54
4 0 _______
African-American White
Ethnicity
31
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Post-hoc t tests followed the MANOVA in order to examine significant
interactions in an effort to further illuminate group differences. These analyses
served to test the hypotheses regarding differences in mean values o f both dependent
and independent variables between age groups with the Ethnicity x Age interaction
term showing whether the effect is specific to ethnicity or reflects general age
differences. Post-hoc t tests found that younger White participants had significantly
higher levels of anxiety (t [128] = 4.51, p < .001) and depression (t [129] = 3.06, p <
.01) than older White participants did, and significantly higher levels of anxiety (t
[121] = -2.32, p < .05; t [121] = -2.83, p < .01) than younger and older African
American participants did respectively. These findings serve to explicate the key
significant differences in the interaction effects found for anxiety and depression.
Thus, differences in mental health outcomes appear for the White groups. While
these findings support the hypothesis that older White participants would experience
the lowest levels o f emotional distress, they do not support the hypothesis that
African Americans would experience more emotional distress.
An additional post-hoc t test to examine the interaction effect of Ethnicity x
Age for homonegativity found that older African American men had significantly
higher levels of homonegativity than older White men, younger White men, and
younger African American men respectively (t [128] = 4.05, p < .001; t [121] = 2.32,
p < .05; t [120] = 1.98, p < .05). Thus, differences in levels of homonegativity
appear for the older groups and these findings support the hypothesis that older
African American men would be highest on this measure.
32
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In addition, t tests were performed in order to examine differences in mean
values between older and younger African American groups on the variable of race-
related stress and to examine differences in mean values between older African
American and older White groups on the variable of ageism experiences. Older
African American men had significantly higher levels of race-related stress than
younger African American men (t [119] = 3.83, p < .001), and significantly higher
levels of ageism experiences than older White men (t [128] = 4.21, p < .001). These
findings support the hypothesis that older African American participants would
experience the highest levels of perceived stigmatization.
In addition, because education and income differed by ethnicity, a
multivariate analysis of covariance (MANCOVA) was performed to test whether
results inferred by ethnicity were confounded by socioeconomic status. Since
education and income were strongly correlated across groups, income alone was
chosen as the covariate. Results of this analysis revealed no changes in significant
findings from the MANOVA analysis, suggesting that socioeconomic status was not
a significant confound.
Finally, scatterplots were generated for all variables by age in order to
confirm that no discontinuities existed in relation to age and in order to check for
possible curvilinear effects. None were found.
Outcome Predictors
Hierarchical regression analyses were employed to illuminate relationships
between coping style, perceived stigmatization, and mental and physical health
33
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outcomes. A series o f three hierarchical regression analyses on outcomes of
Anxiety, Depression, and Physical Illness were performed separately for the younger
African American, younger White, older African American, and older White groups.
These analyses tested the hypotheses that lower levels o f perceived stigmatization
and a more active coping style are associated with positive mental and physical
health outcomes and higher levels o f perceived stigmatization and emotion-focused
coping style are associated with negative mental and physical health outcomes.
The hierarchical regressions contained the same models for each o f the three
outcome variables across all o f the four groups except for the inclusion o f the
Racism variable as a step for African American groups and the inclusion of the
Ageism variable as a step for older adult groups. Step one for all four groups across
all three outcome variables included only income. Again, as with the MANCOVA,
education was not included here because income and education were strongly
correlated across groups. Step two for all four groups across all three outcome
variables added emotion-focused and active coping. Coping was entered here in
order to treat it as a trait measure and examine the effects o f stigma when controlling
for coping. Step three for all four groups across all three outcome variables added
sexual identity disclosure and homonegativity. Step four added racism for both
African American groups and added ageism for the older White group. There were
no further steps for the younger White group, as there were no additional measures
of stigmatization for this group. Step five added ageism for the older African
American group. There were no further steps for the younger African American
34
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group or the older White group, as there were no additional measures of
stigmatization for these groups. Tables 5a, 5b, and 5c display results of all three
outcome variable regressions for all four groups.
Predictors of Anxiety
In step one o f the hierarchical regression for anxiety, income was not a
predictor for any of the groups. Adding emotion-focused coping and active coping
in step two, significantly increased the variance explained across all four groups.
These increases were from 6 to 50 percent in the younger African American group,
from 1 to 26 percent in the Older African American group, from 5 to 40 percent in
the younger White group, and from 4 to 14 percent in the older White group. In this
step, higher levels of emotion-focused coping were associated with higher levels of
anxiety for all four groups. In addition, lower levels o f active coping were
associated with higher levels of anxiety in both younger groups and in the older
African American group. These findings support the hypotheses that higher levels of
emotion-focused coping would be associated with negative mental health outcomes
and partially support the hypothesis that higher levels o f active coping would be
associated with positive mental health outcomes, with the older White group as the
exception. To further illuminate differences between groups in the anxiety
regression, significance tests for the differences in partial regression coefficients
between independent groups were performed. Significant differences were found for
active coping between the older White group and the younger White, older African
American, and younger African American groups respectively (z = 3.73, p < .01; z =
35
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2.21, p < .05; z - 3.68, p < .01). These results indicate that the older White group
varies significantly from the other three groups in that it is the only group without a
significant association between higher levels of active coping and lower levels of
anxiety.
In step three, sexual identity disclosure and homonegativity were added,
resulting in significant increases in the variance explained across both younger
groups and the older White group. These increases were from 50 to 56 percent in the
younger African American group, from 40 to 46 percent in the younger White group,
and from 14 to 39 percent in the older White group. No significant increase in
variance explained was found in the older African American group. In this step,
lower levels of sexual identity disclosure were associated with higher levels of
anxiety only in the younger African American group and higher levels of
homonegativity were associated with higher levels o f anxiety only in the younger
and older White groups. These results only partially support the hypothesis that
higher levels o f perceived stigmatization would be associated with higher levels of
negative mental health outcomes, as these associations are inconsistently significant
across ethnic groups. Thus, it appears that homonegativity is a significant predictor
of anxiety in the younger and older White groups and sexual identity disclosure is a
significant predictor o f anxiety in the younger African American group.
36
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Table 5a
Hierarchical Regressions o f Anxiety fo r each group
African-American White
Younger Older Younger Older
b SE R2 b SE R2 b SE R2 b SE
tep 1 .06 .01 .05
Income -2.60 1.44 -1.00 1.54 -2.25 1.27 -1.33 .85
»tep 2 .50*** .26*** .40
»««
Income -1.50 1.08 -.22 1.38 -1.69 1.10 -1.23 .84
Emotion Coping .91*** .21 .41* .18 .66* .26 .57* .24
Active Coping -.80*** .16 -.46** .13 -.88*** .18 .03 .14
>tep 3 56* .29 .46
*
.3
Income -1.20 1.10 -.67 1.46 -1.42 1.07 -1.46* .73
Emotion Coping .94*** .20 .45* .18 .54* .26 .40 .21
Active Coping -.70’* * .16 -.46*’ .13 -.71*** .18 .05 .12
Sexual identity disc. -2.82* 1.30 2.24 1.60 .96 1.60 -.68 1.05
Homonegativity .06 .15 .17 .17 .45’ .18 .76*** .16
Step 4 63** .30
Income -.28 1.07 -.63 1.46 -1.68* .72
Emotion Coping .81*** .20 .41* .20 .28 .21
Active Coping -.67*** .15 -.45** .13 -.03 .18
Sexual identity disc. -1.78 1.26 2.56 1.63 -.49 1.03
Homonegativity .10 .14 .14 .17 .71*** .16
Racism (Black) .19** .07 .08 .07
Ageism (Older White) .45* .23
Step 5 .35
Income -.61 1.42
Emotion Coping .20 .22
Active Coping -.43” .13
Sexual identity disc. 2.83 1.60
Homonegativity .07 .17
Racism (Black) .08 .08
Ageism (Older Black) .53* .27
Note, b = unstandardized coefficient. R2 with * denotes significant &R2.
