A minority stress-emotion regulation model of sexual compulsivity among highly sexually active gay and bisexual men

Health Psychology

Volumn 34, Issue 8, 2015, Pages 829-840

  Pachankis, John E ^a,b   Jonathon Rendina, H ^b   Restar, Arjee ^b   Ventuneac, Ana ^b   Grov, Christian ^b,c,d   Parsons, Jeffrey T ^d,e  

^a YALE UNIVERSITY   (United States)

^b Center for HIV AIDS Educational Studies and Training (CHEST)   (United States)

^c CITY UNIVERSITY OF NEW YORK   (United States)

^d CITY UNIVERSITY OF NEW YORK   (United States)

^e CITY UNIVERSITY OF NEW YORK   (United States)

Author keywords

Emotion regulation; Gay and bisexual men; Minority stress; Sexual compulsivity; Stigma

Indexed keywords

ADULT; AGED; ANXIETY; ARTICLE; BISEXUAL MALE; CONTROLLED STUDY; DEPRESSION; EMOTIONALITY; EMPLOYMENT; ETHNICITY; HOMOSEXUAL MALE; HUMAN; HUMAN EXPERIMENT; MALE; MENTAL HEALTH; MINI MENTAL STATE EXAMINATION; NORMAL HUMAN; PSYCHOLOGICAL WELL BEING; SEXUAL ADDICTION; SEXUAL BEHAVIOR; SEXUAL COMPULSIVITY; SEXUAL MINORITY; SEXUAL ORIENTATION; SOCIAL REJECTION; SOCIAL STRESS; STRESS; VALIDITY; ADOLESCENT; BISEXUALITY; COMPULSIVE BEHAVIOR; EMOTION; FOLLOW UP; LONGITUDINAL STUDY; MALE HOMOSEXUALITY; MENTAL STRESS; MIDDLE AGED; MINORITY GROUP; NEW YORK; PSYCHOLOGICAL MODEL; PSYCHOLOGY; SEXUALITY; YOUNG ADULT;

ADOLESCENT; ADULT; AGED; BISEXUALITY; COMPULSIVE BEHAVIOR; EMOTIONS; FOLLOW-UP STUDIES; HOMOSEXUALITY, MALE; HUMANS; LONGITUDINAL STUDIES; MALE; MEN; MIDDLE AGED; MINORITY GROUPS; MODELS, PSYCHOLOGICAL; NEW YORK CITY; SEXUAL BEHAVIOR; SEXUAL PARTNERS; STRESS, PSYCHOLOGICAL; YOUNG ADULT;

EID: 84938207854     PISSN: 02786133     EISSN: 19307810     Source Type: Journal    
DOI: 10.1037/hea0000180     Document Type: Article

References (88)

