Susan Kashubeck-West

Internalized Heterosexism: Measurement, Psychosocial Correlates, and Research Directions

This article provides an integrated critical review of the literature on internalized heterosexism/internalized homophobia (IH), its measurement, and its psychosocial correlates. It describes the psychometric properties of six published measures used to operationalize the construct of IH. It also critically reviews empirical studies on correlates of IH in the areas of sexual identity formation and the coming-out process; mental, psychosocial, and physical health; substance use; sexual risk-taking behavior; intimate relationships; parenting and family issues; gender roles and feminism; race and ethnicity; religion; career issues; and counselor—client interactions and treatment interventions. Last, it discusses limitations of the body of research and provides suggestions for future research throughout the review.

Mediators of the Relationship Between Internalized Oppressions and Lesbian and Bisexual Women’s Psychological Distress

This study examined the relationship of internalized oppressions to the psychological distress of 304 lesbian and bisexual women. In addition, it investigated whether self-esteem and social support mediated the relationship between internalized oppressions and mental health. Results indicate that after controlling for education, internalized sexism (IS) and internalized heterosexism/internalized homophobia (IH) are significant predictors of psychological distress and account for 17% of the variance. The interactions between IS and IH are not significant predictors of psychological distress. Furthermore, results reveal that self-esteem and social support fully mediate the relationships between IH and psychological distress. Social support was also found to fully mediate the relationship between IS and psychological distress. However, no support was found for the mediational role of self-esteem in the link between IS and psychological distress. Research and practice implications are discussed.

Training Models in Counseling Psychology Scientist-Practitioner Versus Practitioner-Scholar

Considerable discussion has occurred through the years regarding models of training. With the recent accreditation of counseling psychology programs espousing the practitioner-scholar model, the importance of reexamining the merits of this as well as the traditional scientist-practitioner is now very important for the future of the field. This article consists of two positions: One pro practitioner-scholar and the other pro scientist-practitioner and con practitioner-scholar. The first position (first part of the article) by Biever, Patterson, and Welch argues for inclusion of the practitioner-scholar model as an alternative for training in counseling psychology. The second position (in the second part of the article) by Stoltenberg, Pace, and Kashubeck reviews concerns with two competing models. These authors conclude that the scientist-practitioner model is a better fit for training in counseling psychology. Recommendations for training within models are presented.

Assessment of Eating Disorders in Women

This article reviews current eating disorder self-report and interview measures and makes recommendations for choosing assessment devices for practice and research. The authors also incorporate overviews of related measures, such as body satisfaction and restrained eating. The presentation of women with eating disorders on measures of general psychological functioning (such as the Minnesota Multiphasic Personality Inventory) is also discussed. Implications and recommendations for practice are presented, as are recommendations for future research. The lack of validation of, and urgent need for, eating disorder assessment measures with ethnic minority women is discussed throughout.

Risky Sexual Behavior in Gay and Bisexual Men Internalized Heterosexism, Sensation Seeking, and Substance Use

This study investigated risky sexual behavior in a sample of 209 gay and bisexual men. Using structural equation modeling, the mediating relations of substance use factors (expectations about the sexually enhancing effects of substance use and substance use during sex) between internalized heterosexism (IH) and sensation seeking and unprotected anal intercourse were examined. Expectations that substance use would enhance sexual activity mediated the relationship between IH and risky sexual behavior. Both substance use factors mediated the relationship of sensation seeking to risky sexual behavior. Greater sensation seeking was associated with greater expectations about the sexually enhancing effects of substances, which in turn was associated with greater unprotected anal intercourse. Unexpectedly, less sensation seeking was related to more substance use during sex, which in turn was associated with more risky sexual behavior. Overall, the variables in the model accounted for 66% of the variance in sexual behavior.

The Relations Among Feminist Identity Development, Gender-Role Orientation, and Psychological Well-Being in Women

This study examined relations between feminist identity development, gender-role orientation, and psychological well-being in 244 women of varying ages and backgrounds. As hypothesized, both feminist identity development and gender-role orientation contributed independently to the explanation of variance in psychological well-being. Instrumentality, expressiveness, and a more developed feminist identity were all related positively to psychological well-being. In addition, instrumentality and a more developed feminist identity were correlated positively. Implications of these findings as well as limitations and future directions are discussed.

