Attachment Security and Depressive Symptoms in Sexual Minority Adults

Attachment Security, Sense of Belonging, and Depressive Symptoms Among Sexual-Minority Adults: A Moderated-Mediation Model A thesis submitted in partial fulfillment of the requirements for graduation with Honors in Psychology. 2022 ii Table of Contents Acknowledgements.................................................................................................................... v Abstract ........................................................................................................................................vi List of Tables and Figures..................................................................................................... vii Introduction .................................................................................................................................1 Attachment ........................................................................................................................................... 5 Attachment and Depression ........................................................................................................... 7 Attachment in LGB Individuals ...................................................................................................... 8 Sense of Belonging .......................................................................................................................... 10 Belonging and Depression ........................................................................................................... 12 General Belonging and Belonging to the LGB Community................................................ 14 Attachment and Belonging ........................................................................................................... 15 Attachment and Belonging as Psychological Needs ............................................................ 16 McLaren’s Research on Belonging to the Lesbian Community and General Community......................................................................................................................................... 17 The Present Study ........................................................................................................................... 18 Moderated-Mediation Model....................................................................................................... 20 Hypotheses......................................................................................................................................... 20 Figure 1 ............................................................................................................................................... 22 Method ........................................................................................................................................ 23 Recruitment....................................................................................................................................... 23 Design .................................................................................................................................................. 24 Measures............................................................................................................................................. 24 Screener .............................................................................................................................................. 24 Self-Reported Sense of Belonging .............................................................................................. 25 Self-Reported Adult Attachment ..........................................................................................................................27 Self-Reported Depression ........................................................................................................................................28 Self-Reported Outness .................................................................................................................................................29 Attention Screeners .....................................................................................................................................................29 Demographics .................................................................................................................................................................30 Debriefing and Resources ............................................................................................................................................36 Procedure ........................................................................................................................................... 36 Results ........................................................................................................................................ 39 Exploratory Analyses ..................................................................................................................... 44 Discussion .................................................................................................................................. 47 Limitations ......................................................................................................................................... 51 iii Future Research ............................................................................................................................... 53 Practical Implications .................................................................................................................... 55 References.......................................................................................................................................... 57 Appendix A................................................................................................................................. 70 Appendix B ................................................................................................................................ 72 Appendix C ................................................................................................................................. 73 Appendix D ................................................................................................................................ 75 Appendix E ................................................................................................................................. 77 Appendix F ................................................................................................................................. 79 iv v Abstract We investigated associations among attachment security, sense of belonging, and depressive symptoms in sexual-minority adults both from the United States and countries outside of the United States (N = 364). We completed a partial conceptual replication of a 2009 study by McLaren, who found that sense of belonging to the Lesbian Community was associated negatively with depression among lesbians with low sense of belonging to the general community, but positively associated with depression among lesbians with high sense of belonging to the general community. We tested whether sense of belonging to the LGBQP (lesbian, gay, bisexual, queer, pansexual) Community mediates the relationship between attachment security and depressive symptoms, and whether sense of belonging to the general community moderates the indirect effect of attachment security on depressive symptoms via sense of belonging to the LGBQP Community. We recruited a sufficiently large sample for correlational research through online survey distribution targeting LGBQP-affinity groups. The participants were majority white (81.9%) women (43.4%), between the ages of 18-23 (41.5%), and primarily lesbian (23.9%), bisexual (28.3%), or gay (25.8%) identifying persons. We found a correlation between attachment security and belonging to the LGBQP Community, r(364) = .233, p < .001, as well as between belonging to the LGBQP Community and depression, r(364) = -.357, p < .001. Our results supported the proposed indirect effect of attachment security on depression via sense of belonging to the LGBQP Community, b = -.041, p = .0004, but not the moderation of that indirect effect by general belonging, b = .003, p = .840. This research contributes to a better understanding of factors involved in the mental health of sexualminority individuals. vi List of Tables and Figures Figure 1: Moderated Mediation Model of Proposed Associations Between Attachment Security, Sense of Belonging to the LGBQP Community, Sense of Belonging to the General Community, and Depressive Symptoms ...………….……………………...…..28 Figure 2: Correlation Coefficients and Conditional Probabilities Found in our Proposed Moderated Mediation Model ……………………………………………..……………..43 Table 1: Demographic Characteristics .………………………………………………….37 Table 2: Attention Check Items …………..……………………………………………..40 Table 3: Descriptive Statistics and Pearson Correlation Matrix for Continuous Variables …………..………………………………………………………………………………..45 Table 4: Results of Mediation Analysis: Regression Coefficients of Attachment and LGBQP Belonging on Depression ………………..………………………………….….46 Table 5: Results of Mediation Analysis: Regression Coefficients of Attachment and LGBQP Belonging on Depression …………..…………………………………………..47 vii Introduction Researchers have documented higher rates of mental health disparities among sexual-minority individuals compared to their heterosexual counterparts (Marshal et al., 2011; Meyer, 2013). Previous research has investigated links between sexual orientation and suicidality (Russell and Joyner, 2001; Wichstrom & Hegna, 2003), depression (Case et al., 2004; Cochran et al., 2003; King et al. 2008; Mills et al., 2004; Westefeld et al., 2001), and substance abuse (Cochran et al., 2004; Marshal et al., 2008). Efforts to better understand mental health in lesbian, gay, and bisexual (LGB) individuals has included research on minority stress, homonegativity, and negative attitudes toward homosexuality as possible contributors to health disparities (Meyer, 2003; Stuber et al., 2008). Negative attitudes towards homosexuality may lead to discriminatory acts against sexual-minority individuals. Discrimination based on sexual orientation often includes physical violence, verbal abuse, or general hostility towards sexual-minority individuals (Huebner et al., 2004). Researchers have identified discrimination as a potential risk factor for suicide in sexual and gender-minority youth (Baldwin et al., 2019; Marshal et al., 2011). There is a continued search for protective health factors and interventions regarding sexual-minority individuals and mental health (Battalen et al., 2021; Eisenberg & Resnick, 2006; Fish et al., 2019; Meyer, 2015). Attachment has emerged in previous research as an important predictor of depression (Bifulco et al., 2002; Murphy, 1997). A study among Dutch adults with a recent diagnosis of depression indicated that secure attachment may be related to lower levels of depression (Conradi & de Jonge, 2009). Existing research investigating the connection between attachment and depression among sexual-minority individuals is limited. However, some researchers have suggested that attachment may be particularly important in understanding the well-being of sexual-minority individuals (Cook & Calebs, 2016), and also that sexual-minority individuals have both higher rates of insecure attachment and depression than heterosexuals (Popa-Velea et al., 2019). Having a strong sense of belonging, either generally or to a specific community, has also been associated with lower levels of depression, including among sexualminority adults (McLaren, 2009; McLaren et al., 2013; McLaren & Castillo, 2021). Specifically, this research suggests that a high sense of belonging to the sexual-minority community may be an important protective factor against depression for sexual-minority adults, especially those who have a low sense of belonging to the general community (McLaren, 2009). Overall, both attachment and sense of belonging appear to be potential predictors of depression, especially among sexual-minority individuals. Some existing research investigates links between sense of belonging and attachment (Ron, 2004), providing a foundation for further research on those associations. The present study builds on prior research to better understand the relationships among belonging, attachment, and depression in a sexual-minority population. We will first outline the minority stress model as it applies to sexual-minority individuals, to provide a foundation for the way we approached our investigation of factors related to the stress that people with minority sexual orientations experience. Then, we will present an overview of adult attachment theory and the theory of sense of belonging, which are the two main theories that informed our research. Next, we will discuss McLaren’s (2009) research regarding sense of belonging among Australian lesbians, which we replicated and extended. Finally, we will introduce the model and hypotheses of the present study. 