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When significance tests for the differences in partial regression coefficients
between independent groups were performed, significant differences were found for
homonegativity between the older White group and the older and younger African
American groups respectively (z = 2,56, p < .05; z = 3.16, p < .01) and for sexual
identity disclosure between the younger and older African American group (z = 2.46,
p < .05). These results indicate that the association between increased levels of
homonegativity and increased levels of anxiety is significantly stronger for the older
White group than for the African American groups and the association between
decreased levels o f sexual identity disclosure and increased levels of anxiety is
significantly stronger for the younger African American group than for the older
African American group.
In step four, racism was added for the African American groups and ageism
was added for the older White group. There were no further steps for the younger
White group. This resulted in significant increases in the variance explained for the
younger African American group and the older White group. These increases were
from 56 to 63 percent in the younger African American group and from 39 to 42
percent in the older White group. Higher levels of experiences o f racism were
associated with higher levels of anxiety in the younger African American group and
higher levels of experiences of ageism are associated with higher levels of anxiety in
the older White group. These results only partially support the hypothesis that
higher levels of perceived stigmatization would be associated with higher levels
negative health outcomes, as these associations are inconsistently significant for
38
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racism in the African American groups. The significant association of higher levels
of experiences o f ageism and higher levels o f anxiety in the older White group,
supports the hypothesis that higher levels of stigmatization would be associated with
higher levels o f negative mental health outcomes. However, this result is not
consistent across older groups. When ageism is added for the older African
American group in step five, although higher levels o f experienced ageism are
associated with higher levels o f anxiety, no significant increases in the variance
explained for anxiety resulted from the step. Thus is appears that experiences of
racism are a significant predictor o f anxiety in the younger African American group
and experiences o f ageism are a significant predictor o f anxiety in the older White
group only. To further clarify this result, a post-hoc test of experiences of ageism as
a predictor o f anxiety for the older African American group was performed as a new
regression model in which ageism was added earlier at step three and all other
stigmatization measures were dropped. Results showed that experiences of ageism
still did not significantly predict anxiety for the older African American group.
Predictors o f Depression
In step one o f the hierarchical regression for depression, income was a
significant predictor for the older White group only, predicting 7 percent o f the
variance explained indicating an association between lower levels o f income and
higher levels of depression. Adding emotion-focused coping and active coping in
step two, significantly increased the variance explained across all four groups. These
increases were from 3 to 41 percent in the younger African American group, from 2
39
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to 22 percent in the Older African American group, from 2 to 37 percent in the
younger White group, and from 7 to 32 percent in the older White group. In this
step, higher levels o f emotion-focused coping were associated with higher levels of
depression for all four groups. In addition, lower levels of active coping were
associated with higher levels o f depression in both younger groups and in the older
African American group. These findings support the hypotheses that higher levels of
emotion-focused coping would be associated with negative mental health outcomes
and partially support the hypothesis that lower levels of active coping would be
associated with negative mental health outcomes, with the older White group as the
exception. When significance tests for the differences in partial regression
coefficients between independent groups were performed, significant differences
were found for active coping between the older White group and the younger White,
older African American, and younger African American groups respectively (z =
4.31, p < .001; z - 2.38, p < .05; z = 2.81, p < .01). These results indicate that the
older White group varies significantly from the other three groups in that it is the
only group without a significant association between higher levels of active coping
and lower levels o f depression. Significant differences were also found for emotion-
focused coping between the older and younger African American groups (z = 1.99, p
< .05). These results indicated that while the association between emotion-focused
coping and depression was significant in both o f these groups, when compared, this
association was significantly greater in the younger African American group.
40
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Table 5b
Hierarchical Regressions o f Depression fo r each group
Afri can-American White
Younger Older Younger Older
b SE R2 b SE R2 b SE R2 b SE R2
Step 1 .03 .02 .02 .07*
Income -1.67 1.37 -1.63 1.59 -1.36 1.27 -1.65* .74
Step 2
A
.41 .22” .37*** .32***
Income -.73 1.02 -.84 1.47 -.75 1.11 -1.38* .66
Emotion Coping 1.00” * .22 .43’ .19 .69* .27 .86**’ .19
Active Coping -.50” .16 -.38** .14 -.87” * .18 .04 .11
Step 3 .43 .26 .42
49*»*
Income -.55 1.17 -1.69 1.54 -.70 1.10 -1.59” .59
Emotion Coping 1.02” * .22 .57” .21 .58* .26 .72’* * .17
Active Coping -.44* .17 -.40” .14 -.74*** .19 .10 .10
Sexual identity disc. -1.58 1.30 2.53 1.70 -.97 1.64 -.11 .84
Homonegativity .04 .16 .00 .18 .29 .18 .58*" .13
Step 4 .49* .29 .52
Income -.26 1.17 -1.63 1.52 -1.76” .58
Emotion Coping
9j***
.21 .52* .21 .62" .17
Active Coping -.42* .15 -.40” .14 .03 .10
Sexual identity disc. -.66 1.37 3.03 1.70 .03 .83
Homonegativity .08 .16 -.05 .18 .59*” .13
Racism (Black) .17* .07 .11 .07
Ageism (Older White) .34 .18
Step 5 .33
Income -1.61 1.49
Emotion Coping .31 .23
Active Coping -.38” .14
Sexual identity disc. 3.29 1.68
Homonegativity -.12 .18
Racism (Black) .03 .08
Ageism (Older Black) .51 .28
Note, b = unstandardized coefficient. R2 with * denotes significant AR2.
> <.05; * > < .0 1 ; **><.001
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In step three, sexual identity disclosure and homonegativity were added,
resulting in significant increases in the variance explained in the older White group
only. These increases were from 32 to 49 percent in the older White group. No
significant increases in variance explained were found for the other three groups. In
this step, higher levels of homonegativity were associated with higher levels of
depression only in the older White group. These results only partially support the
hypothesis that higher levels of perceived stigmatization would be associated with
higher levels o f negative mental health outcomes, as these associations are
inconsistently significant across older groups and not significant across younger
groups. Thus, it appears that homonegativity is a significant predictor of depression
in the older White group. When significance tests for the differences in partial
regression coefficients between independent groups were performed, significant
differences were found for homonegativity between the older White group and the
older and younger African American groups respectively (z = 2.78, p < .01; z = 2.59,
p < .01). These results indicate that the association between increased levels of
homonegativity and increased levels of depression is significantly stronger for the
older White group than the older and younger African American groups. It should
also be noted that because differences for sexual identity disclosure between the
younger and older African American groups approached significance (z = 1.88, p <
.06) caution should be taken in concluding that the association between sexual
identity disclosure and depression does not differ between younger and older African
American groups.
42
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In step four, racism was added for the African American groups and ageism
was added for the older White group. There were no further steps for the younger
White group. This resulted in significant increases in the variance explained for the
younger African American group only. These increases were from 43 to 49 percent.