1. Abu Ruz, M. E., Lennie, T. A., Riegel, B., McKinley, S., Doering, L. V., & Moser, D. K. (2010). Evidence that the brief symptom inventory can be used to measure anxiety quickly and reliably in patients hospitalized for acute myocardial infarction. Journal of Cardiovascular Nursing, 25, 117-123. http://dx.doi.org/10.1097/JCN.0b013e3181b56626
2. Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotionregulation strategies across psychopathology:A meta-analytic review. Clinical Psychology Review, 30, 217-237. http://dx.doi.org/10.1016/j .cpr.2009.11.004
3. American Psychiatric Association, DSM-5 Workgroup on Sexual and Gender Identity Disorders. (2010). Hypersexual disorder screening inventory. Retrieved July 26, 2011, from http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid_415
4. Antoni, M. H., Cruess, S., Cruess, D. G., Kumar, M., Lutgendorf, S., Ironson, G., . . . Schneiderman, N. (2000). Cognitive-behavioral stress management reduces distress and 24-hour urinary free cortisol output among symptomatic HIV-infected gay men. Annals of Behavioral Medicine, 22, 29-37. http://dx.doi.org/10.1007/BF02895165
5. Bailey, J. M., Nothnagel, J., & Wolfe, M. (1995). Retrospectively measured individual differences in childhood sex-typed behavior among gay men:Correspondence between self-and maternal reports. Archives of Sexual Behavior, 24, 613-622. http://dx.doi.org/10.1007/BF01542183
6. Balsam, K. F., Rothblum, E. D., & Beauchaine, T. P. (2005). Victimization over the life span:A comparison of lesbian, gay, bisexual, and hetero-sexual siblings. Journal of Consulting and Clinical Psychology, 73, 477-487. http://dx.doi.org/10.1037/0022-006X.73.3.477
7. Bancroft, J., & Vukadinovic, Z. (2004). Sexual addiction, sexual compulsivity, sexual impulsivity, or what? Toward a theoretical model. Journal of Sex Research, 41, 225-234. http://dx.doi.org/10.1080/00224490409552230
8. Barlow, D., Ellard, K., Fairholme, C., Farchione, T., Boisseau, C., Allen, L., & Ehrenreich-May, J. (2011). The unified protocol for transdiagnostic treatment of emotional disorders:Client workbook. New York, NY:Oxford University Press.
9. Baum, M., & Fishman, J. (1994). AIDS, sexual compulsivity, and gay men:A group treatment approach. In S. A. Cadwell, R. A. Burnham, Jr., & M. Forstein (Eds.), Therapists on the front line:Psychotherapy with gay men in the age of AIDS (pp. 255-274). Washington, DC:American Psychiatric Press, Inc.
10. Black, D. W. (2000). The epidemiology and phenomenology of compulsive sexual behavior. CNS Spectrums, 5, 26-72.
11. Chaudoir, S. R., Fisher, J. D., & Simoni, J. M. (2011). Understanding HIV disclosure:A review and application of the Disclosure Processes Model. [Review]. Social Science & Medicine, 72, 1618-1629. http://dx.doi.org/10.1016/j.socscimed.2011.03.028
12. Coleman, E. (1990). The obsessive-compulsive model for describing compulsive sexual behavior. American Journal of Preventive Psychiatry and Neurology, 2, 9-14.
13. Corliss, H. L., Cochran, S. D., & Mays, V. M. (2002). Reports of parental maltreatment during childhood in a United States population-based survey of homosexual, bisexual, and heterosexual adults. Child Abuse & Neglect, 26, 1165-1178. http://dx.doi.org/10.1016/S0145-2134(02) 00385-X
14. Derogatis, L. R. (1975). Brief Symptom Inventory. Baltimore:Clinical Psychometric Research.
15. Dodge, B., Reece, M., Herbenick, D., Fisher, C., Satinsky, S., & Stupiansky, N. (2008). Relations between sexually transmitted infection diagnosis and sexual compulsivity in a community-based sample of men who have sex with men. Sexually Transmitted Infections, 84, 324-327. http://dx.doi.org/10.1136/sti.2007.028696
16. Downey, G., & Feldman, S. I. (1996). Implications of rejection sensitivity for intimate relationships. Journal of Personality and Social Psychology, 70, 1327-1343. http://dx.doi.org/10.1037/0022-3514.70.6.1327
17. Eisenberg, M. E. (2002). The association of campus resources for gay, lesbian, and bisexual students with college students' condom use. Journal of American College Health, 51, 109-116. http://dx.doi.org/10.1080/07448480209596338