2 The Minority Stress Model and Homonegativity The minority stress model (Meyer, 2003) provides a social-psychological framework for understanding negative mental-health outcomes, including depression, specific to individuals from marginalized groups. The foundational research contributing to the development of the minority stress model (Meyer, 2003) included a study on gay men in New York City to determine the correlates of sexual-minority stress and mental health (Meyer, 1995). This seminal study examined the continued, chronic stress and stigma gay men are subjected to due to their sexual orientation. Research on minority stress, and the term itself, have been adapted from social-psychological and sociological theories (Meyer, 1995; 2003). In line with the study’s theoretically-based hypotheses, results indicated that internalized homophobia, perceived stigma, and prejudice events cumulatively predicted a two-to threefold increase in mental distress for gay men (Meyer, 1995). Emerging from these findings, the minority stress model (Meyer, 2003; 2013; 2015) is a multi-factor model that involves a distinction between distal and proximal stressors, with distal stressors defined as external experiences independent of identification with a minority status, and proximal stressors defined as internal experiences of stress related to minority identity (Meyer, 2003). According to this model, LGB identity may be a source of stress relief when it provides access to social support, or other factors that buffer against minority stress, based on shared identity. However, identifying with one’s minority status may lead to increased stress if an individual internalizes perceptions of the self as negative. 3 The minority stress model is an important foundation of our research for two reasons. First, internal acceptance and disclosure of one’s minority sexual orientation are necessary precursors to accessing social support based on shared identity, involvement in the sexual-minority community, and subsequently a sense of belonging to the sexualminority community (Meyer, 2003). The minority stress model provides a framework for understanding the effects of sexual-minority stress on the process of acceptance and disclosure of sexual orientation. Second, the minority stress model and attachment theory both attempt to explain factors that contribute to the way individuals respond to different kinds of stressors. Researchers engaged in efforts to integrate attachment theory and the minority stress model have argued that the two frameworks provide complementary perspectives for investigating the well-being of sexual-minority individuals (Cooks & Caleb, 2016). Along with attempting to come to terms with their stigmatized identity internally, sexual-minority individuals may attempt to “come out” by disclosing their identity broadly or to specific individuals. A failure to resist internalization of stigma during the coming out process may result in internalized homophobia (Morris et al., 2001), which describes the internalization of homonegative attitudes in sexual-minority individuals (Meyer & Dean, 1998). Sexual-minority individuals may maintain varying degrees of internalized homophobia throughout their lifetimes, which puts them at risk for continuing distress (Meyer, 2003). Now that we have provided a foundation for our study through the minority stress model, and how it informs research on the experiences of sexual-minority individuals, we will present an overview of adult attachment theory. 4 Attachment Adult attachment theory (Brennan et al., 1995; 1998) describes internal psychological processes within close relationships due to social, developmental, and genetic factors that potentially affect an individual in stressful situations or times of need (Ravitz et al., 2010). Foundational theory (Bowlby, 1969; 1977; 1988) and research on attachment first examined infants’ attachments to their mothers and later expanded to introduce other bonds throughout the lifespan (Ainsworth, 1989). Bonds that are significant and long-lasting may include ones with peers as well as romantic partners. They may become attachment bonds, whereby peers or partners serve as attachment figures in addition to attachment bonds with parental figures (Ainsworth, 1989) One mechanism through which attachment patterns theoretically develop is through internal working models (Bowlby, 1969; 1988). Starting in early infancy, the responsiveness of children’s caregivers influences their feelings of protection and security. These early experiences with caregivers lead children to develop internal working models, which are generalized internal expectations about the self, others, and the world. Children who experience their caregivers as sensitive and consistently responsive to their needs for protection and security will develop secure attachment. In secure attachment, children have an internal representation of the self as loveable, acceptable, and worthy of care, and of their caregiver as consistent, caring, accepting, and trustworthy. Into adulthood, these internal working models persist and impact individuals’ thought processes and beliefs about themselves and others in relationships. The first measure of adult attachment was the coding system for the Adult Attachment Interview (AAI; George et al., 1985), in which trained clinicians and 5 researchers used interview narratives to identify three main categories: secure/autonomous, avoidant/dismissing, and anxious/preoccupied (Ravitz et al., 2010). This model of individual differences in attachment (Hazan & Shaver, 1987) proposes three categories of attachment patterns: (a) secure attachment, which is associated with comfort concerning both intimacy and autonomy, (b) avoidant attachment, which is associated with explicit emphasis on self-reliance and self-worth achieved at the expense of intimacy and close relationships, and (c) anxious attachment, which is associated with fear of abandonment and desire for extreme closeness (Cassidy & Shaver, 2016). The four-category model of attachment (Bartholomew & Horowitz, 1991) builds on this conceptualization by adding a fourth attachment category: fearful-avoidant attachment, which describes the attachment patterns of individuals who desire close relationships while distrusting others, and avoid relationships that may bring rejection (Cassidy & Shaver, 2016). In the attachment literature, there is a distinction between categorical and dimensional models of attachment patterns (Cassidy & Shaver, 2016; Ravitz et al., 2010). Categorical models conceptualize attachment as discrete types or styles (e.g. secure, anxious, avoidant, dismissing-avoidant, fearful-avoidant) that are assigned to participants based on their predominant attachment patterns (Ravitz et al., 2010). Dimensional models conceptualize attachment security, avoidance, and anxiety as continua and describe the degree to which each attachment process or style is present in an individual’s patterns of relating (Fraley et al., 2015). Categorical models are criticized for limitations based on decreased precision in measurement and statistical power in testing hypotheses in comparison to dimensional models, failing to account for nuanced individual differences, 6 and assumptions regarding the descriptions of each attachment style (Cassidy & Shaver, 2016; Ravitz et al., 2010). Additionally, categorical models are criticized for conceptualizing attachment styles as mutually exclusive (Cassidy & Shaver, 2016), which ignores the possibility that individuals may differ in important ways in all three dimensions of attachment (Fraley et al., 2015). These differences in conceptualization result in a variety of existing measures of attachment. In contrast to the AAI, which involves researchers coding observed behavior, some attachment measures collect self-reported data (Ravitz et al., 2010). Some selfreport attachment measures focus on two main factors: anxiety and avoidance (Cassidy & Shaver, 2016). The Experiences in Close Relationship Scale (ECR; Brennan et al., 1998) measures these two factors as dimensions and has been widely used as a self-report measure of attachment with validity supported by multiple studies (Cassidy & Shaver, 2016). In the ECR, attachment security is conceptualized as a lack of insecurity, and it is captured by low scores on both the anxiety and avoidance dimensions (Brennan et al., 1998; Wei et al., 2007). Having provided an overview of adult attachment theory and measurement, we will now make an argument for the importance of studying attachment as an integral factor in understanding the psychological well-being of sexual-minority individuals. Attachment and Depression Attachment theory provides insight into the relationship between dimensions of attachment and depression. In some attachment research (Bifulco et al., 2002), insecure attachment correlated with high levels of depression, whereas secure attachment correlated with lower levels of depression. In other research, anxiously attached 7 individuals experienced a higher likelihood of depression compared to securely attached individuals (Murphy, 1997). A longitudinal study measuring depressive symptoms before and eight weeks after an attachment assessment corroborated this finding (Conradi & de Jonge, 2009). Research on the associations between attachment and mental health is especially limited for sexual minority individuals, and further understanding of attachment dimensions and their relationships to depression allows greater insight into why attachment matters. Attachment in LGB Individuals Attachment may be a significant factor in predicting elements of well-being in a sexual-minority population (Cook & Calebs, 2016). The existing body of research on adult attachment largely omits participant sexual orientation or includes only heterosexual adults, thus limiting our ability to understand the relationships among sexual orientation, attachment, and psychological outcomes. Empirical and theoretical work on attachment includes efforts to understand how attachment processes affect the ways in which individuals respond to stress. However, these frameworks largely do not take into consideration the social and psychological stress associated with having a minority sexual orientation (Cooks & Caleb, 2016). Disclosure of sexual orientation during the coming out process of sexual-minority individuals may result in conflict situations with attachment figures (Mohr & Fassinger, 2003). Family rejection of a significant other due to sexual orientation constitutes a distal stressor within the framework of the minority stress model (Meyer, 2013). Experiences of discrimination and rejection lead to expectation and anticipation of negative regard. The stress and distress accorded to experiences of rejection may be especially impactful from 8 close, long-lasting bonds and theoretically could alter dimensions of attachment (Cook & Calebs, 2016). Given the higher rates of depression experienced by individuals in the LGB Community compared to heterosexuals, and the possibility that minority sexual orientation may disrupt attachment security, more research is needed to better understand attachment within this population. Theoretically, the implication here is that sexualminority individuals may experience less attachment security overall compared to heterosexuals. Previous research using a categorical model of attachment has found an association between LGB identity and depression, with LGB individuals more prone to depression than heterosexuals (Popa-Velea et al., 2019). The results of this research also indicated that the higher levels of depression observed in LGB participants was mainly attributable to attachment style across the entire sample, independently of sexual orientation. Popa-Velea et al. (2019) reported that, among their sample (N = 374), with 58% of participants identifying as LGB, 70.32% had an insecure attachment style, whereas 29.67% had a secure attachment style. Of those with an insecure attachment style, 66.15% were LGB individuals. Furthermore, the most prevalent type of attachment among the LGB group was fearful-avoidant (45.8%), followed by fearful-dismissive (19.9%), secure (19.4%), and anxious (14.8%). Comparatively, among the heterosexual participants, secure was the most common attachment style (43.7%), followed by fearfulavoidant (22.8%), fearful-dismissive (22.2%), and anxious (11.4%). Although the results from any individual study should be interpreted cautiously, these findings suggest that sexual-minority individuals do, indeed, have higher prevalence of insecure attachment than heterosexuals. 