Higher levels of experiences of racism were associated with higher levels of
depression in the younger African American group. These results only partially
support the hypothesis that higher levels o f perceived stigmatization would be
associated with higher levels negative mental health outcomes, as these associations
are inconsistently significant for experiences o f racism in the African American
groups. The lack o f significant association between higher levels o f experiences of
ageism and higher levels o f depression in the older White group, does not support the
hypothesis that higher levels of stigmatization would be associated with higher levels
of negative mental health outcomes. This result is consistent across older groups.
When ageism is added for the older African American group in step five, no
significant increases in the variance explained for depression resulted from the step.
Thus, it appears that experiences of racism are a significant predictor of depression
in the younger African American group only and that experiences o f ageism are not a
significant predictor of depression in older African American or White groups.
To further clarify this result, a post-hoc test of experiences of ageism as a
predictor of anxiety for the older African American group was performed as a new
regression model in which ageism was added earlier at step three and all other
43
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stigmatization measures were dropped. Results showed that experiences of ageism
still did not significantly predict anxiety for the older African American group.
Predictors of Physical Illness
In step one o f the hierarchical regression for physical illness, income was a
significant predictor for the older African American group only, predicting 8 percent
o f the variance explained indicating an association between lower levels o f income
and higher levels o f physical illness. Adding emotion-focused coping and active
coping in step two, significantly increased the variance explained in the older White
group only. This increase was from 0 to 16 percent in the older White group. No
significant increases in variance explained were found for the other three groups. In
this step, higher levels of both emotion-focused coping and active coping were
associated with higher levels of physical illness in the older White group. No
significance differences were found when tests for the differences in partial
regression coefficients between independent groups were performed at this step.
These findings conflict with the model and do not fully support the hypotheses that
higher levels of emotion-focused coping and lower levels o f active coping would be
associated with negative physical health outcomes.
In step three, sexual identity disclosure and homonegativity were added,
again resulting in significant increases in the variance explained in the older White
group only. These increases were from 16 to 26 percent in the older White group.
No significant increases in variance explained were found the other three groups. In
this step, higher levels o f both homonegativity and sexual identity disclosure were
44
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Table 5c
Hierarchical Regressions o f Physical Illness fo r each group
African-American White
Younger Older Younger Older
b SE R2 b SE R2 b SE R2 b SE R2
Step 1 .03 .08* .01 .00
Income -.19 .16 -.42* .19 -.10 .11 .01 .12
Step 2 .04 .15 .09 .16**
Income -.18 .17 -.35 .19 .06 .12 .09 .11
Emotion Coping .02 .03 .05* .02 .04 .03 .10** .03
Active Coping -.08 .02 .01 .09 .03 .02 .05* .02
Step 3 .04 .17 .10 .26*
Income -.20 .18 -.31 .20 .06 .12 .05 .11
Emotion Coping .02 .03 .05 .03 .05 .03 .08* .03
Active Coping .01 .03 .10 .13 .03 .02 .04* .02
Sexual identity disc. -.04 .21 -.20 .22 .05 .18 .31* .16
Homonegativity -.01 .03 -.02 .02 .01 .02 .06* .02
Step 4 .06 .17 .37”
Income -.14 .19 -.31 .20 .00 .10
Emotion Coping .01 .03 .05 .03 .05 .03
Active Coping -.01 .03 .10 .02 .02 .02
Sexual identity disc. .03 1.26 -.19 .22 .35* .15
Homonegativity .01 .03 .02 .02 .05** .02
Racism (Black) .01 .01 .00 .01
Ageism (Older White) .10” .03
Step 5 .17
Income -.31 ,20
Emotion Coping .05 .03
Active Coping .10 .02
Sexual identity disc. -.19 .23
Homonegativity .02 .02
Racism (Black) .00 .01
Ageism (Older Black) .00 .04
Note, b - unstandardized coefficient. R2 with * denotes significant SR2 .
*p < .05; **p < .01; ***p < .001
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associated with higher levels of physical illness in the older White group. The latter
finding was unexpected and conflicts with the model. As such, the findings in this
step do not fully support the hypothesis that higher levels of perceived stigmatization
would be associated with higher levels o f negative physical health outcomes.
When significance tests for the differences in partial regression coefficients
between independent groups were performed, significant differences were found for
homonegativity between the older White group and the younger White, older African
American, and younger African American groups respectively (z =2.27, p < .05; z -
1.99, p < .05; z — 2.02, p < .05). These results indicate that the association between
increased levels o f homonegativity and increased levels o f physical illness is
significantly stronger for the older White group than for all other groups. It should
also be noted that because differences for sexual identity disclosure between the
older White and African American groups approached significance (z = 1.92, p <
.06) caution should be taken in concluding that the association between sexual
identity disclosure and physical illness does not differ between the older White and
African American groups.
In step four, racism was added for the African American groups and ageism
was added for the older White group. There were no further steps for the younger
White group. This resulted in no significant increases in the variance explained for
African American groups. These results do not support the hypothesis that higher
levels of perceived stigmatization would be associated with higher levels of negative
physical health outcomes. In this step, there was a significant increase in the
46
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variance explained for the older White group, resulting in an increase from 26 to 37
percent. Higher levels o f experienced ageism were associated with higher levels of
physical illness. This association supports the hypothesis that higher levels of
stigmatization would be associated with higher levels o f physical health outcomes.
However, this result was not consistent across older groups. When ageism was
added for the older African American group in step five, no significant increases in
the variance explained for physical illness resulted from the step. Thus, it appears
that experiences o f racism are not a significant predictor o f physical illness in the
African American groups and that experiences o f ageism are a significant predictor
of physical illness in the older White group only. When significance tests for the
differences in partial regression coefficients between independent groups were
performed, significant differences were found for experiences o f ageism between the
Africa-American and White older groups (z = 1.99, p < .05). These results indicate
that the association between increased levels of ageism and increased levels of
physical illness is significantly stronger for the older White group than for the older
African American group.
Predictors of Coping Style
In order to look at possible effects of perceived stigmatization on coping
styles, hierarchical regressions were performed separately for both emotion-focused
coping style and active coping style. Homonegativity, racism and ageism were
included in order as steps in the regression. Results showed that perceived
stigmatization did not significantly predict coping styles among the four groups, with
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one exception. Perceived ageism significantly predicted emotion-focused coping
style among the older African American group (b = .63, p < .01; AR2 = .21, p < .01).
48
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Chapter 4
Discussion
Studies of gay men have failed to adequately represent older adults and
different ethnic groups. While a few studies o f similar size have examined gay older
adult samples primarily comprised o f White participants, this is the largest study to
date of African American older adult gay men and the first of its kind to examine
differences between African American older adult gay men and White older adult
gay men with additional comparison groups o f African American and White younger
adult gay men. In this study, the perceived stigmatization o f homonegativity,
ageism, and racism, as well as varying coping styles, are associated with differences
in mental and physical health outcomes. A sociocultural stress and coping model is
supported as these influences varied by ethnicity and age and thus, may suggest a
possible presence o f crisis-competence in the face o f multiple minority status.
Findings from this study have implications for intervention research and practice
among African American and White older and younger gay men.
In this study, findings regarding mean differences in perceived stigmatization
by age and ethnicity support the notion that multiple minority status is compounded
among African American older adult gay men. These men experienced significantly
higher levels o f homonegativity and lower levels of sexual identity disclosure across
all groups, significantly higher levels o f experienced racism than younger African
American gay men did, and significantly higher levels of experienced ageism than
White older adult gay men did. These data support previous findings of
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compounded negative experiences of ethnic minority and sexual minority status
among African American men (Crawford et a l, 2002).
