# Biopsychosocial mechanisms underlying internalizing psychopathology in a prospective, population-based cohort of sexual minority young adults

> **NIH NIH R01** · YALE UNIVERSITY · 2021 · $678,829

## Abstract

PROJECT SUMMARY
Sexual minority (SM) individuals (e.g., those who identify as lesbian, gay, or bisexual) are substantially more
likely than heterosexuals to experience internalizing psychopathology and associated comorbidity. Young and
early adulthood (ages 18 to 34) represents the period during which significant sexual orientation disparities in
internalizing psychopathology emerge. Yet, little is known about the biopsychosocial mechanisms underlying
the sexual orientation disparity in mental disorders during this critical developmental stage. We have created a
rare opportunity, currently unavailable in US-based studies, to address these knowledge gaps by capitalizing
on three methodological advancements available in a large prospective, population-based dataset in Sweden:
the Swedish National Public Health Survey (SNPHS). These advancements include the opportunity to: (1)
follow back SM survey respondents sampled using probability designs; (2) match those SM respondents to a
heterosexual comparison using registry data that contains objective records of sociodemographic and mental
health characteristics shown to robustly predict internalizing psychopathology; and (3) link longitudinal
biomarker data to mental health assessments. Capitalizing on these strengths, our research will address three
aims. First, we will evaluate whether psychosocial mechanisms (e.g., negative self-schemas, attentional threat
bias, social avoidance) explain the young adult SM disparity in internalizing psychopathology. We address this
aim by following a new representative cohort of SM young adults ages 18-34 (N=673) and a matched
heterosexual cohort (N=673) drawn from the SNPHS, which we will call the PLUS (Pathways to Longitudinally
Understanding Stress) cohort. We will administer to this cohort an online battery of self-report and behavioral
measures of internalizing psychopathology and proposed mechanisms for four years annually. Second, we will
evaluate whether biological mechanisms explain the young adult SM disparity in internalizing psychopathology.
To address this aim, we will collect biomarkers from the PLUS sample, which will be self-collected via the dried
blood spot method. These biological measures will capture stress-sensitive inflammatory processes (C-
reactive protein, IL-6, TNF) implicated in internalizing psychopathology. Third, we will examine whether
stigma-related reactions (e.g., identity concealment) and the biopsychosocial mechanisms identified in Aims 1
and 2 mediate the prospective association between stigma-related stress and internalizing psychopathology
among SM young adults in the new PLUS cohort. Secondary analyses for all aims will examine the
generalizability of our model to externalizing comorbidities and to intersectional populations of SM. Existing
research, and our own pilot data, indicates that the results will generalize to understanding mechanisms
underlying internalizing psychopathology among SM in the US and abroad. This theore...

## Key facts

- **NIH application ID:** 10072080
- **Project number:** 5R01MH118245-03
- **Recipient organization:** YALE UNIVERSITY
- **Principal Investigator:** Richard Branstrom
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $678,829
- **Award type:** 5
- **Project period:** 2019-03-01 → 2023-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10072080

## Citation

> US National Institutes of Health, RePORTER application 10072080, Biopsychosocial mechanisms underlying internalizing psychopathology in a prospective, population-based cohort of sexual minority young adults (5R01MH118245-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10072080. Licensed CC0.

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