18. Epstein, S. (1983, July 2, 2010). [The Mother, Father, Peer Scale].
19. Farchione, T. J., Fairholme, C. P., Ellard, K. K., Boisseau, C. L., Thompson-Hollands, J., Carl, J. R., . . . Barlow, D. H. (2012). Unified protocol for transdiagnostic treatment of emotional disorders:A randomized controlled trial. Behavior Therapy, 43, 666-678. http://dx.doi.org/10.1016/j.beth.2012.01.001
20. Feinstein, B. A., Goldfried, M. R., & Davila, J. (2012). The relationship between experiences of discrimination and mental health among lesbians and gay men:An examination of internalized homonegativity and rejection sensitivity as potential mechanisms. Journal of Consulting and Clinical Psychology, 80, 917-927. http://dx.doi.org/10.1037/a0029425
21. First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. (2002). Structured clinical interview for DSM-IV-TR axis I disorders, research version, patient ed. with psychotic screen (SCID-I/P W/PSY Screen). New York:Biometrics Research, New York State Psychiatric Institute.
22. Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). "Mini-mental state." A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189-198. http://dx.doi.org/10.1016/0022-3956(75)90026-6
23. Goodman, R. E. (1997). Understanding human sexuality-specifically homosexuality and the paraphilias-in terms of chaos theory and fetal development. Medical Hypotheses, 48, 237-243. http://dx.doi.org/10.1016/S0306-9877(97)90313-3
24. Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation:Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26, 41-54. http://dx.doi.org/10.1023/B:JOBA.0000007455.08539.94
25. Green, K. E., & Feinstein, B. A. (2012). Substance use in lesbian, gay, and bisexual populations:An update on empirical research and implications for treatment. Psychology of Addictive Behaviors, 26, 265-278. http://dx.doi.org/10.1037/a0025424
26. Greenberg, L. (2002). Emotion-focused therapy:Coaching clients to work through their feelings. Washington, DC, US:American Psychological Association.
27. Grov, C., Parsons, J. T., & Bimbi, D. S. (2010). Sexual compulsivity and sexual risk in gay and bisexual men. Archives of Sexual Behavior, 39, 940-949. http://dx.doi.org/10.1007/s10508-009-9483-9
28. Hatzenbuehler, M. L. (2009). How does sexual minority stigma "get under the skin"? A psychological mediation framework. Psychological Bulletin, 135, 707-730. http://dx.doi.org/10.1037/a0016441
29. Hatzenbuehler, M. L. (2010). Social factors as determinants of mental health disparities in LGB populations:Implications for public policy. Social Issues and Policy Review, 4, 31-62. http://dx.doi.org/10.1111/j .1751-2409.2010.01017.x
30. Hatzenbuehler, M. L., McLaughlin, K. A., & Nolen-Hoeksema, S. (2008). Emotion regulation and internalizing symptoms in a longitudinal study of sexual minority and heterosexual adolescents. Journal of Child Psychology and Psychiatry, 49, 1270-1278. http://dx.doi.org/10.1111/j .1469-7610.2008.01924.x
31. Hatzenbuehler, M. L., Nolen-Hoeksema, S., & Dovidio, J. (2009). How does stigma "get under the skin"?:The mediating role of emotion regulation. Psychological Science, 20, 1282-1289. http://dx.doi.org/10.1111/j.1467-9280.2009.02441.x
32. Hatzenbuehler, M. L., Nolen-Hoeksema, S., & Erickson, S. J. (2008). Minority stress predictors of HIV risk behavior, substance use, and depressive symptoms:Results from a prospective study of bereaved gay men. Health Psychology, 27, 455-462. http://dx.doi.org/10.1037/0278-6133.27.4.455
33. Hatzenbuehler, M. L., O'Cleirigh, C., Grasso, C., Mayer, K., Safren, S., & Bradford, J. (2012). Effect of same-sex marriage laws on health care use and expenditures in sexual minority men:A quasi-natural experiment. American Journal of Public Health, 102, 285-291. doi:10.2105/AJPH.2011.300382
34. Herek, G. M., Cogan, J. C., Gillis, J. R., & Glunt, E. K. (1998). Correlates of internalized homophobia in a community sample of lesbians and gay men. Journal of the Gay & Lesbian Medical Association, 2, 17-25.