When examining the younger African American group and both White
groups, the data reveal other possible occurrences of compounded multiple minority
status. While homonegativity did not vary across these three groups, African
American younger adult gay men and White older adult gay men had significantly
lower levels o f sexual identity disclosure. This might suggest compounded minority
status due to age and ethnicity. Further evidence for compounded multiple minority
status is seen across age and ethnicity status, as African American groups had
generally higher levels of perceived stigmatization than White groups and Older
groups had generally higher levels of perceived stigmatization than younger groups.
Given previous findings on the effects o f perceived stigmatization on mental
and physical health outcomes (Cole et al., 1996; Kauth & Prejean, 1997; Meyer,
1995), one might expect significantly higher levels of negative mental and physical
outcomes among the African American older adult group as a result of multiplicative
stigmatization. However, in this study that was not the case. African American
older adult gay men did not experience the highest levels of negative mental health
outcomes across groups. In fact, those experiencing the highest level of negative
mental health outcomes were White younger adult gay men. This finding appears
ironic if one follows the logic of expected effects of compounded multiple minority
status. In the absence of ethnic minority status and older age status, one might
expect younger White gay men to have lower levels of negative mental health
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outcomes than older African American men and at least similar or perhaps lower
levels of negative mental health outcomes than younger African American men.
Thus, the finding that younger White gay men experienced the greatest emotional
distress is intriguing. These findings may have implications for mental health
interventions among White younger adult gay men. Further research is indicated to
replicate these findings and subsequently examine potential sources of this emotional
distress that are not examined in the current study.
Concerning negative physical health outcomes, older African American men
did not experience significantly higher levels o f physical illness, except as part of an
overall age group comparison between younger and older groups in which the older
group had higher levels of physical illness than the younger group. This difference
was to be expected as numerous studies have reported prevalence rates of physical
illness differing significantly across age groups (Whitboume, 1998). However,
African American older adult gay men did not differ from White older adult gay men
on rates o f physical illness. As such, while the findings on perceived stigmatization
support the presence o f compounded multiple minority status for African American
older adult gay men, findings on both mental and physical health outcomes do not
support the presence of any negative outcomes related to that status. Thus,
suggestions o f crisis-competence begin to emerge for African American older adult
gay men and variations in coping styles warrant further attention.
In this study, findings concerning mean differences in coping styles for
African American older adult gay men as compared to White older adult gay men
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support previous studies that indicated African Americans (Knight et al., 2000) and
African American gay men (Hayes, 1996) were more likely to use emotion-focused
coping styles than Whites and White gay men respectively. While levels of active
coping style did not differ across groups, active coping did emerge along with
emotion-focused coping as predictive of mental health and some physical health
outcomes. It is in the predictive ability o f coping styles as compared to that of
various forms o f perceived stigmatization, where group differences emerge to
suggest the possibility o f crisis-competence among African American older adult gay
men.
Coping style was a significant predictor o f anxiety and depression across all
groups. However, when various forms of stigmatization were added to the model,
predictive ability increased across all groups except for the older African American
group. Coping style remained the greatest predictor of negative outcomes for
African American older adult gay men. While other groups had significant
associations between the various forms of perceived stigmatization and negative
mental health outcomes, African American older adult gay men did not. This
suggests the potential presence of a mechanism occurring through coping strategies
that is allowing these men to manage the stigma of their sexual minority, ethnic
minority, and age statuses, resulting in a buffering effect against negative mental
health outcomes. Such a mechanism would support crisis-competence among these
men. In addition, the older African American group was the only group in which the
perceived stigmatization of ageism predicted emotion-focused coping style. Further
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research examining possible relationships between specific subtypes of active and
emotion-focused coping styles and negative mental health outcomes, might serve to
further explicate the nature o f the mechanism underlying these possible effects.
These findings may have significant implications for the development of therapeutic
interventions for the management o f compounded multiple minority status among
African American gay men.
While the results for African American older adult gay men are particularly
striking, the picture of crisis competence for White older adult gay men is less clear.
This group does not experience higher levels of homonegativity than the other
groups but does experience lower levels of sexual identity disclosure than younger
White gay men. The latter finding might suggest either simple cohort effects or
effects of compounded sexual minority and age status. In addition, the lower levels
o f perceived stigmatization due to sexual minority status that White older adult gay
men experience when compared to African American older adult gay men would
support the hierarchy o f effects suggested by compounded multiple minority status.
In order to follow this hierarchy further down concerning the effects of experienced
ageism, one would need to compare the group o f White older adult gay men to a
group of White older adult heterosexual men. Because this comparison is not
available in this study, it not possible to examine the level at which ageism
contributes to compounded multiple minority status among White older adult gay
men. Further research examining differences in experiences o f ageism between
White older adult gay men and White older adult heterosexual men is indicated.
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Concerning evidence of crisis-competence among White older adult gay
men, results are mixed. There is clear evidence for crisis-competence among White
older adult gay men when one considers the findings that while White older adult
gay men had significantly lower levels of sexual identity disclosure and similar
levels of homonegativity when compared to White younger gay men, they had
significantly lower levels of negative mental health outcomes than the younger
group. However, when the models of prediction for mental health outcomes among
the White older adult group are examined, both coping styles and homonegativity
appear as significant predictors. Thus, the picture of prediction for White older adult
gay men is not as clearly focused on coping style as that for African American older
adult gay men. However, if one considers these differences between African
American and White older adult gay men within the hierarchy o f compounded
multiple minority status, it would follow that the evidence for crisis-competence
would be clearer in the group with increased multiple minority status. As such, it is
concluded that these data provide some support for the theories o f crisis-competence
among White older adult gay men as suggested by previous authors (Berger, 1996;
Kimmel, 1978; Pope & Schulz, 1990).
In addition to the findings on mental health among White older adult gay
men, the findings for the physical illness outcome were notable. This group was the
only group in which coping style and perceived stigmatization in regard to sexual
minority status and age status, significantly predicted increased physical illness.
This finding supports similar findings in previous studies o f gay men (Kauth &
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Prejean, 1997). Further research on White older adult gay men that would explore
the effects of coping style and perceived stigmatization on physical health using a
variety o f specific health measures is indicated to further understand possible
relationships among these variables.
Limitations
While this study is the largest o f its kind to examine differences between
African American and White older adult gay men, the findings herein are not based
on a representative sample of African American and White younger and older adult
gay men due to the essential impossibility o f obtaining a random sample of these
men. Given the relatively small numbers o f the study population within the greater
population, it was unfeasible to obtain a random sample. In addition, previous
authors have noted the inherent difficulty in recruiting random samples of gay people
of color given the sociocultural differences that may render them inaccessible to
researchers (Croom, 2000). As such, this study relies on comparisons of
convenience samples and caution should be used in generalizing these results to
African American and White younger and older adult gay men.
While a concerted effort was made to recruit a diverse sample that would
include participants that were not normally involved in the gay community, it is
acknowledged that the sample likely does not represent those older adult gay men
who are extremely isolated from any contact with gay people. In addition, further
research with increased sample sizes that would divide groups further by younger,
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middle, and older adult status, may be indicated to explain differences by age and
ethnicity more precisely.