9 By further examining the role of attachment and its connection to health outcomes such as depression, there is an opportunity to continue research on potential vulnerabilities for sexual-minority individuals. In addition to attachment theory, our study investigates belonging. We will now give an overview of the theory of sense of belonging. Sense of Belonging Many researchers have described belonging as a basic human need (Baumeister & Leary, 1995; Maslow, 1954; Sheldon, 2011). Early research on the concept indicated that belonging was key to a relational perspective on understanding mental illness (Anant, 1967). However, methodological concerns about the validity and reliability of measures, as well as sampling and procedural concerns, attenuated interpretations of these early findings that belongingness was inversely related to anxiety and other psychological concerns. More recently, researchers have revisited belongingness as an essential relational experience and have provided a substantive account of the concept (Hagerty, 1992). In the dominant conceptual model of belonging, Hagerty et al. (1992) expanded on the definition provided by Anant (1967) of sense of belonging as the experience of personal involvement and integration within a system or environment, to the extent that a person believes or thinks they play a special role in that system or environment. In this model, sense of belonging is a psychological experience with cognitive and affective components. Initial research indicated that sense of belonging has positive links to affiliative behavior, including involvement in community activities and attendance of religious services, as well as negative links to variables related to psychological and 10 social functioning, including loneliness, depression, suicidality, history of psychiatric treatment, and anxiety (Hagerty et al., 1992, 1995, 1996). Sense of belonging involves feeling connected, needed, and valued within a community or environment. According to the dominant model, sense of belonging involves two defining features: (a) valued involvement – the belief that one’s own presence and involvement in a community is valued and needed by others, and (b) fit – the belief that one’s characteristics fit in with a community or environment (Hagerty et al., 1992). This idea of fit, that sharing similar or complementary qualities is important to feeling a part of a group or community, is the key attribute (Hagerty et al., 1996). In the initial empirical work on developing a measure of sense of belonging and testing its theoretical basis, Hagerty and Patusky (1995) used factor analysis and correlations with other measures of psychological functioning to evaluate the construct validity of the Sense of Belonging Instrument (SOBI). Factor analysis resulted in two subscales: the SOBI-P (psychological experience, measuring fit and valued involvement), and the SOBI-A (antecedents, measuring precursors to belonging). Sample items within the SOBI-P include: “I often wonder if there is any place on earth where I fit in,” “I am just not sure where I fit in with my friends,” and “I would describe myself as a misfit in most social situations.” Sample items within the SOBI-A include: “It is important to me that I am valued or accepted by others,” “In the past, I have felt valued and important to others,” and “It is important to me that I fit in somewhere in this world.” Subsequent research using the SOBI has focused on aspects of belonging related to either psychological experience or antecedents, and researchers commonly use only one of the subscales (McLaren, 2006, 2009, 2020, 2021). In the initial development of the 11 SOBI-P, the researchers reported that, even in subjects who were not depressed at the time (of the study), sense of belonging was consistently related to measures of prior psychological functioning such as history of suicidality and psychiatric treatment (Hagerty et al., 1996). Despite observing that correlations with other measures of psychological functioning indicated that the SOBI-P had a correlation with depression between -.54 and -.62, a correlation with anxiety of about -.53, and a correlation with loneliness between .66 and -.78 (Hagerty et al., 1996), the researchers concluded that these correlations were not high enough to suggest strongly that sense of belonging is readily reducible to depression, anxiety, or loneliness (Hagerty et al., 1996). However, these correlations suggest that those aspects of psychological functioning are highly related to sense of belonging. We accept the argument (of these researchers), but we do have reservations about whether sense of belonging is truly a separate construct, and we acknowledge this as a limitation of our study. Our concern about the high correlation between the SOBI-P and these other measures of psychological functioning contributed to our reasons for selecting an alternative measure of sense of belonging, which we will discuss later on. Now that we have provided a theoretical background on sense of belonging, we will make an argument for the use of this theory alongside attachment theory to better understand depression among sexual-minority individuals. Belonging and Depression Research has indicated that individuals who feel a greater sense of belonging tend to have lower levels of depression (Hagerty et al., 1996; McLaren, 2002). In a path analysis, researchers reported that in one study (Hagerty & Williams, 1999), sense of 12 belonging explained 64% of variance in depression, leading the researchers to conclude that sense of belonging was the best predictor of depression in comparison to social support, loneliness, and conflict. In a sample of veterans experiencing severe mental illness (i.e., bipolar disorder, schizophrenia, schizoaffective disorder, or depressive disorders with psychotic features), researchers reported that even when controlling for depression and level of education, sense of belonging moderated the relationship between internalized stigma and suicidal ideation, in a way such that low sense of belonging was associated with the strongest relationship between internalized stigma and suicidal ideation (Wastler et al., 2020). This suggests both that sense of belonging may have incremental validity over depression and that high levels of sense of belonging may serve as a buffer against the psychological consequences of internalized stigma1. Accordingly, in sexual-minority individuals, sense of belonging to the LGB Community may serve as a buffer against the psychological consequences of internalized homonegativity. In light of the immense body of research suggesting that sexual-minority individuals experience depression at higher rates than 1 We would like to acknowledge the distinction between veteran and sexual-minority identities. Although there is stigma, varied sense of belonging, and increased stress associated with individuals who identify with both of these identities, heterosexual veterans often have the privilege of institutional and public support along with legal protections. Sexual-minority individuals are not afforded this same level of institutional privilege, legal, and public support. Thus, caution must be exercised in the association of these two identities. 13 heterosexual adults (Case et al., 2004; Cochran et al., 2003; Mills et al., 2004; Wang et al., 2007; Westefeld et al., 2001), sense of belonging can be investigated as a related factor (McLaren, 2006, 2009, 2020, 2021). General Belonging and Belonging to the LGB Community Communities entail shared attitudes and ideology among their members, and the LGB Community is, in part, based on shared attitudes about sexual orientation and the rejection of heteronormativity (Atkins, 1998). Sexual-minority adults are a part of both the general community and the LGB Community. Disclosure of minority sexual orientation is often a necessary precursor to affiliation with other individuals with shared sexual-minority identity and a sense of being a part of the LGB Community (Meyer, 2003). Researchers have reported that gay men (McLaren et al., 2007) and lesbians (McLaren, 2006) experience less of a sense of belonging to the general community than heterosexual adults. This may be due to heteronormative ideals and negative perceptions of homosexuality in the general community, experiences of discrimination based on sexual orientation that their targets associate with the community at large, and internalized homonegativity (Huebner, 2004; McLaren, 2020; Meyer et al, 1998; 2003). Sense of belonging to both of those communities may correlate with depression, but research about this is limited. Some research (McLaren, 2009) has indicated that sense of belonging to the Lesbian Community is related to lower levels of depression through an indirect effect mediated by sense of belonging to the general community. This research also found support for a model in which sense of belonging to the general community moderated the relationship between sense of belonging to the Lesbian Community and depression. Results suggested that sense of belonging to the Lesbian 14 Community was most beneficial to lesbians who had low sense of belonging to the general community. These findings may indicate the importance of feeling a sense of belonging to the sexual-minority Community for the psychological well-being of sexualminority individuals, especially those who do not feel they belong in the general community due to their sexual orientation. Minority-group belonging may bring about two functions of coping: the support from an environment where stigma is not in the forefront, and support against negative perceptions of the minority group (Jones et al., 1984; Peterson et al., 1996). The establishment of an in-group allows for reappraisal and validation of similar thoughts, feelings, and experiences among the ingroup members (Thoits, 1985). However, there are instances when non-heterosexual persons may feel withdrawn from their minority groups. For example, bisexual individuals often report feeling isolated from both heterosexuals and the LGBQP Community (DeLucia & Smith). Biphobia references the discriminatory attitudes and prejudice bisexual-identifying individuals face from their straight and queer counterparts (DeLucia & Smith, 2021). Discriminatory treatment is associated with negative mental health outcomes for bisexual people in some research (Bostwick, 2012). Attachment and Belonging Research examining the relationship between sense of belonging and attachment is in short supply. A study investigating relationships among attachment, sense of belonging, and depression in a sample of unhoused adults showed a significant relationship between sense of belonging and attachment (Ron, 2004). In this study, the relationships between specific attachment styles and sense of belonging were nonsignificant, possibly because the study was underpowered at 101 participants, or because 15 of the limitations of the measure of attachment style used (Ron, 2004). Theoretically, there is reason to believe that the psychological processes underlying attachment and sense of belonging may be related, but further research is needed to understand the relationship between those factors. Attachment and Belonging as Psychological Needs The process of developing a sense of belonging to any given community remains unclear, but some researchers have proposed that sense of belonging may be rooted in early attachment systems (Hagerty et al., 2002). Attachment and belonging are related in their phenomenology of connectedness, either to individuals or to communities and environments. As such, they can be seen as complementary concepts, each expanding into domains of human experience that the other does not cover (Ron, 2004). The twoprocess model of psychological needs (TPM; Sheldon, 2011) proposes that universal psychological needs motivate individuals to pursue foundational social experiences to feel well and flourish, and to do so in evolutionarily adapted ways. The TPM suggests that psychological needs can be understood as analogous to physiological needs. Conceptualizing attachment and sense of belonging as psychological needs creates vulnerability: if people are