35. Hook, J. N., Hook, J. P., Davis, D. E., Worthington, E. L., Jr., & Penberthy, J. K. (2010). Measuring sexual addiction and compulsivity:A critical review of instruments. Journal of Sex & Marital Therapy, 36, 227-260. http://dx.doi.org/10.1080/00926231003719673
36. Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis:Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1-55. http://dx.doi.org/10.1080/10705519909540118
37. Kafka, M. P. (2010). Hypersexual disorder:A proposed diagnosis for DSM-V. Archives of Sexual Behavior, 39, 377-400. http://dx.doi.org/10.1007/s10508-009-9574-7
38. Kalichman, S. C., & Rompa, D. (2001). The sexual compulsivity scale:Further development and use with HIV-positive persons. Journal of Personality Assessment, 76, 379-395.
39. Kaysen, D., Lostutter, T. W., & Goines, M. A. (2005). Cognitive processing therapy for acute stress disorder resulting from an anti-gay assault. Cognitive and Behavioral Practice, 12, 278-289. http://dx.doi.org/10.1016/S1077-7229(05)80050-1
40. Kingston, D., & Firestone, P. (2008). Problematic hypersexuality:A review of conceptualization and diagnosis. Sexual Addiction & Compulsivity, 15, 284-310. http://dx.doi.org/10.1080/10720160802289249
41. Landolt, M. A., Bartholomew, K., Saffrey, C., Oram, D., & Perlman, D. (2004). Gender nonconformity, childhood rejection, and adult attachment:A study of gay men. Archives of Sexual Behavior, 33, 117-128. http://dx.doi.org/10.1023/B:ASEB.0000014326.64934.50
42. Lin, Y. J., & Israel, T. (2012). A computer-based intervention to reduce internalized heterosexism in men. Journal of Counseling Psychology, 59, 458-464. http://dx.doi.org/10.1037/a0028282
43. Linehan, M. M. (1993). Dialectical behavior therapy for treatment of borderline personality disorder:Implications for the treatment of substance abuse. NIDA Research Monograph, 137, 201-216.
44. Lippa, R. (2008). The relation between childhood gender nonconformity and adult masculinity-femininity and anxiety in heterosexual and homosexual men and women. Sex Roles, 59, 684-693. http://dx.doi.org/10.1007/s11199-008-9476-5
45. Mays, V. M., & Cochran, S. D. (2001). Mental health correlates of perceived discrimination among lesbian, gay, and bisexual adults in the United States. American Journal of Public Health, 91, 1869-1876. http://dx.doi.org/10.2105/AJPH.91.11.1869
46. Mennin, D. S., & Farach, F. J. (2007). Emotion and evolving treatments for adult psychopathology. Clinical Psychology:Science and Practice, 14, 329-352. http://dx.doi.org/10.1111/j.1468-2850.2007.00094.x
47. Mennin, D. S., & Fresco, D. M. (2009). Emotion regulation as an integrative framework for understanding and treating psychopathology. New York:Guilford Press.
48. Mennin, D. S., Heimberg, R. G., Turk, C. L., & Fresco, D. M. (2005). Preliminary evidence for an emotion dysregulation model of generalized anxiety disorder. Behaviour Research and Therapy, 43, 1281-1310. http://dx.doi.org/10.1016/j.brat.2004.08.008
49. Meyer, I. H. (2003a). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations:Conceptual issues and research evidence. Psychological Bulletin, 129, 674-697. http://dx.doi.org/10.1037/0033-2909.129.5.674
50. Meyer, I. H. (2003b). Prejudice as stress:Conceptual and measurement problems. American Journal of Public Health, 93, 262-265.
51. Missildine, W., Feldstein, G., Punzalan, J., & Parsons, J. (2005). S/he loves me, s/he loves me not:Questioning heterosexist assumptions of gender differences and romantic attraction. Sexual Addiction & Compulsivity, 12, 1-11. http://dx.doi.org/10.1080/10720160590933662
52. Morlan, K. K., & Tan, S. Y. (1998). Comparison of the brief psychiatric rating scale and the brief symptom inventory. Journal of Clinical Psychology, 54, 885-894. http://dx.doi.org/10.1002/(SICI)1097-4679(199811)54:7_885::AID-JCLP33.0.CO;2-E
53. Moses, E. B., & Barlow, D. H. (2006). A new unified treatment approach for emotional disorders based on emotion science. Current Directions in Psychological Science, 15, 146-150. http://dx.doi.org/10.1111/j.0963-7214.2006.00425.x