In addition, while an effort was made to recruit subjects with moderate to
lower income status in order to avoid the common pitfall of higher socioeconomic
status samples in gay older adult research, it is acknowledged that in this study
income was significantly higher in the White groups. However, income in White
groups was at minimum similar, and more often lower, than that o f White groups in
previous studies reviewed (Berger, 1996; D ’Augelli et al., 2001). In addition,
income and education level for African American groups was somewhat higher than
that o f previous studies of African Americans reviewed (Crawford et al., 2002;
Stokes & Peterson, 1998). Thus, efforts to reduce the usual disparity in
socioeconomic status between African American and White groups, coupled with the
use o f MANCOVA to control for this status, likely indicate that differences in results
between ethnic groups are due to sociocultural rather than socioeconomic
differences. Nonetheless, further research is indicated with White and African
American groups o f lower socioeconomic status.
While limitations of the current study include issues of sampling and
socioeconomic status often seen in studies of this kind, concerted efforts to recruit a
diverse sample minimized the extent of these limitations and narrowed disparities as
compared to previous studies. The result o f these efforts provided the largest sample
to date that compares African American and White younger and older adult gay men.
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Summary
In sum, the results o f this analysis effectively begin to explore the
sociocultural modeling of stress and coping processes in relation to perceived
stigmatization and mental and physical health outcomes among African American
and White younger and older adult gay men. The purpose of this study was to
determine if the experience of compounded stigmatization due to multiple minority
status would be associated with either negative mental and physical health outcomes,
or with more effective coping skills that would support the theory o f crisis-
competence. Results showed that African American older adult gay men
experienced significantly higher levels o f experienced ageism than the older White
group, significantly higher levels of experienced racism than the younger African
American group, and significantly higher levels of homonegativity and lower levels
of sexual identity disclosure than all other groups. However, African American
older adult gay men did not experience significantly higher levels of negative mental
or physical health outcomes, even though these outcomes were predicted by
perceived stigmatization in the other groups. Coping style remained the greatest
predictor o f negative outcomes for African American older adult gay men, providing
evidence for the existence of crisis-competence among African American older adult
gay men.
Although not as clearly as for African American older adult gay men, results
also provided evidence of crisis-competence among White older adult gay men when
compared to White younger adult gay men on measures of perceived stigmatization,
57
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coping style, and mental health outcomes. The findings o f this study have
implications for intervention research and practice among African American and
White younger and older adult gay men.
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References
Adams, C. L., Jr., & Kimmel, D. C. (1997). Exploring the lives of older African
American gay men. In B. Greene (Ed.), Ethnic and cultural diversity among
lesbians and gay men (Vol. 3, pp. 132-151). Thousand Oaks, CA, US: Sage
Publications.
Berger, R. M. (1984). Realities o f gay and lesbian aging. Social Work, 29(1), 57-62.
Berger, R. M. (1992). Passing and social support among gay men. Journal of
Homosexuality, 23(3), 85-97.
Berger, R. M. (1996). Gay and gray: The older homosexual man (2nd ed.). New
York, NY, US: Harrington Park Press/Haworth Press, Inc.
Carver, C. S. (1997). You want to measure coping but your protocol's too long:
Consider the Brief COPE. International Journal o f Behavioral Medicine,
4(1), 92-100.
Carver, C. S., & Scheier, M. F. (1994). Situational coping and coping dispositions in
a stressful transaction. Journal o f Personality & Social Psychology, 66(1),
184-195.
Carver, C. S., Scheier, M. F., & Weintraub, J. K. (1989). Assessing coping strategies:
A theoretically based approach. Journal o f Personality & Social Psychology,
56(2), 267-283.
Chan, C. S. (1993). Issues of identity development among Asian American lesbians
and gay men. In D. C. Kimmel (Ed.), Psychological perspectives on lesbian
and gay male experiences (pp. 376-387). New York, NY, US: Columbia
University Press; New York.
Clark, R. (1997). Skin tone, coping, and cardiovascular responses to ethnically-
relevant stimuli. Dissertation Abstracts International: Section B: The
Sciences & Engineering, J7(12-B), 7719.
Cole, S. W., Kemeny, M. E., Taylor, S. E., & Visscher, B. R. (1996). Elevated
physical health risk among gay men who conceal their homosexual identity.
Health Psychology, 15(4), 243-251.
Crawford, I , Allison, K. W., Zamboni, B. D., & Soto, T. (2002). The influence of
dual-identity development on the psychosocial functioning of African
American gay and bisexual men. Journal o f Sex Research, 39(3), 179-189.
59
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Croom, G. L. (2000). Lesbian, gay, and bisexual people o f color: A challenge to
representative sampling in empirical research. In G. L. Croom (Ed.),
Education, research, and practice in lesbian, gay, bisexual, and
transgendered psychology: A resource manual (Vol. 5, pp. 263-281).
Thousand Oaks, CA, US: Sage Publications.
D'Augelli, A. R. (1994). Lesbian and gay male development: Steps toward an
analysis of lesbians' and gay men's lives. In G. M. Herek (Ed.), Lesbian and
gay psychology: Theory, research, and clinical applications (Vol. 1, pp. 118-
132). Thousand Oaks, CA, US: Sage Publications.
D'Augelli, A. R., Grossman, A. H.» Hershberger, S. L., & O'Connell, T. S. (2001).
Aspects o f mental health among older lesbian, gay, and bisexual adults.
Aging & Mental Health, 5(2), 149-158.
Ehrenberg, M. (1996). Aging and mental health: Issues in the gay and lesbian
community. In C. J. Alexander (Ed.), Gay and lesbian mental health: A
sourcebook for practitioners (pp. 189-209). New York, NY, US: Harrington
Park Press/Haworth Press.
Friend, R. A. (1987). The individual and social psychology o f aging: Clinical
implications for lesbians and gay men. Journal o f Homosexuality, 74(1-2),
307-331.
Friend, R. A. (1989). Older lesbian and gay people: Responding to homophobia.
Marriage & Family Review, 74(3-4), 241-263.
Friend, R. A. (1990). Older lesbian and gay people: A theory of successful aging.
Journal o f Homosexuality, 20(3-4), 99-118.
Gatz, M. (2000). Variations on depression in later life. In N. Abeles (Ed.),
Psychology and the aging revolution: How we adapt to longer life (pp. 239-
254). Washington, DC, US: American Psychological Association.
Gatz, M., Kasl-Godley, J. E., & Karel, M. J. (1996). Aging and mental disorders. In
et al. (Ed.), Handbook o f the psychology o f aging (4th ed., pp. 365-382). San
Diego, CA, US: Academic Press.
Gray, J., & Hedge, B. (1999). Psychological distress and coping in the partners of
gay men with HIV-related disease. British Journal o f Health Psychology,
4( Part 2), 117-126.
60
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Grossman, A. H., D'Augelli, A. R., & O'Connell, T. S. (2001). Being lesbian, gay,
bisexual, and 60 or older in North America. Journal o f Gay & Lesbian Social
Services: Issues in Practice, Policy & Research, 13(4), 23-40.
Hayes, R. A. (1996). Differences in social support, coping, and attitudes toward
homosexuality between African American and Caucasian men living with
HIV. Dissertation Abstracts International: Section B: The Sciences &
Engineering, 5<5(9-B), 5171.
Jones, B. E., & Hill, M. J. (1996). African American lesbians, gay men, and
bisexuals. In T. S. Stein (Ed.), Textbook o f homosexuality and mental health
(pp. 549-561). Washington, DC, US: American Psychiatric Association.