even temporarily unable to fulfill their psychological needs, then psychological suffering results. The TPM concerns how needs operate and does not revolve around proposals of specific human psychological needs. However, in agreement with prior researchers, Sheldon endorsed three primary psychological needs: relatedness, competence, and autonomy. Thus, humans may need attachment relationships and sense of belonging to fulfill their need for relatedness. Conceptualizing belonging and attachment as psychological needs suggests that not meeting those needs may result in 16 psychological distress (Sheldon, 2011). Taken together with the aforementioned findings on the prevalence of psychological distress among sexual-minority individuals, the TPM provides a strong rationale for the need to understand secure attachment and sense of belonging in this population. Therefore, by developing a foundational understanding of attachment and belonging as psychological needs, past and present research on sexualminority individuals can be better contextualized. McLaren’s Research on Belonging to the Lesbian Community and General Community We completed a partial conceptual replication of a study by McLaren (2009), who investigated sense of belonging to the general community and sense of belonging to the Lesbian Community as predictors of depression in a modest sample of 178 Australian lesbians (McLaren, 2009). McLaren’s (2009) study was founded on research that had found that, compared to heterosexual women, lesbians may be at an increased risk for depression (Case et al., 2004; Fergusson et al., 1999; Westefeld et al., 2001), and suicide (Fergusson et al., 1999; Garcia et al., 2002), as well as alcohol and drug abuse (Case et al., 2004; Fergusson et al., 1999). McLaren’s own previous research also suggested that the negative view of lesbians in Australian society (reflecting homonegativity) may cause lesbians to experience a lesser sense of belonging to the general community (McLaren, 2006). McLaren (2006) concluded that identifying as a lesbian was associated with lower levels of belonging to the general community. Thus, she aimed to build upon previous research by testing the belonging to the general community and sense of belonging to the Lesbian Community as predictors of levels of depression among lesbians. McLaren 17 (2009) proposed three different mediation and moderation models. She recruited women via friendship groups, advertisements, lesbian social events, and websites. Participants completed the Psychological subscale of the Sense of Belonging Instrument (SOBI-P), the Depression subscale of the Depression Anxiety Stress Scales (DASS), and a demographic questionnaire. Support emerged for one mediation model, in which sense of belonging to the general community mediated the relationship between sense of belonging to the Lesbian Community and depression. Additionally, support for a moderation model indicated that the relationship between depression and belonging to the Lesbian Community was negative for lesbians with low general belonging, but positive for lesbians with high general belonging. In other words, a high sense of belonging to the Lesbian Community was associated with lower levels of depression primarily for lesbians who had low sense of belonging to the general community, but with higher levels of depression for lesbians who had high general belonging (McLaren, 2009). We intended to expand this research to include non-heterosexuals in general. The Present Study We replicated McLaren’s (2009) study by examining how sense of belonging to the general community and specific belonging to the sexual-minority Community correlate with frequency of depressive symptoms. Additionally, our study expanded on the McLaren (2009) study with a larger and more inclusive LGBQP (Lesbian, Gay, Bisexual, Queer, Pansexual) sample. We were interested in people who have lived with the experience of having a minority sexual orientation, therefore, we defined our population of interest broadly as people who identify as non-heterosexual. A strength of this approach is that it acknowledges that there is something shared among these people 18 that deeply impacts their experiences. From a minority stress model perspective, anyone who is not heterosexual experiences that minority stress similarly, if not necessarily equally or in exactly the same ways. There are a few limitations of this approach that are important to address. We want to acknowledge that the way we defined our sample does not map consistently with the way previous research has defined the sample in similar studies. Although previous research has investigated relationships among attachment, sense of belonging, and depression among people with minority sexual orientations, most of it has focused on one specific population at a time, recruiting people who identify only as lesbian, or gay, or bisexual. Considerable research on lesbian, gay, and bisexual identities in relation to attachment, belonging, and depression have informed our research and our hypotheses. The concern underlying all of this research is the well-being of sexual-minority people generally, so we decided to define our population of interest broadly as people with minority sexual orientations. However, we do not have any evidence from the literature that queer or pansexual identities specifically are associateed with risk of attachment issues, depression, or decreased sense of belonging to the general community due to minority stress. Therefore, it is on the basis of the theoretical shared experiences of minority stress, as well as potentially disrupted attachment security and decreased sense of belonging, that we decided to include all of these minority sexual orientations in our research. It is possible that the model we have proposed applies to some sexualities but not others, and we acknowledge that the relationships between these variables may vary among sexual orientations in a way that our analysis plan was not designed to capture. 19 Additionally, our study is an attempt to improve upon previous research regarding belonging to sexual-minority communities by using an arguably more fitting measure of sense of belonging. Finally, our study incorporates attachment security as an additional link in a model that examines attachment security, general belonging, sense of belonging to the LGBQP Community, and depression. The addition of attachment security as a variable is based on the aforementioned research that associates attachment security with depressive symptoms, and it ventures to fill the gap in the literature regarding the relationship between attachment and belonging. Moderated-Mediation Model As shown in Figure 1, we proposed a moderated mediation model. In our model, sense of belonging to the LGBQP Community mediates the relationship between attachment security and depressive symptoms, and sense of belonging to the general community moderates the indirect effect of attachment security on depressive symptoms via sense of belonging to the LGBQP Community. Hypotheses H1: Attachment security will correlate positively with sense of belonging to the LGBQP Community. H2: Sense of belonging to the LGBQP Community will correlate negatively with symptoms of depression. H3: Sense of belonging to the LGBQP Community will mediate, as part of an indirect effect, the relationship between attachment security and symptoms of depression. H4: Sense of belonging to the general community will moderate the indirect effect of attachment security on depression via sense of belonging to the LGBQP Community. 20 This moderation will occur in a way such that, after controlling for attachment security, the effect of sense of belonging to the LGBQP Community on depression will be positive among participants with high levels of belonging to the general community, and negative among participants with low levels of belonging to the general community. In other words, low sense of general belonging and low sense of belonging to LGBQP Community will correspond to the highest levels of depression, and high sense of general belonging and low sense of LGBQP belonging will generally correspond to the lowest levels of depression. Furthermore, high sense of belonging to the LGBQP Community will correspond to moderate levels of depression, with low sense of general belonging corresponding to slightly higher levels of depression than high sense of general belonging. 21 Figure 1 Moderated Mediation Model of Proposed Associations Between Attachment Security, Sense of Belonging to the LGBQP Community, Sense of Belonging to the General Community, and Depressive Symptoms 22 Method Recruitment To recruit a sufficiently large sample of LGBQP adults, our sampling strategy was to target LGBQP-specific online spaces. We recruited participants from Whitman College student listservs, as well as American universities’ LGB affinity groups and listservs (full list provided in Appendix A), and LGBQP affinity group forums on the online news and discussion website Reddit.com (full list provided in Appendix B). We administered our survey through Qualtrics, a software platform that utilizes security protocols that include encryption to protect data. Participants outside of Whitman College had the opportunity to enter a raffle for four $25 gift cards. Because of limited availability of procedures to estimate power for moderated mediation models, we were unable to readily conduct a conclusive a priori power analysis. However, previous studies investigating similar models informed our decision to aim to recruit about 350 participants (Daheim, 2020; McLaren, 2021; Mostafa, 2021; Zhao & Zhang, 2021; Zheng et al., 2021). The sample (of the present study) consisted of 364 adults, ages ranging from 18 to 65+. Although 560 participants started the survey, only 374 completed it with 372 participants providing permission for their data to be included in the study. We excluded the 18 who did not respond to the last question of the survey, which asked for final permission to use their data. Because the analysis program we used was unable to deal with missing data, we only included data from participants who responded to every question on the main measures, and, therefore, excluded eight additional participants who 23 completed the survey but left one or more items blank. Because our population of interest was sexual-minority individuals, we included two items screening for sexual orientation. The first item asked “Do you identify as heterosexual (“straight”)?” Only participants who responded “No” were shown the rest of the survey. The second item asked participants to select the sexual orientation they primarily identified as, with the options lesbian, gay, bisexual, queer, pansexual, or other. Design We used a correlational design to study the naturally occurring relationships among LGBQP attachment, sense of belonging, and levels of depression. The variables were attachment security, sense of belonging to the general community, sense of belonging to the LGBQP Community, and depression, which was operationalized as frequency of depressive symptoms within the past week. We wrote and planned to test our hypotheses without such potential covariates as age, gender identity, a previous diagnosis of depression from a mental health professional, treatment for depression, and outness levels. We also planned to conduct exploratory analyses controlling for these covariates for the purposes of statistical control and thoroughness, but were only able to successfully control for age and outness. Measures Screener In a short screening section at the beginning of our study, we advised participants that the survey would ask them questions about their sexual orientation, encouraged them 24 to complete the survey in private, and asked participants to confirm that they were ready to take the survey. Additionally, we asked participants whether they were comfortable answering questionnaires in English, and we asked them to confirm that they identified as non-heterosexual. Self-Reported Sense of Belonging The 12-item General Belonging Scale (GBS; Malone, Pillow, & Osman, 2011) is designed to measure participants’ experiences of feeling included, accepted, and connected in a community. Participants give ratings on a 7-point Likert-type scale ranging from Strongly disagree (1) to Strongly agree (7) in response to such statements as “When I am with other people, I feel included,” “I feel connected with others,” and “I have a place at the table with others,” as well as some reverse-scored statements such as “I feel as if people do not care about me.” Participants completed the GBS twice, once in response to statements about the general community they are a part of (i.e., “When I am with other people, I feel included,” “I feel accepted by others”), and once in response to statements about “the LGBQP Community.” In line with previous research (Hanley & McLaren, 2015; McLaren, 2009; McLaren & Castillo, 2021; McLaren et al., 2013), we modified each item on the GBS to relate to the LGBQP Community (i.e., “When I am with other people in the LGBQP Community, I feel included,” “I feel accepted by others in the LGBQP Community”). We observed a high level of internal consistency for both sense of belonging to the LGBQP Community (ω = .93) and the general community (ω = .92), suggesting that the data obtained through this measure were internally consistent. 