54. Muench, F., & Parsons, J. T. (2004). Sexual compulsivity and HIV:Identification and treatment. Focus (San Francisco, Calif.), 19, 1-5.
55. Muthén, L. K., & Muthén, B. O. (2012). Mplus user's guide (seventh ed.). Los Angeles, CA:Muthén & Muthén.
56. Newcomb, M. E., & Mustanski, B. (2010). Internalized homophobia and internalizing mental health problems:A meta-analytic review. Clinical Psychology Review, 30, 1019-1029. http://dx.doi.org/10.1016/j.cpr .2010.07.003
57. Pachankis, J. E. (2014). Uncovering clinical principles and techniques to address minority stress, mental health, and related health risks among gay and bisexual men. Clinical Psychology:Science and Practice, 21, 313-330.
58. Pachankis, J. E., & Bernstein, L. (2012). An etiological model of anxiety in young gay men:From early stress to public self-consciousness. Psychology of Men & Masculinity, 13, 107-122. http://dx.doi.org/10.1037/a0024594
59. Pachankis, J. E., & Goldfried, M. R. (2006). Social anxiety in young gay men. Journal of Anxiety Disorders, 20, 996-1015. http://dx.doi.org/10.1016/j.janxdis.2006.01.001
60. Pachankis, J. E., Goldfried, M. R., & Ramrattan, M. E. (2008). Extension of the rejection sensitivity construct to the interpersonal functioning of gay men. Journal of Consulting and Clinical Psychology, 76, 306-317. http://dx.doi.org/10.1037/0022-006X.76.2.306
61. Pachankis, J. E., Rendina, H. J., Ventuneac, A., Grov, C., & Parsons, J. (2014). The role of maladaptive cognitions in hypersexuality among highly sexually active gay and bisexual men. Archives of Sexual Behavior, 43, 669-683. http://dx.doi.org/10.1007/s10508-014-0261-y
62. Pachankis, J. E., Westmaas, J. L., & Dougherty, L. R. (2011). The influence of sexual orientation and masculinity on young men's tobacco smoking. Journal of Consulting and Clinical Psychology, 79, 142-152. http://dx.doi.org/10.1037/a0022917
63. Parsons, J. T., Grov, C., & Golub, S. A. (2012). Sexual compulsivity, co-occurring psychosocial health problems, and HIV risk among gay and bisexual men:Further evidence of a syndemic. American Journal of Public Health, 102, 156-162. http://dx.doi.org/10.2105/AJPH.2011.300284
64. Parsons, J. T., Kelly, B. C., Bimbi, D. S., DiMaria, L., Wainberg, M. L., & Morgenstern, J. (2008). Explanations for the origins of sexual compulsivity among gay and bisexual men. Archives of Sexual Behavior, 37, 817-826. http://dx.doi.org/10.1007/s10508-007-9218-8
65. Parsons, J. T., Kelly, B. C., Bimbi, D. S., Muench, F., & Morgenstern, J. (2007). Accounting for the social triggers of sexual compulsivity. Journal of Addictive Diseases, 26, 5-16. http://dx.doi.org/10.1300/J069v26n03_02
66. Parsons, J. T., Rendina, H. J., Ventuneac, A., Cook, K. F., Grov, C., & Mustanski, B. (2013). A psychometric investigation of the hypersexual disorder screening inventory among highly sexually active gay and bisexual men:An item response theory analysis. Journal of Sexual Medicine, 10, 3088-3101. http://dx.doi.org/10.1111/jsm.12117
67. Pincu, L. (1989). Sexual compulsivity in gay men:Controversy and treatment. Journal of Counseling & Development, 68, 63-66. http://dx.doi.org/10.1002/j.1556-6676.1989.tb02495.x
68. Quadland, M. C., & Shattls, W. D. (1987). AIDS, sexuality, and sexual control. Journal of Homosexuality, 14(1-2), 277-298. http://dx.doi.org/10.1300/J082v14n01_20
69. Raymond, N. C., Coleman, E., & Miner, M. H. (2003). Psychiatric comorbidity and compulsive/impulsive traits in compulsive sexual behavior. Comprehensive Psychiatry, 44, 370-380. http://dx.doi.org/10.1016/S0010-440X(03)00110-X
70. Rieger, G., Linsenmeier, J. A., Gygax, L., & Bailey, J. M. (2008). Sexual orientation and childhood gender nonconformity:Evidence from home videos. Developmental Psychology, 44, 46-58. http://dx.doi.org/10.1037/0012-1649.44.1.46
71. Roemer, L., Orsillo, S. M., & Salters-Pedneault, K. (2008). Efficacy of an acceptance-based behavior therapy for generalized anxiety disorder:Evaluation in a randomized controlled trial. Journal of Consulting and Clinical Psychology, 76, 1083-1089. http://dx.doi.org/10.1037/a0012720