Kasl-Godley, J. E., Gatz, M., & Fiske, A. (1998). Depression and depressive
symptoms in old age. In et al. (Ed.), Clinical geropsychology (pp. 211-217).
Washington, DC, US: American Psychological Association.
Kauth, M. R , & Prejean, J. (1997). Health behavior in gay men. In D. S. Gochman
(Ed.), Demography, development, and diversity (Vol. 3, pp. 125-140). New
York, NY, US: Plenum Press.
Kimmel, D. C. (1978). Adult development and aging: A gay perspective. Journal of
Social Issues, 34(3), 113-130.
Kimmel, D. C. (2002). Aging and sexual orientation. In M. J. Hill (Ed.), Mental
health issues in lesbian, gay, bisexual, and transgender communities (pp. 17-
36). Washington, DC, US: American Psychiatric Publishing.
Knight, B. G., Silverstein, M., McCallum, T. J., & Fox, L. S. (2000). A sociocultural
stress and coping model for mental health outcomes among African
American caregivers in southern California. Journals o f Gerontology: Series
B: Psychological Sciences & Social Sciences, 55B(3), P142-P150.
Lackner, J. B., Joseph, J. G., Ostrow, D. G., Kessler, R. C., & et al. (1993). A
longitudinal study o f psychological distress in a cohort of gay men: Effects of
social support and coping strategies. Journal o f Nervous & Mental Disease,
181(1), 4-12.
Liang, J. (1986). Self-reported physical health among aged adults. Journal of
Gerontology, 41(2), 248-260.
61
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Lopez-Kinney, D. I. (2002). Racism-related stress, appraisal, and coping among
Latinos/as. Dissertation Abstracts International: Section B: The Sciences &
Engineering, 62{7-B), 3383.
Manalansan, M. F. I. V. (1996). Double minorities: Latino, Black, and Asian men
who have sex with men. In K. M. Cohen (Ed.), The lives o f lesbians, gays,
and bisexuals: Children to adults (pp. 393-415). Orlando, FL, US: Harcourt
Brace College Publishers.
Meyer, I. H. (1995). Minority stress and mental health in gay men. Journal of Health
& Social Behavior, 36(1), 38-56.
Minnigerode, F. A. (1976). Age-status labeling in homosexual men. Journal o f
Homosexuality, 1 ( 3 ) , 273-276.
Minnigerode, F. A., & Adelman, M. R. (1978). Elderly homosexual women and
men: Report on a pilot study. Family Coordinator, 27(4), 451-456.
Miranda, J., & Storms, M. (1989). Psychological adjustment o f lesbians and gay
men. Journal o f Counseling & Development, 65(1), 41-45.
Morrow, D. F. (2001). Older gays and lesbians: Surviving a generation of hate and
violence. Journal o f Gay & Lesbian Social Services: Issues in Practice,
Policy & Research, 13(1-2), 151-169.
Palmore, E. (2001). The Ageism Survey: First findings. Gerontologist, 41(5), 572-
575.
Patterson, R. L., O'Sullivan, M., & Spielberger, C D. (1980). Measurement of state
and trait anxiety in elderly mental health clients. Journal o f Behavioral
Assessment, 2, 89-97.
Pope, M., & Schulz, R. (1990). Sexual attitudes and behavior in midlife and aging
homosexual males. Journal o f Homosexuality, 20(3-4), 169-177.
Quam, J. K. (1993). Gay and Lesbian Aging. SIECUS Report.
Radloff, L. S. (1977). The CES-D Scale: A self-report depression scale for research
in the general population. Applied Psychological Measurement, 1(3), 385-
401.
Radloff, L. S., & Teri, L. (1986). Use of the Center for Epidemiological Studies-
Depression Scale with older adults. Clinical Gerontologist, 5(1-2), 119-136.
62
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Savin-Williams, R. (1999). Ethnic-minority and sexual-minority youths. In et al.
(Ed.), Gender, culture, and ethnicity: Current research about women and
men (pp. 121-134). Mountain View, CA, US: Mayfield Publishing Co.
Sharp, C. E. (1997). Lesbianism and later life in an Australian sample: How does
development of one affect anticipation of the other? Journal o f Gay, Lesbian,
and Bisexual Identity, 2(3/4), 247-263.
Shidlo, A. (1994). Internalized homophobia: Conceptual and empirical issues in
measurement. In G. M. Herek (Ed.), Lesbian and gay psychology: Theory,
research, and clinical applications (Vol. 1, pp. 176-205). Thousand Oaks,
CA, US: Sage Publications.
Spielberger, C. D. (1985). Assessment o f state and trait anxiety: Conceptual and
methodological issues. Southern Psychologist, 2(4), 6-16.
Stokes, J. P., & Peterson, J. L. (1998). Homophobia, self-esteem, and risk for HIV
among African American men who have sex with men. AIDS Education &
Prevention, 10(3), 278-292.
Utsey, S. O. (1999). Development and validation of a short form of the Index of
Race-Related Stress (IRRS)-Brief Version. Measurement & Evaluation in
Counseling & Development, 32(3), 149-167.
Whitboume, S. K. (1998). Physical changes in the aging individual: Clinical
implications. In et al. (Ed.), Clinical geropsychology (pp. 79-108).
Washington, DC, US: American Psychological Association.
Zea, M. C., Reisen, C. A., & Poppen, P. J. (1999). Psychological well-being among
Latino lesbians and gay men. Cultural Diversity & Ethnic Minority
Psychology, 5(4), 371-379.
63
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APPENDIX A
STUDY QUESTIONNAIRE
Stress and Coping
Among Gay Younger and Older Adults
Questionnaire
Steven David, Doctoral Student, and Bob Knight, Ph.D.
Department o f Psychology and Leonard Davis School of Gerontology
University o f Southern California
Steven David
University o f Southern California, GER 122
Los Angeles, CA 90089-0191
Phone: (213) 740-7637 ext.2
Email: stevenda@usc.edu
Supervised by:
Bob G. Knight, Ph.D.
Phone: (213) 740-1373
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Background Information
1) Age (in years): _________________
2) Gender: 1. Male 2. Female
3) Ethnic Identity:
1 .____ African-American/Black
2 .____ Asian or Pacific Islander
3 .____ European/Caucasian/White
4 .____ Latino/Latina/Hispanic
5 .____ Other (please specify)______________________
4) Number o f years o f education completed: _______years
(Ex: High School = 12 years)
5) Your total annual personal income:
1 ._____ Below $20,000
2 .____ $20,000 to $39,999
3 .____ $40,000 to $59,999
4 .____ $60,000 to $79,999
5 .____ $80,000 to $99,999
6 ._____$100,000 +
6) Your total annual household income:
1 ._____ Below $20,000
2 .____ $20,000 to $39,999
3 .____ $40,000 to $59,999
4 .____ $60,000 to $79,999
5 .____ $80,000 to $99,999
6 ._____$100,000 +
7) Relationship status:
1 .____ single
2 ._____ legally married
3 ._____domestic partner
4 ._____significant other
5 ._____other (please specify)_____________ currently
• If you are currently in a relationship, how long have you been together?
years
• If you are not currently in a relationship, did you have a relationship
partner who died in the past five years?
yes no
• If your relationship partner died in the last five years, how many years
were you together before his/her death? _____ years
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8) How would you currently describe yourself?
(Choose the answer below that most applies.)