25 Research on the subject of sense of belonging to the LGBQP Community has most commonly used the Psychological subscale of the Sense of Belonging Instrument (SOBI-P; Hagerty & Patusky, 1995). We considered using this measure, but we had concerns about its face validity and length. The SOBI-P contains a few items (e.g., “I could disappear for days and it wouldn’t matter to my family,” “If I died tomorrow, very few people would come to my funeral,” and “I could not see or call my friends for days and it wouldn’t matter to them”) that appear to primarily measure other constructs more so than sense of belonging. Specifically, we suspect that items such as these may be behind the large correlations noted earlier between the SOBI-P, depression, and loneliness. Additionally, we aimed to capture a sense of LGBQP Community that included online communities, and some of the items on the SOBI-P did not suit that purpose. Conceptually, the SOBI-P and the GBS seem to measure slightly different theoretical constructs. The SOBI-P contains predominantly negatively-worded items to measure an individual’s fulfillment of their psychological need to belong. Consequently, the SOBI-P measures a sense of belonging indirectly, by assessing the extent to which individuals feel that they do not belong. The GBS contains a more balanced set of negative and positive items to measure an individual’s achieved sense of belonging to a community. The GBS has demonstrated convergent validity coefficients of .64 to .86 with the SOBI-P, suggesting that the measures may be used interchangeably (Malone et al., 2011). Taking all of this into consideration, we thought that the GBS was an appropriate and preferable choice, and our use of it represents a conceptual replication and an improvement upon previous research that uses the SOBI-P. 26 Self-Reported Adult Attachment The 12-item Experiences in Close Relationships Scale-Short Form (ECR-S; Wei et al., 2007) is a self-report measure of adult attachment that quantifies attachment on two dimensions: avoidance and anxiety. Participants respond on a 7-point Likert-type scale ranging from Strongly disagree (1) to Strongly agree (7) to statements about their experiences and feelings in emotionally intimate relationships. Each item is expected to load primarily onto either an avoidance or an anxiety subscale. Participants who score low on both the avoidance and the anxiety subscales are considered to have secure attachment styles, whereas participants who score highly on either one of the subscales are considered to have an insecure attachment style in whichever dimension predominates. Much of the previous research on attachment styles in LGB populations has used the original 36-item Experiences in Close Relationships scale (Hainen et al. 2015; Sommantico et al. 2020; Sommantico et al., 2021). Previous research has demonstrated the reliability and validity of ECR scores in American and Dutch samples of the general adult population as well as college psychology students (Conradi et al., 2006). There is evidence that the short form produces comparably reliable and valid results from studies among undergraduate students in psychology classes from large universities (Wei et al., 2007). To increase participant compliance and retention by asking participants to respond to fewer questions where possible, we selected the ECR-S (Shelton et al., 2020; Wei et al., 2007). Participants responded to a question asking whether they had ever been in an emotionally intimate romantic relationship. If a participant responded “yes,” then the survey displayed the original version of the ECR-S, which asked them to respond to 12 27 statements concerning how they generally feel in romantic relationships, with such items as, “I turn to my partner for many things, including comfort and reassurance.” In our sample, 84% of participants completed the original romantic partner version of the ECRS. Participants who responded that they had not been in a romantic relationship viewed an alternate version of the ECR-S, which we adapted to read “people I’m close with” instead of “romantic partner” (e.g., “I turn to people I'm close with for many things, including comfort and reassurance,” etc.). In our sample, 16% of participants completed this non-romantic version of the ECR-S. We observed moderate internal consistency for both the avoidance (ω = .74) and anxiety subscales (ω = .70). To quantify attachment security, we inverted the mean of each participant’s responses to the full ECR-S. Taking the means of the full questionnaire, including both the anxiety and avoidance subscales, created an approximation of the average amount of attachment insecurity overall for each participant, which we reversed to create an approximation of the average amount of attachment security for each participant. For this measure, we observed a moderate overall internal consistency (ω = .70). Self-Reported Depression The 20-item Center for Epidemiologic Studies Depression Scale (CES-D; Radloff, 1977) measures the frequency of depressive symptoms that participants have felt or experienced in the past week. Participants rate items on a 4-point frequency scale ranging from Rarely or none of the time (0) to Most or all of the time (3). The CES-D is one of the most commonly used measures of depression in survey research (Battelen et al., 2021; Hanley & McLaren, 2015; McLaren & Castillo, 2021; McLaren et al., 2013; McLaren et al., 2015), including previous research investigating links between belonging 28 and depression in LGBQP populations (McLaren & Castillo, 2021). We found a high level of internal consistency (ω = .91), suggesting that this measure was also internally consistent. Self-Reported Outness We used the 5-item Nebraska Outness Scale-Disclosure (NOS-D; Meidlinger & Hope, 2014) to measure participants’ level of outness based on disclosure of their sexual orientation to different groups of people. The disclosure portion of the NOS asks questions that frame outness based on sharing information about an individual’s sexual orientation, and the concealment portion of the NOS asks questions that frame outness based on withholding such information. For the purposes of this study, we utilized the NOS-D portion of the measure based on disclosure because the coming out process for sexual-minority individuals involves revealing information about one’s sexual orientation (Mohr & Fassinger, 2003). Participants respond to the question “What percent of the people in the groups below do you think are aware of your sexual orientation? In other words, what percent know that you consider yourself to identify as gay, lesbian, or bisexual, etc.?” with regard to the following groups: members of your immediate family, members of your extended family, people you socialize with, people at your work/school, and strangers. The response scale is measured on an 11-point scale from 0% to 100%. An outness demographics table is available in Appendix F. Attention Screeners We added a thirteenth item to each version of the General Belonging Scale (GBS; Malone, Pillow, & Osman, 2011) as attention screeners, asking participants to respond on 29 the same scale to the statements, “I am thinking carefully about my responses to these questions,” and “I am doing my best to respond to these statements thoughtfully.” A growing body of research suggests that omitting participants’ data based on failed responses to attention screener questions introduces additional bias in data and decreases external validity of results (Anduiza & Galais, 2016; Berinsky, Margolis, & Sances, 2016). Consequently, as previous research on attention screener questions suggests, we did not exclude any participants based on their responses to these questions, although we acknowledge that this represents a potential threat to the internal validity of our results. We included these participant attention screener questions as a way to better understand the quality of our data, and overall did not have significant concerns. In response to the first attention check question (“I am thinking carefully about my responses to these questions”), 77.2% noted that they Agreed (33.2%) or Strongly Agreed (44%). In response to the second attention check question (“I am doing my best to respond to these questions thoughtfully”), 84.1% noted that they Agreed (33.8%) or Strongly Agreed (50.3%). Table 2 contains a full report of the distribution of responses on these questions. Demographics Participants responded to demographics questions about their age, race, gender identity, relationship status, sexual orientation, diagnosis and treatment of depressive illness, and a measure of outness. If participants indicated that they were 18 years or older, then they were allowed to participate in the survey. Participants self-reported their gender identity and responded to a question about their relationship status as well as their sexual orientation. Participants responded to two items about whether they currently had a diagnosis and treatment for depressive illness: the first item asked, “Did a healthcare 30 provider ever diagnose you with a depressive illness?” and the second item asked, “which of the following types of treatment for depression are you currently receiving, if any?” These two items were included in the demographic questionnaire in order to better understand our samples’ current history with depression and potential ongoing treatment for depression which may affect the relationship between our predictors with depressive symptoms. The participants were majority white (81.9%) women (43.4%), between the ages of 18-23 (41.5%), and primarily lesbian (23.9%), bisexual (28.3%), or gay (25.8%) identifying persons. See Tables 1 and 2 for a full account of participant demographic characteristics. 31 Table 1 Participant Characteristics (N = 364) Characteristic n % Gender Male 135 37.1 Female 158 43.4 Non-binary 46 12.6 Prefer not to say 9 2.5 Other 16 4.4 Age 18-23 151 41.5 24-29 122 33.5 30-35 49 13.5 36-41 25 6.9 42-47 6 1.6 48-53 4 1.1 54-59 5 1.4 60-64 1 0.3 65+ 1 0.3 Race/Ethnicity White, Caucasian, or European American 298 81.9 Black or African American 6 1.6 American Indian or Alaska Native 1 0.3 Asian 15 4.1 Native Hawaiian or Pacific Islander 1 0.3 Hispanic, Latino, or Spanish Origin 17 4.7 Middle Eastern or North African 3 0.8 32 Other 23 6.3 Gay (Homosexual Man or Nonbinary) 94 25.8 Lesbian (Homosexual Woman or Nonbinary) 87 23.9 Bisexual of any gender 103 28.3 Pansexual of any gender 25 6.9 Queer of any gender 37 10.2 Other 18 4.9 Sexual Orientation Relationship Status Single 161 44.2 Married 152 41.8 In a relationship 51 14.0 Country of Origin The United States of America 295 81.0 Other 69 19.0 Depression Diagnosis & Treatment No depression, No treatment 163 44.8 Yes depression, No Treatment 32 Yes depression, Yes treatment 162 44.5 Other 8.8 7 1.9 Whitman College email listserv 80 22.0 Reddit post 223 61.3 Other college or university email 51 14.0 Other 10 2.7 6 1.6 Survey Recruitment Comfortable taking questionnaire in English No 33 Yes 358 98.4 Ready to take survey right now No 13 Yes 351 96.4 34 3.6 Table 2 Attention Check Response Distributions Survey Item n % "I am thinking carefully about my responses to these questions" Strongly disagree 4 1.1 Disagree 6 1.6 Somewhat disagree 11 3.0 Neither agree nor disagree 19 5.2 Somewhat agree 43 11.8 Agree 121 33.2 Strongly agree 160 44.0 "I am doing my best to respond to these statements thoughtfully" Strongly disagree 0 0.0 Disagree 4 1.1 Somewhat disagree 6 1.6 Neither agree nor disagree 23 6.3 Somewhat agree 25 6.9 Agree 123 33.8 Strongly agree 183 50.3 35 Debriefing and Resources After completing the survey, participants were provided with information about the purposes and hypotheses of the study as well as our contact information (See Appendix E). We gave participants an opportunity to enter their email addresses at the end of the survey for a chance to win one of four $25 gift cards. Participants currently enrolled as students at Whitman College were instructed not to enter their emails into this raffle due to institutional requirements and restrictions on compensation. The survey ended with a page of mental health resources for LGBQP individuals, with links to the LGBT organizations’ websites, phone numbers, and short descriptions of each organization. These resources appeared under the instructions: “If responding to the questions in this survey has raised concerns for you about your mental health, please consider reaching out to one of the following resources.” We included a list of resources for participants due to the sensitive nature of our study and the possibility that asking questions concerning depression, relationships, and outness may create a need for individuals to reach out to talk about their experiences with a professional. Resources can be viewed in Appendix C. Procedure To recruit LGBQP participants ages 18 and over, we specified in recruitment materials that the population of interest for this research was non-heterosexual adults. Participants indicated that they identified as LGBQP or other minority sexual orientations. Participants gave written informed consent after having the opportunity to read a short summary of the research topics as well as information about confidentiality and voluntary participation (Appendix D). 