72. Rosser, B. R., Bockting, W. O., Ross, M. W., Miner, M. H., & Coleman, E. (2008). The relationship between homosexuality, internalized homo-negativity, and mental health in men who have sex with men. Journal of Homosexuality, 55, 185-203. http://dx.doi.org/10.1080/00918360802129394
73. Russell, S. T., Muraco, A., Subramaniam, A., & Laub, C. (2009). Youth empowerment and high school Gay-Straight Alliances. Journal of Youth and Adolescence, 38, 891-903. http://dx.doi.org/10.1007/s10964-008-9382-8
74. Ryan, C., Russell, S. T., Huebner, D., Diaz, R., & Sanchez, J. (2010). Family acceptance in adolescence and the health of LGBT young adults. Journal of Child and Adolescent Psychiatric Nursing, 23, 205-213. http://dx.doi.org/10.1111/j.1744-6171.2010.00246.x
75. Schrimshaw, E. W., Siegel, K., Downing, M. J., & Parsons, J. T. (2013). Disclosure and concealment of sexual orientation and the mental health of non-gay-identified, behaviorally bisexual men. Journal of Consulting and Clinical Psychology, 81, 141-153. http://dx.doi.org/10.1037/a0031272
76. Shepherd, L. (2010). Cognitive behavior therapy for sexually addictive behavior. Clinical Case Studies, 9, 18-27. http://dx.doi.org/10.1177/1534650109348582
77. Sher, K., & Grekin, E. (2007). Alcohol and affect regulation. New York:Guilford Press.
78. Shields, A. M., Cicchetti, D., & Ryan, R. M. (1994). The development of emotional and behavioral self-regulation and social competence among maltreated school-age children. Development and Psychopathology, 6, 57-75. http://dx.doi.org/10.1017/S0954579400005885
79. Skidmore, W. C., Linsenmeier, J. A., & Bailey, J. M. (2006). Gender nonconformity and psychological distress in lesbians and gay men. Archives of Sexual Behavior, 35, 685-697. http://dx.doi.org/10.1007/s10508-006-9108-5
80. Sobell, M. B., & Sobell, L. C. (1992). Problem drinkers:Guided selfchange treatment. New York:Guilford Press.
81. Stall, R., Friedman, M., & Catania, J. A. (Eds.). (2008). Interacting epidemics and gay men's health:A theory of syndemic production among urban gay men. Unequal opportunity:Health disparities affecting gay and bisexual men in the United States (pp. 251-274). New York, NY:Oxford University Press.
82. Stall, R., Mills, T. C., Williamson, J., Hart, T., Greenwood, G., Paul, J., . . .Catania, J. A. (2003). Association of co-occurring psychosocial health problems and increased vulnerability to HIV/AIDS among urban men who have sex with men. American Journal of Public Health, 93, 939-942. http://dx.doi.org/10.2105/AJPH.93.6.939
83. Stall, R., Paul, J. P., Greenwood, G., Pollack, L. M., Bein, E., Crosby, G. M., . . . Catania, J. A. (2001). Alcohol use, drug use and alcoholrelated problems among men who have sex with men:The Urban Men's Health Study. Addiction, 96, 1589-1601. http://dx.doi.org/10.1046/j .1360-0443.2001.961115896.x
84. Walsh, K., & Hope, D. A. (2010). LGB-affirmative cognitive behavioral treatment for social anxiety:A case study applying evidence-based practice principles. Cognitive and Behavioral Practice, 17, 56-65. http://dx.doi.org/10.1016/j.cbpra.2009.04.007
85. Weiss, D. (2004). Prevalence of depression in male sex addicts residing in the United States. Sexual Addiction & Compulsivity, 11(1-2), 57-69. http://dx.doi.org/10.1080/10720160490458247
86. Williams, A. D., Grisham, J. R., Erskine, A., & Cassedy, E. (2012). Deficits in emotion regulation associated with pathological gambling. British Journal of Clinical Psychology, 51, 223-238. http://dx.doi.org/10.1111/j.2044-8260.2011.02022.x
87. Williams, D. R., Yan, Yu., Jackson, J. S., & Anderson, N. B. (1997). Racial differences in physical and mental health:Socio-economic status, stress and discrimination. Journal of Health Psychology, 2, 335-351. http://dx.doi.org/10.1177/135910539700200305
88. Woolf-King, S. E., Rice, T. M., Truong, H. M., Woods, W. J., Jerome, R. C., & Carrico, A. W. (2013). Substance use and HIV risk behavior among men who have sex with men:The role of sexual compulsivity. Journal of Urban Health, 90, 948-952. http://dx.doi.org/10.1007/s11524-013-9820-0