Religious Attitudes, Internalized Homophobia, and Identity in Gay and Lesbian Adults

ABSTRACT The purpose of this study was to develop an empirical base for interventions and further research for lesbian, gay, and bisexual adults experiencing conflict between their religious beliefs and sexual orientation by identifying relations between religious beliefs, commitments, and attitudes to indicators of positive adjustment. Ninety-nine lesbian, gay, or bisexual participants responded to measures of internalized homophobia, gay identity development, religious commitment, scriptural literalism, and postconventional religious reasoning. Results indicated that among gay and lesbian adults: (1) levels of religious commitment did not predict positive adjustment and did not appear to interact with the other religious variables assessed; (2) scriptural literalism (i.e., interpreting Biblical scripture with comparatively little attention to historical context) was not related to internalized homophobia or sexual identity development; and (3) higher levels of postconventional religious reasoning (i.e., making religious decisions independently rather than in deference to other authorities) predicted lower levels of internalized homophobia and higher levels of sexual identity development. These findings provide a basis for future research that may lead to the development of counseling interventions for lesbian and gay clientele experiencing religious conflict.

Eating Disorders in Women Etiology, Assessment, and Treatment

Most counseling psychologists will be called on to deal with eating disorders (EDs) in some way during their careers (Kalodner, 1998)—either directly through clients who present for such disorders or indirectly through clients who present for other reasons but who also have a comorbid ED. Counseling psychologists in college counseling centers see large numbers of women who present with concerns pertaining to eating and weight, making knowledge of EDs imperative for counseling psychologists in these agencies (Schwitzer, Berghold, Dore, & Salimi, 1998). Likewise, due to high comorbidity between EDs and child sexual abuse (Jarvis & Copleland, 1997), substance abuse (Katz, 1992), affective, anxiety, and personality disorders (Brewerton, 1999), knowledge of EDs is critical for counseling psychologists who treat clients with such concerns. For example, experts recommend that counselors should routinely screen for EDs in clients with substance abuse disorders (Wilson, 1999). Without knowledge of EDs, counseling psychologists may fail to assess and thus adequately treat clients who have an ED. In short, a working knowledge of EDs is paramount for all counseling psychologists working in applied settings including, but not limited to, college counseling centers, private practices, and community agencies. Counseling psychologists in nonapplied (i.e., faculty) positions also have much to gain from a working knowledge of EDs. The study of EDs is philosophically consistent with the field of counseling psychology. First, counseling psychology is concerned with issues that have global and cultural meaning. Eating disorders have clear cultural roots, and thus the study of them is consistent with the goals of counseling psychology. Second, counseling psychology espouses a scientist-practitioner model, and the field of EDs is an example of one in which science and practice can converge. Theoretical and

Internalized Heterosexism: Clinical Implications and Training Considerations

This article focuses on implications of empirical research on the construct of internalized heterosexism (IH) in lesbian, gay, and bisexual (LGB) individuals. First, suggestions for practice with LGB clients are provided using the framework proposed by Goodman et al. for social justice work at micro, meso, and macro levels. Second, ideas for the training of counseling psychologists on the construct of IH are presented. Ways in which counseling psychologists can train students beyond the traditional micro-level approach are included.

Testing a mediation framework for the link between perceived discrimination and psychological distress among sexual minority individuals.

Perceived discrimination is a risk factor for mental health problems among sexual minority individuals. An increasing number of research studies have investigated the mechanisms through which stigma-related stressors such as perceived discrimination are linked with adverse mental health outcomes for sexual minority populations. The integrative mediation framework proposed by Hatzenbuehler (2009) underscores the importance of identifying mediators in the association between stigma-related stressors and mental health outcomes. This study tested 3 mediators--expectations of rejection, anger rumination, and self-compassion--in the perceived discrimination-distress link. Moreover, it examined associations among these mediators. A nationwide sample of 265 sexual minorities responded to an online survey. Structural equation modeling results supported the mediator roles of expectations of rejection, anger rumination, and self-compassion. More specifically, perceived discrimination was associated with expectations of rejection, which, in turn, was associated with increased anger rumination and less self-compassion, resulting in greater psychological distress. The findings suggest several avenues for prevention and intervention with sexual minority individuals.