36 The survey first displayed screening questions, including questions about their sexual orientation. Then, participants completed a version of the GBS regarding their sense of belonging to their general community as well as another version of the GBS, adapted to concern their sense of belonging to the LGBQP Community. Next, participants completed the CES-D regarding the frequency of depressive symptoms they experienced during the past week. Participants then responded to a question asking if they have ever been in an emotionally intimate romantic relationship, and were either displayed the standard version of the ECR-S or a version of the ECR-S modified to concern close relationships generally. Finally, participants responded to a series of demographic questions, including the NOS-D. Participants then saw a debriefing form providing more information about the purpose and hypotheses of the study, and information about mental health resources for LGBQP individuals (Appendix C and E). 37 Figure 2 Correlation coefficients and conditional probabilities found in our moderated mediation model. 38 Results We first computed composite scores for each participant’s sense of belonging to the general community, sense of belonging to the LGBQP Community, attachment security, depressive symptoms, and outness. As stated previously, we wrote and planned to test our hypotheses without controlling for any covariates, but planned to conduct exploratory analyses with the covariates: age, gender identity, previous diagnosis and current treatment of a depressive illness, and self-reported level of outness. We tested the hypotheses using the linear regression and reliability analysis functions in Jamovi (Version 2.2.5), as well as two models from Hayes’ (2018) PROCESS for SPSS. To our knowledge, there is currently no agreement about how to interpret effect sizes of unstandardized regression coefficients from multiple regression analyses, particularly when testing indirect effects. Interpreting regression coefficients in complex moderated mediation models is controversial and may not be very meaningful, and so we did not attempt to interpret them (see, Hayes, 2018). We conducted bivariate correlational analyses to test our first and second hypotheses (see Figure 2 and Table 3). In Hypothesis 1, we predicted that attachment security will positively correlate with sense of belonging to the LGBQP Community. Providing support for this hypothesis, results indicated that attachment security was positively associated with sense of belonging to the LGBQP Community, r(364) = .233, p < .001, with a small effect size. In Hypothesis 2, we predicted that sense of belonging to the LGBQP Community will correlate negatively with depression. Providing support for this hypothesis, results showed that sense of belonging to the LGBQP Community 39 was negatively associated with depression, r(364) = -.357, p < .001, with a moderate effect size. In Hypothesis 3, we predicted that sense of belonging to the LGBQP community will mediate, as an indirect effect, the relationship between attachment security and depression. We tested this hypothesis by performing mediation analysis using Hayes (2018) PROCESS model 3. Providing support for this hypothesis, results indicated that there was a negative indirect effect (through sense of belonging to the LGBQP Community) of attachment security on depression, b = -.041, p = .0004, 95% CI [-.07, .02]. See Table 4. Although not addressed in our hypotheses, the direct effect of attachment security on depression was also significant, b = -.259, p < .001, 95% CI [-.32, -.20]. Overall, this simple mediation model explained approximately 21% of the variance in well-being (R = .205), a moderate effect, and resulted in support for an indirect effect 2 of attachment security on depression via sense of belonging to the LGBQP community as a mediating variable. In Hypothesis 4, we predicted that, after controlling for attachment, sense of belonging to the general community will moderate the indirect effect of attachment security on depression via sense of belonging to the LGBQP Community. We tested this hypothesis by conducting a conditional process analysis using Hayes (2018) PROCESS model 14. Contrary to our prediction, we did not detect a significant moderating effect of sense of belonging to the general community, b = .003, p = .840, 95% CI [-.03, .03], see Table 5. This resulted in no support for our prediction of sense of belonging to the general community moderating the indirect effect of attachment security on depression via sense of belonging to the LGBQP Community. However, the moderated-mediation 40 41 42 43 model explained approximately 48% of the variance in depression (R = .477), indicating 2 that, taken together, the variables we examined were significant predictors of depression. Although the R of this moderated-mediation model seems much higher than that 2 of the simple mediation model, this should not be interpreted as the moderation adding significantly to the indirect effect of attachment security on depression through sense of belonging. R cannot be compared between models that differ in the number of predictor 2 variables, because R almost always increases when a predictor is added to a model 2 (Hayes, 2018). Speculatively, this R may also be inflated because testing for moderation 2 creates a large degree of intercorrelation among predictor variables, and some of our variables are moderately correlated with each other (see Table 3). Additional results from this conditional process analysis shed light on the relationships among these variables and are important to make note of, although they are outside the scope of our hypotheses. The results indicated a significant negative effect of sense of belonging to the general community on depression, b = -.277, p < .001, 95% CI [-.43, -.13], when attachment security and sense of belonging to the LGBQP Community are held fixed. With the addition of sense of belonging to the general community as a predictor of depression in this model, the effect of sense of belonging to the LGBQP Community on depression becomes not significant b = -.068, p = .328, 95% CI [-.21, .07]. Exploratory Analyses After testing our hypotheses, which we intended to do without controlling for any covariates, we conducted exploratory analyses with additional variables as covariates. We intended to use age, gender identity, previous diagnosis and current treatment of a 44 depressive illness, and self-reported level of outness as covariates, but only the analyses with age and outness covariates were successful. When attempting exploratory analyses controlling for gender identity and depression diagnosis or treatment, SPSS produced irregular output, suggesting that fitting the regression model failed, perhaps because of uneven or skewed distributions of the covariates. Taking age and outness into account as covariates ultimately did not substantively change our results, or the support shown for any of our hypotheses. In Hypothesis 1, we predicted that attachment security will positively correlate with sense of belonging to the LGBQP Community. When controlling for age and outness, results indicated that attachment security was still positively associated with sense of belonging to the LGBQP Community, r(364) = .203, p < .001, with a small effect size. In Hypothesis 2, we predicted that sense of belonging to the LGBQP Community will correlate negatively with depression. When controlling for age and outness, results showed that sense of belonging to the LGBQP Community was negatively associated with depression, r(364) = -.359, p < .001, with a moderate effect size. In Hypothesis 3, we predicted that sense of belonging to the LGBQP community will mediate, as an indirect effect, the relationship between attachment security and depression. When controlling for age and outness as covariates, results indicated that there was a negative indirect effect (through sense of belonging to the LGBQP Community) of attachment security on depression, b = -.038, p = .001, 95% CI [-.06, .02]. Although not included in our hypotheses, when controlling for age and outness, the direct effect of attachment security on depression was also significant, b = -.252 p < .001, 95% CI [-.31, -.19]. Including age and outness, this simple mediation model explained 45 approximately 22% of the variance in well-being (R = .217), resulting in further support 2 for an indirect effect of attachment security on depression via sense of belonging to the LGBQP community as a mediating variable. In Hypothesis 4, we predicted that, after controlling for attachment, sense of belonging to the general community will moderate the indirect effect of attachment security on depression via sense of belonging to the LGBQP Community. When controlling for age and outness as covariates, again, we did not detect a significant moderating effect of sense of belonging to the general community, b = .002, p = .886, 95% CI [-.03, .03]. This resulted in, again, no support for the idea that sense of belonging to the general community may moderate the indirect effect of attachment on depression through sense of belonging to the LGBQP Community. 46 Discussion We aimed to examine the relationships among belonging, attachment, and depression in a population of sexual-minority adults. We proposed a moderatedmediation model, wherein sense of belonging to the LGBQP Community mediated the relationship between attachment security and depressive symptoms, and sense of belonging to the general community moderated this indirect effect of attachment on depression through belonging to the LGBQP Community. Because previous research has shown that sexual-minority individuals experience higher rates of health disparities (Meyer, 2003; Stuber et al., 2008), including mental health disparities (Case et al., 2004; Cochran et al., 2003; King et al. 2008; Mills et al., 2004; Westefeld et al., 2001), it is important to further investigate factors contributing to negative mental health outcomes among sexual-minority individuals, as well as possible protective factors. Our research contributes to these efforts by proposing and investigating a potential mechanism by which attachment and sense of belonging may contribute to depression. We first examined the relationship between attachment and belonging to the LGBQP Community. In support of our first hypothesis, we found that higher levels of attachment security were associated with greater sense of belonging to the LGBQP Community. This suggests that attachment and belonging, and perhaps the processes underlying them both, may be related. Initial research on belonging speculated that it may be rooted in attachment systems (Hagerty, 1992). One possibility is that this happens through internal working models. Secure attachment results in internal working models of the self as loveable, acceptable, and worthy of care, and of others as caring, accepting, and trustworthy (Bowlby 1969; 1988). Individuals who view themselves as loveable and 47 acceptable, due to high levels of attachment security, may be more inclined to experience the “valued involvement” factor of sense of belonging, which is the belief that their own presence and involvement