1 ._____Gay
2 ._____Queer
3 ._____Lesbian
4 ._____Bisexual, but mostly gay or lesbian
5 .____ Bisexual, but mostly heterosexual
6 .____ Heterosexual
9) Who knows/knew about your sexual orientation?
(Enter numbers for each, e.g., 1 grandparent, 2 brothers, etc.)
grandparents
parents
_brother(s)
sister(s)
children
co-workers (former and current)
employers (former and current)
other (specify)________________
10) What percentage of people who currently know you
are aware that you are gay or bisexual?
1 ._____less than 25%
2 ._____25% to 50%
3 ._____51% to 75%
4. more than 75%
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The following statements relate to being gay. Please circle the best a n s w e r.
R H A I
Strongly
Disagree
Mainly
Disagree
Mainly
Agree
Strongly
Agree
a. W hen I am in a conversation w ith a gay
man and he touches me, it does not
make m e uncomfortable.
1 2 3 4
b. Whenever I think a lot about being gay,
I feel depressed.
1 2 3 4
c. I am glad to be gay. 1 2 3 4
d. When I am sexually attracted to another
gay man, I feel uncomfortable.
1 2 3 4
e. I am proud to be part o f the gay
community.
1 2 3 4
f. My homosexuality does not make me
unhappy.
1 2 3 4
g-
Whenever I think a lot about being gay,
I feel critical about myself.
1 2 3 4
h. I wish 1 were heterosexual. 1 2 3 4 1
i. I do not think I will be able to have a
long-term relationship with another
man.
1 2 3
4 i
j-
I have been in counseling because I
want to stop having sexual feelings for
other men.
1 2 3 4
k. I have tried killing m yself because I
could not accept my homosexuality.
1 2 3 4
1 . There have been times when I have felt
so rotten about being gay that I wanted
to be dead.
1 2 3 4
m I have tried killing m yself because it
seemed that m y life as a gay person was
too miserable to bear.
1 2 3 4
n. I find it important that I read gay books
or newspapers.
1 2 3 4
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
0. It is important to m e to feel part o f the
gay community.
1 2 3 4
p-
Hom osexuality is not as satisfying as
heterosexuality.
1 2 3 4
q-
Homosexuality is a natural expression
o f sexuality in humans.
1 2 3 4
r. Gay men do not dislike w om en any
more than heterosexual m en dislike
women.
1 2 3 4
s. Marriage between gay people should be
realized.
1 2 3 4
t. Gay m en are overly promiscuous. 1 2 3 4
u. Most problems that gay persons have
come from their status as an oppressed
minority, not from their homosexuality
per se.
1 2 3 4
V. Gay person’s lives are not as fulfilling
as heterosexual’s lives.
1 2 3 4
w Children should be taught that being gay
is a normal and healthy way for people
to be.
1 2 3 4
X. Homosexuality is a sexual perversion. 1 2 3 4
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STAI-T
A number of statements which people have used to describe themselves
are given below.
> Read each statement and then circle the number to the right of the statement to
indicate how you generally feel.
1-ALMOST NEVER
2=S OMETIMES
S O F T E N
4=ALMOST ALWAYS
1 I feel pleasant 1 2 3 4
2 I feel nervous and restless 1 2 3 4
3 I feel satisfied with myself 1 2 3 4
4 I wish I could be as happy as others seem to be 1 2 3 4
5 I feel like a failure 1 2 1 3 4
6 I feel rested 1 2 3 4
7 I am “calm, cool, and collected” 1 2 3 4
8 I feel that difficulties are piling up so that I cannot overcome them 1 2 3 4
9 I worry too much over something that really doesn’t matter 1 2 3 1 4
10 I am happy 1 2 3 4
11 I have disturbing thoughts 1 2 3 | 4
12 I lack self-confidence
1 1 2
3 4
13 I feel secure 1 2 3 4
14 I make decisions easily 1 2 3 4
15 I feel inadequate 1 2 3 4
16 I am content 1 2 3 4
17 Some unimportant thought runs through my mind and bothers me 1 2 3 4
18 I take disappointments so keenly that I can’t put them out of my
mind
1 2 3 4
19 I am a steady person 1 2 3 4
20 I get in a state of tension or turmoil as I think over my recent
concerns and interests
1 2 3 4
69
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Below is a list o f ways you might have felt or behaved. CES-D
> Please indicate how often you have felt this way in the past week:
0 = Rarely or None of the time
1 = Some o f the time
2 = Occasionally
3 = Most or All of the time
In the past week: Circle one:
1 I was bothered by things that don’t usually bother me. 0 1 2 3
2 I did not feel like eating, my appetite was poor. 0 1 2 3
3 I felt that I could not shake the blues, even with help from my
family and friends.
0 1 2 3
4 I felt that I was just as good as other people. 0 1 2 3
5 I had trouble keeping my mind on what I was doing. 0 1 2 3
6 I felt depressed. 0 1 2 3
7 I felt that everything I did was an effort. 0 1 2 3
8 I felt hopeful about the future. 0 1 2 3
9 I thought my life had been a failure. 0 1 2 3
10 I felt fearful. 0 1 2 3
11 My sleep was restless. 0 1 2 3
12 I was happy. 0 1 2 3
13 I talked less than usual. 0 1 2 3
14 I felt lonely. 0 1 2 3
15 People were unfriendly. 0 1 2 3
16 I enjoyed life. 0 1 2 3
17 I had crying spells. 0 1 2 3
18 I felt sad. 0 1 2 3
19 I felt that people disliked me. 0 1 2 3
20 I could not get “going”. 0 1 2 3
70
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We are interested in how people respond when they confront difficult or stressful events in
their lives. There are lots of ways to try to deal with stress. This questionnaire asks you to
indicate what YOU usually do when YOU experience a stressful event. Obviously, different
events bring out somewhat different responses, but think about what you USUALLY do
when you are under a lot of stress.
1=1 usually don't do this at all
2 = 1 usually do this a little bit
3 = 1 usually do this a medium amount
4 = 1 usually do this a lot
1
I turn to work or other activities to take m y mind o ff things. 1 2 3 4
2 I concentrate my efforts on doing something about the situation I'm in. 1 2 3 4
3 I say to m yself, "this isn't real." 1 2 3 4
4 I use alcohol or other drugs to make m yself feel better. 1 2 3 4
5 I get emotional support from others. 1 2 3 4
6 I give up trying to deal with it. 1 2 3 4
7 I take action to try to make the situation better. 1 2 3 4
8 I refuse to believe that it has happened. 1 2 3 4
9 I say things to let m y unpleasant feelings escape. 1 2 3 4
10 I get help and advice from other people. 1 2 3 4
11 I use alcohol or other drugs to help me get through it. 1 2 3 4
12 I try to see it in a different light, to make it seem more positive. 1 2 3 4
13 I criticize m yself. 1 2 3 4
14 I try to com e up with a strategy about what to do. 1 2 3 4
15 I get comfort and understanding from someone. 1 2 3 4
16 I give up the attempt to cope. 1 2 3 4
17 I look for something good in what is happening. 1 2 3 4
18 I make jokes about it. 1 2 3 4
19
I do something to think about it less, such as go to movies, watch TV, read,
daydream, sleep, or shop.