in a community is valued and needed by others in that community. Similarly, individuals who view others as trustworthy and available may more easily experience “fit,” the belief that their own characteristics fit in with others within a community. This is a possible implication of our results for attachment theory and the theory of sense of belonging. However, the fact that our results showed a significant positive correlation between attachment security and sense of belonging to the LGBQP Community should not be interpreted, in of itself, as evidence for the causal effect between these variables. We also examined the relationship between sense of belonging to the LGBQP community and depression. In support of our second hypothesis, we found that greater sense of belonging to the LGBPQP Community was associated with lower levels of depression. These results provide support for the theory of sense of belonging, which suggests that having a low sense of belonging to a community is associated with higher levels of depression (Hagerty et al., 1992, 1995, 1996). These results are in agreement with previous research on sense of belonging, which has found a significant negative correlation between sense of belonging to the LGB Community and depressive symptoms among sexual-minority individuals (McLaren, 2009; McLaren et al., 2013; McLaren & Castillo, 2021). These results also provide support for the minority stress model, which proposes that a minority identity may be a positive factor in an individual’s life if it provides access to social support based on shared identity (Meyer, 2003). If this were true, we would expect that people who feel more connected, involved, and valued within 48 the LGBQP community on the basis of their minority sexual orientation would also tend to have lower levels of depression (although it is important to note here that sense of belonging is not necessarily equivalent to, or a facet of, social support), and this is indeed what we found. Overall, taken at face value, these results suggest that sense of belonging to the LGBQP Community may be an important factor in understanding, and potentially preventing, depression among sexual-minority individuals. One of our expectations was that this study would yield evidence that one way attachment security may be exerting an effect on depression is by promoting belonging to the LGBQP Community, which in turn reduces depression. If this is true, then we would expect to observe a statistically significant indirect effect of attachment on depression via sense of belonging to the LGBQP Community, which is indeed what we found. Previous research has observed a direct effect of attachment on depression, with attachment security being negatively associated with depression (Bifulco et al., 2002; Murphy, 1997). In addition to providing support for the existence of this direct effect, our results provide one possibility for how this process might take shape. In addition, we predicted that the mechanism outlined above (that attachment security affects depression indirectly through sense of belonging to the LGBQP Community) may vary based on other factors, such as sense of belonging to the general community. Specifically, we expected that greater belonging to the LGBQP Community would be a more important mechanism negatively influencing depression among individuals with low belonging to the general community. However, we did not find support for this interaction effect happening in our sample. Taking this at face value, this finding suggests that sense of belonging to the LGBQP community is an important 49 mechanism by which attachment may influence depression, regardless of an individual’s sense of belonging to the general community. This also lends support to the idea we discussed earlier from the minority stress model, that social support based on shared identity should be associated with lower levels of depression (Meyer, 2003). Building upon the work of McLaren (2009), we were interested in examining how sense of belonging to the general community and specific belonging to the LGBQP Community are related in their effect on depression. One of McLaren (2009)’s main results involved a finding that a high sense of belonging to the Lesbian Community was associated with lower levels of depression for lesbians who felt low sense of belonging to the general community. McLaren’s results suggest that the impact of sense of belonging to the queer community on depression varies based on sense of belonging to the general community. If that is the case, we would expect that, even when controlling for attachment, our results would show that sense of belonging to the general community moderated the indirect effect of attachment on depression through sense of belonging to the LGBQP community. However, we did not find support for this effect in our sample. Our results suggest that sense of belonging to the LGBQP Community is not impacted by sense of belonging to the general community.2 Since very little research has been done on 2 It is important to acknowledge that we do not wish to directly compare McLaren (2009)’s moderation model to our moderated mediation model. However, we believe that addressing inconsistencies between our findings involving sense of belonging to the general community and sense of belonging to the LGBQP Community are worth noting. 50 these variables, and our model is different from McLaren’s overall, it is hard to know what to make of this disagreement within our results. Limitations The current study aims to explore the relationships between dimensions of attachment security, sense of belonging, and depressive symptoms in sexual-minority adults. There are several limitations to this study that may have affected our efforts to explore these associations and subsequent results. This study may be limited by the use of self-report measures. Self-report measures have been found to be vulnerable to social desirability bias (Latkin et al., 2017; Paulhus, 1984). The implication of this bias, particularly for our ECR-S measure, is that participants may have altered their responses in order to produce a more socially appropriate image of themselves. We observed only moderate internal consistency on this measure in our sample (ω = .70). If the ECR-S was not a valid measure of attachment insecurity, it may therefore have impacted the internal validity of the study overall. Although this does not raise specific concerns about our results, we acknowledge it as a potential threat to internal validity. Further, our recruitment strategy involved reaching out to LGBQP-centered spaces such as Reddit forums, University organizations, and national databases centered around queer identity. Consequently, we primarily recruited participants who voluntarily sought out membership and participation in online or in-person LGBQP groups. Thus, participants in our sample may have a higher sense of belonging to the LGBQP Community than the average of queer individuals in the general population. This may have affected our findings, specifically the significant support for our second as well as third hypotheses. If our sample has an above average sense of belonging as a result of 51 consistent community, this may mean that our results cannot be generalized to the LGBQP community as a whole. An additional limitation that is important to address is that the correlational and cross-sectional design of this study limits causal interpretations of the results. Our hypotheses and model imply a specific temporal order of causal events. Namely, we propose that higher levels of attachment security lead to greater sense of belonging to the LGBQP Community, which leads to lesser depression. Although our results showed significant correlations between attachment and LGBQP belonging, as well as between LGBQP belonging and depression, these correlations cannot be interpreted as causal connections. Additionally, although our results showed a significant indirect effect of attachment on depression via sense of belonging, indicating that there is statistical support for the effect in the way we proposed, this should not be interpreted as evidence of causality. Further research using a longitudinal design is needed to investigate the causal relationships among these variables. Possible alternative explanations to the relationships found include the possibility that the GBS (Malone, Pillow, & Osman, 2011) may be measuring loneliness instead of measuring sense of belonging. As discussed above, the measures of sense of belonging currently available do have high correlations with other measures of psychological functioning such as loneliness, depression, and anxiety (Hagerty et al., 1996). It is possible that sense of belonging is an independent construct, and the current measures are not accurately assessing it. It is also possible that reduced sense of belonging is simply an aspect of depression, loneliness, or something else entirely, rather than an independent construct. Neuroticism and other psychological factors may also be interacting with the 52 GBS (Malone, Pillow, & Osman, 2011) as participants may vary widely in how much neuroticism they experience. Some previous research has found that by controlling for neuroticism, correlations between depression and other variables such as self-esteem may significantly change (Mu et al., 2019). Another possible alternative explanation link involves the concept of identity centrality. Identity centrality is defined as the extent to which one’s identity is central to one’s self definition (Mohr & Kendra, 2011). We may be making an assumption about non-heterosexual individuals through this research. Based on the minority stress model and the theory of sense of belonging, our model makes the assumption that if sexualminority individuals do feel a low sense of belonging to the general community due to their sexual orientation, it is a greater sense of belonging to the LGBQP community specifically that will buffer against experiencing depression. However, people live multifaceted lives and are a part of multiple communities. There may be any number of other communities besides the LGBQP Community that non-heterosexual individuals feel a higher, more prolonged sense of belonging to, that may have a greater effect on their depression than sense of belonging to the LGBQP Community. Future Research Future research may continue to explore the relationship between the general and LGBQP Communities. Continued research may lend a better understanding to subtleties within these communities and potential alternative variables that may contribute to the relationships among them. Perhaps future studies with a strong foundation in the minority stress model may be able to elucidate additional factors at play that were not captured within the present study. 53 Additionally, the use of a different attachment measure may lend a deeper understanding of relationships to specific dimensions of attachment security. Because the ECR-S is a self-report measure, it may be appropriate to explore associations between attachment security, belonging and depressive symptoms through a non-self-report measure. Through the use of an alternative measure, perhaps the validity of attachment measurement and internal validity of future studies may be improved. Future research may consider a recruitment strategy that does not sample from established LGB groups online and in-person. To ensure that sense of belonging is not higher in the sample than in the population, due to established belonging in a close-knit group, perhaps researchers may seek non-heterosexuals broadly in non-sexuality forums and groups. Alternatively, researchers may still sample established LGB groups, yet compare these results to non-heterosexuals from non-sexuality related forums or groups. Our research was limited due to its correlational as well as cross-sectional nature; future research may explore the parameters of a possible experimental or longitudinal study to further investigate causal relationships between variables. In order to evaluate the effectiveness of the General Belongingness Scale (GBS; Malone, Pillow, & Osman, 2011), additional close assessment of its psychometric properties may be appropriate to determine whether it is assessing sense of belonging or other psychological factors including loneliness. Some previous research has indicated that neuroticism may be a confounding variable for depression (Mu et al., 2019). Further research is needed to determine if neuroticism interacts with the GBS measure, or if by controlling for neuroticism the relationships between attachment, sense of belonging, and depression differ from results in the present study. 54 The incorporation of identity centrality into future studies may combat the assumption we make in the present study that the LGBQP Community is central to nonheterosexuals’ self definition and thus a high sense of belonging to the LGBQP Community will lower their levels of depression based on the minority stress model. However, by including levels of identity centrality, future research may more fully capture other factors contributing to sense of belonging to the LGBQP Community, as well as perhaps expand to include other prominent communities in participants’ lives. Subsequent research may look into a study on gender minority individuals specifically, to explore the ways in which gender may affect relationships among attachment security, sense of belonging, and depressive symptoms. Our study was limited in its investigation of sexual-minority individuals specifically. Future research might expand to better understand these factors within a gender minority sample. Practical Implications The present study may have some important implications. Perhaps our findings may contribute to mental health prevention and intervention efforts vis-a-vis depression for queer individuals. Connecting people to the LGBQP Community may help them to feel a stronger sense of belonging and, in turn, positively impact their mental health. Mental health practitioners, community organizers, individuals, and larger institutions should consider the impact of creating safe, consistent non-heterosexual spaces or resources for sexual-minority individuals to participate in (Toomey, 2011). Sexual-minority individuals experience higher rates of negative health outcomes and mental distress compared to heterosexuals (Meyer, 1995; Meyer, 2003; Stuber et al., 2013). Conflicts with attachment figures may arise due to attempts to “come out” 55 resulting in a lack of support (Mohr & Fassinger, 2003). There are positive implications in future efforts to inform the general public on potential health and wellness disparities among sexual-minority adults compared to heterosexual counterparts, as well as an opportunity to explore avenues for psychosocial adjustment and broader public implementation of shared spaces for belonging. One opportunity for education may involve trainings for college administrators on the importance of a sense of belonging, specifically for students who experience minority stress. More research needs to be done to investigate the effects of attachment and belonging on depression among sexual-minority individuals. Specifically, research examining the importance of sense of belonging to the LGBQP community to the mental well-being of sexual-minority individuals is surprisingly limited. Additionally, our research provides support for the use of attachment and belonging together to understand depression in future studies. 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Journal of Abnormal Psychology, 112, 144-151. https://doi.org/10.1037/0021843X.112.1.144 69 Appendix A LGB Affinity Groups and Listservs Contacted During Participant Recruitment University of Pittsburgh Allies Network Clemson University Athlete Ally/C-SAGA/OSTEM/PRISM/CQSCA/CSF/LAVGRAD North Carolina State University GLBTCA Purdue University Delta Lambda Pi/Gamma Rho Lambda/Krannert Out/LGBTQ+ Student Alliance/National Gay Pilots Assocation/Queer Students of Color Brigham Young University Office of Student Success and Inclusion University of Georgia Pride Center University of Illnois-Urbana Champaign Fuse/oSTEM/Women of Pride University of Wisconsin Out4B/QTPOC/Sex Out Loud/The Pride Society Virginia Tech LGBTQ+ Resource Center University of Texas eQual MBAs at McCombs/HangOut/Engineering LGBQTies/iSchool Pride/Outletes and Allies/Q&A/QPHA/QTBIPOCA University of California-Berkeley Biyuti/oSTEM/O4B/QAPPA/Queering Public Health/QTPOCC University of Virginia Sigma Omicron Rho/Queer Student Union University of Michigan AHAVA/BiLateral/Coalition for Queer People of Color University of Southern California QuASA/QGA Rutgers Delta Lambda Phi/oSTEM/Q&A/Queer and Christian/Rainbow Pines The Ohio State University GRL/NGPA at OSU/PRIDE/SHADES/SDES University of Massachusetts Amherst BPQ Collective/LGBTQIA+ Support Group University of Oregon Pansy/Pride 70 University of Pennsylvania J-Bagel/Lambda Alliance/QCF/QSA/QPOC/Sappho Princeton University The Pride Alliance/LGBTQ-J/PULPO LGBT+ Branch Lehigh University Spectrum/SPEAK/oSTEM University of Louisville HSC Pride/SAGA/Shades University of Maryland Pride Alliance/Hamsa GLBT Asians and Friends - Houston GLBT Interpride - Houston GLBT Woodlands Pride - Texas GLBT Pride Chorus - Houston 71 Appendix B Full List of Online Reddit.com Forums Used During Participant Recruitment r/ActualLesbians r/LGBT r/AreTheStraightsOK r/LGBTnews r/AskGayBros r/MarriedAndBi r/AskGayMen r/Omnisexual r/AskLesbians r/Pansexual r/AskLGBT r/Queer r/BiBros r/Sexuality r/Bisexual r/SuddenlyLesbian r/Bisexual_Women_Chat r/BisexualAdults r/BisexualHumans r/BisexualMen r/BiWomen r/ComingOut r/CompHet r/Gay r/GayBros r/GayChristians r/LateBloomerLesbians r/LesbianActually 72 Appendix C Mental-Health Resources for LGBQP Individuals Provided In the Debriefing Form 1. The Trevor Project: (866) 488-7386. The Trevor Project is the leading national organization providing crisis intervention and suicide prevention services to lesbian, gay, bisexual, transgender and questioning (LGBTQ) young people ages 13-24. 2. National Suicide Prevention Lifeline: (800) 273-8255 (online chat available). The National Suicide Prevention Lifeline is a national network of local crisis centers that provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week. 3. Crisis Text Line: Text START to 741-741. Crisis Text Line is free, 24/7 support for those in crisis. Text from anywhere in the USA to text with a trained Crisis Counselor. 4. The Gay, Lesbian, Bisexual and Transgender National Hotline: (888) 843-4564 Toll-Free National Hotline, Monday – Friday 4 p.m. to 12 a.m. ET, Saturday 12 p.m. to 5 p.m. ET. 5. The GLBT National Youth Talkline: (800) 246-7743. Both provide telephone, online private one-to-one chat and email peer-support, as well as factual information and local resources for cities and towns across the United States. Youth serving youth through age 25. 73 6. SAGE LGBT Elder Hotline 1-877-360-LGBT (5428). Talk and be heard at the SAGE LGBT Elder Hotline. Connects LGBT older people with friendly responders. For LGBT elders and caretakers. Confidential support and crisis response, available 24/7. 7. THRIVE Lifeline Text 'oSTEM' to +1 (313) 662-8209 anytime, from anywhere. THRIVE Lifeline’s text based crisis hotline brings together experienced suicide interveners partnered with oSTEM to help keep you safe during times of acute mental health crises. If you are not in an acute crisis, but are dealing with stress as you navigate identity, orientation, or barriers to academic and professional entry, THRIVE can help! Available 24/7/365, Must be 18 years or older. 74 Appendix D Informed Consent Form This survey is designed to take about 10-15 minutes to complete. At the end of the survey, you can provide your email address to be entered into a raffle for one of four $25 gift cards. On April 7th, 2022, we will randomly select four gift-card recipients. What is this research? Abigail Bergey and Olivia Liponis, psychology students at Whitman College, are conducting this study as a part of their thesis research. We are trying to better understand the links between relationships, belonging to a community, and well-being in LGBQP (lesbian, gay, bisexual, queer, pansexual) persons. Your participation will help us toward this goal. The questions in this survey are about your experiences in relationships, your feelings of connection to different communities, and your mood. Voluntary participation. Right to Withdraw. Your participation in this study is voluntary, and you can exit the survey at any time. Most people feel at ease participating in questionnaire research like ours. The risks from participating are considered minimal. Some people feel uncomfortable or upset when answering questions about themselves. If a question makes you feel uncomfortable, you can skip it. Confidentiality. 75 This survey is administered through Qualtrics (an online survey platform), which uses encryption and a firewall to protect the data. We will keep the information you provide confidential. The only people that will be able to access the information will be the researchers, and their thesis advisor Dr. Pavel S. Blagov, PhD. The data files will be stored in encrypted folders, on our password-protected personal computers. The study is not meant to draw conclusions about individuals, and all data will be combined for the purpose of statistical analyses. The data will only be used for our research purposes, and individual responses will never be published. If you choose to provide your email address, it will be kept separate from the rest of your responses and deleted immediately after we select the raffle winners. Questions or concerns. This study has been approved by Whitman College’s Institutional Review Board, a committee that reviews the ethics for research with human participants. You may contact the researchers at bergeyae@whitman.edu or liponiom@whitman.edu with any questions you may have about this study. You may direct any concerns you have to us or you may contact the Whitman College IRB at irb@whitman.edu. We hope you enjoy participating in our study! 76 Appendix E Debriefing Form Thank you for your participation in this research study. More information about this study: Previous research has found that people with a strong sense of belonging are less likely to have high levels of depression. Similarly, people who describe their close relationships with a great deal of trust and security are less likely to have high levels of depression. Previous studies have found that depression is disproportionately common in sexual minority individuals. We are trying to understand whether a sense of belonging to the LGBQP community may be part of that process. We anticipate that people who have experienced closeness and security in relationships will have higher sense of belonging to the LGBQP community, and that will lead to lower levels of depression. We will use statistical analyses to determine if these ideas have some support. Please do not disclose research procedures and/or purpose to anyone who might participate in this study in the future, as this could affect the results of the study. If you have questions: The researchers conducting this study are Abigail Bergey and Olivia Liponis, overseen by Pavel S. Blagov, PhD in the Department of Psychology at Whitman College. If you have questions later, you may contact Abigail Bergey at bergeyae@whitman.edu or Olivia Liponis at liponiom@whitman.edu. If you have any questions or concerns 77 regarding your rights as a research participant in this study, you may contact the Institutional Review Board (IRB) chairperson at irb@whitman.edu. Gift-card raffle: If you provide your email address and agree to have your data used for this study, you will still be entered into the raffle for a chance to win one of four $25 gift cards for your participation. (Only applicable for participants who are not currently enrolled as students at Whitman College) On April 7th, 2022, we will randomly select four gift-card recipients, and notify them by email. Mental health resources for LGBQP individuals: If responding to the questions in this survey has raised concerns for you about your mental health, please consider reaching out to one of the following resources. (Refer to Appendix C) 78 Appendix F Outness Demographics Table Characteristic n % Sexual orientation disclosure to members of your immediate family 0% 42 11.5 10% 36 9.9 20% 27 7.4 30% 17 4.7 40% 13 3.6 50% 22 6.0 60% 13 3.6 70% 22 6.0 80% 27 7.4 90% 15 4.1 100% 130 35.7 Sexual orientation disclosure to members of your extended family 0% 102 28.0 10% 50 13.7 20% 29 8.0 30% 31 8.5 40% 16 4.4 50% 22 6.0 60% 13 3.6 70% 22 6.0 80% 20 5.5 79 90% 20 5.5 100% 39 10.7 Sexual orientation disclosure to people you socialize with 0% 7 1.9 10% 29 8.0 20% 19 5.2 30% 19 5.2 40% 18 4.9 50% 28 7.7 60% 21 5.8 70% 28 7.7 80% 40 11.0 90% 61 16.8 100% 94 25.8 Sexual orientation disclosure to people at your work/school 0% 64 17.6 10% 34 9.3 20% 22 6.0 30% 34 9.3 40% 27 7.4 50% 37 10.2 60% 31 8.5 70% 20 5.5 80% 33 9.1 90% 17 4.7 100% 45 12.4 Sexual orientation disclosure to strangers 80 0% 137 37.6 10% 3 14.6 20% 38 10.4 30% 31 8.5 40% 27 7.4 50% 35 9.6 60% 11 3.0 70% 11 3.0 80% 9 2.5 90% 4 1.1 100% 8 2.2 81