1 2 3 4
20 I accept the reality o f the fact that it has happened. 1 2 3 4
21 I express my negative feelings. 1 2 3 4
22 I try to find comfort in my religion or spiritual beliefs. 1 2 3 4
23 I try to get advice or help from other people about what to do. 1 2 3 4
24 I learn to live with it. 1 2 3 4
25 I think hard about what steps to take. 1 2 3 4
26 I blame m yself for things that happened. 1 2 3 4
27 I pray or meditate. 1 2 3 4
28 I make fun o f the situation. 1 2 3 4
71
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Physical Health Questions (Check one answer for each item)
1. Your current physical condition?
Excellent Good Fair Poor
2. Your physical condition as compared to your peers?
Excellent Good Fair Poor
3. Physical condition as compared to one year ago?
Excellent Good Fair Poor
4. How well are you taking care of your health?
Excellent Good Fair Poor
5. Do you see a physician? Yes No
If yes, how
often? daily weekly monthly bimonthly twice/year annually
Are you now troubled by any lasting or continuing health problems, physical
problems, or handicaps? (IF YES) What is/are these problems?
(Circle Yes or No)
a. Any lasting health problems/illness? Yes No
If yes, please list__________________________________________
b. Respiratory problems/illness? Yes No
If yes, please list__________________________________________
c. Circulatory problems/illness? Yes No
If yes, please list__________________________________________
d. Digestive/internal problems/illness? Yes No
If yes, please list__________________________________________
e. Nervous system problems/illness? Yes No
If yes, please list__________________________________________
f. Glandular problems/illnesses? Yes No
If yes, please list__________________________________________
h. Arthritis or rheumatism? Yes No
If yes, please list__________________________________________
i. Cancer or tumor? Yes No
If yes, please list__________________________________________
j. Other problems/illnesses? Yes No
If yes, please list__________________________________________
72
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> If you are 55 years old or older, please complete this page. AS
> If you are less than 55 years old, please skip this page.
Please circle the number that shows how often you have experienced that event.
Never Once
?
More than
once
1. I was told a joke that pokes fun at old people. 0 1 2
2. I was sent a birthday card that pokes fun at old people 0 1 2
3.
I was ignored or not taken seriously because o f my
age.
0 1 2
4. I was called an insulting name related to my age. 0 1 2
5.
I was patronized or talked down to because o f my
age.
0 1
2
6. I was refused rental housing because o f my age. 0 1 2
7. I had difficulty getting a loan because o f m y age. 0 1 2
8.
I was denied a position o f leadership because o f my
age.
0 1 2
9. I was rejected as unattractive because o f my age. 0 1 2
10.
I was treated with less dignity and respect because o f
m y age.
0 1 2
11. A waiter or waitress ignored me because o f m y age. 0 1 2
12.
A doctor or nurse assumed my ailments were cause
by my age.
0 1 2
13. I was denied m edical treatment because o f m y age. 0 1 2
14. I was denied employment because o f m y age. 0 1 2
15. I was denied promotion because o f m y age. 0 1 2
16.
Someone assumed I could not hear w ell because o f
my age.
0 1 2
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
17.
Someone assumed I could not understand because o f
my age.
0 1 2
18. Someone told me, “Y ou’re too old for that.” 0 1 2
19. My house was vandalized because o f m y age. 0 1 2
20. I was victimized by a criminal because o f my age 0 1
.........
2
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IR R 8 -B
> If you are African-American/Black, please complete this section.
> If you are White or non-Black, please skip this section.
Respond to the items
below by circling one
number for each, using these
response choices:
0 = This never happened to me.
1 = This event happened, but did not bother me.
2 = This event happened & I was slightly upset.
3 = This event happened & I was upset.
4 = This event happened & I was extremely upset.
a.
You notice that crimes committed by White people tend
to be romanticized, whereas the same crime committed
by a Black person is portrayed as savagery, and the
Black person who committed it, as an animal.
0 1 2 3 4
b.
Sales people/clerks did not say thank you or show other
forms o f courtesy and respect (e.g., put your things in a
bag) when you shopped at some White/non-Black
owned businesses.
0 1 2 3 4
c.
You notice that when Black people are killed by police,
the media informs the public o f the victim's criminal
record or negative information in their background,
suggesting they got what they deserved.
0 1 2 3 4
d.
You have been threatened with physical violence by an
individual or group o f White/non-Blacks.
0 1 2 3 4
e.
You have observed that White kids who commit violent
crimes are portrayed as “boys being boys,” while Black
kids who commit similar crimes are wild animals.
0 1 2 3 4
f.
You seldom hear or read anything positive about Black
people on radio, TV in newspapers, or history books.
0 1 2 3 4
g-
While shopping at a store, the sales clerk assumed that
you couldn’t afford certain items (e.g., you were
directed toward the items on sale).
0 1 2 3 4
h.
You were the victim of a crime and the police treated
you as if you should just accept it as part o f being
Black.
0 1 2 3 4
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
i.
You were treated with less respect and courtesy than
Whites and other non-Blacks while in a store,
restaurant, or other business establishment.
0 1 2 3 4
j-
You were passed over for an important project although
you were more qualified and competent than the
White/non-Black person given the task.
0 1 2 3 4
k.
Whites/non-Blacks have stared at you as if you didn’t
belong in the same place with them; whether it was a
restaurant, theater, or other place o f business.
0 1 2 3 4
1 .
You have observed the police treat White/non-Blacks
with more respect and dignity than they do Blacks.
0 1 2 3 4
m.
You have been subjected to racist jokes by Whites/non-
Blacks in positions o f authority and you did not protest
for fear they might have held it against you.
0 1 2 3 4
n.
While shopping at a store, or when attempting to make
a purchase, you were ignored as if you were not a
serious customer or did not have any money.
0 1 2 3 4
0 .
You have observed situations where other Blacks were
treated harshly or unfairly by Whites/non-Blacks due to
their race.
0 1 2 3 4
P-
You have heard reports of White people/non-Blacks
who have committed crimes, and in an effort to cover
up their deeds falsely reported that a Black man was
responsible for their crime.
0 1 2 3 4
q-
You notice that the media plays up those stories that
cast Blacks in negative ways (child abusers, rapists,
muggers, etc.), usually accompanied by a large picture
of a Black person looking angry or disturbed.
0 1 2 3 4
r.
You have heard racist remarks or comments about
Black people spoken with impunity by White public
officials or other influential White people.
0 1 2 3 4
s.
You have been given more work, or the most
undesirable jobs at your place o f employment while the
White/non-B lack o f equal or less seniority and
credentials is given less work, and more desirable tasks.
0 1 2 3 4
76
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t.
You have heard or seen other Black people express a
desire to be White or to have White physical
characteristics because they disliked being Black or
thought it was ugly.
0 1 2 3 4
u.
White people or other non-Blacks have treated you as if
you were unintelligent and needed things explained to
you slowly or numerous times.
0 1 2 3 4
V.
You were refused an apartment or other housing: you
suspect it was because you’re Black.
0 1 2 3 4
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Asset Metadata

Creator David, Steven (author)

Core Title Stress and coping among gay older adults

Contributor Digitized by ProQuest (provenance)

Degree Master of Arts

Degree Program Psychology

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag Gerontology,OAI-PMH Harvest,Psychology, clinical,psychology, social

Language English

Permanent Link (DOI) https://doi.org/10.25549/usctheses-c16-307777

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Identifier 1417918.pdf (filename),usctheses-c16-307777 (legacy record id)

Legacy Identifier 1417918.pdf

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Rights David, Steven

Type texts

Source University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the au...

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus, Los Angeles, California 90089, USA