BODIES UNDER STRESS – PSYCHOLOGICAL MEDIATION MODELS ON MINORITY STRESS, BODY IMAGE AND EATING BEHAVIOURS IN LGBTQ+ PEOPLE

The experience of minority stress is a known risk factor for a number of negative health consequences. Exploring the impact of minority stress on disordered eating and body image and how this impact is determined could inform both policymaking and clinical practice. Drawing theoretical standing from Minority Stress Theory and the Psychological Mediation Framework, this dissertation will explore how minority stress in LGBTQ+ people can determine a heightened risk of disordered eating behaviours and body image concerns, reviewing its impact on a number of intrapsychic characteristics. The thesis presents two systematic reviews of the literature aimed at mapping existing knowledge and identifying gaps in the literature, representing the founding empirical basis of the dissertation. Four studies are then conducted on collected self-report data aimed at filling some of the identified gaps in the literature – three in the Italian context and one across the Italian and British contexts. The first chapter presents the systematic review of the literature on the relationship between minority stress and body image. The review finds minority stress to be reliably linked to increased body image concerns and lower body esteem in existing literature. Several mediating factors are identified, as well as specificities of LGBTQ+ people in body image concerns. The second chapter presents the systematic review of the literature on the relationship between minority stress and disordered eating. The review finds minority stress to be reliably linked to disordered eating in existing literature and identifies several mediating factors and specificities of LGBTQ+ people. The third chapter presents a study on the role of daily heterosexist experiences in heightening eating disorder risk, focusing on the possible mediating role of self-esteem, emotion regulation and shame. Results show how distress related to heterosexist experiences heightens eating disorder risk through its impact on low self-esteem and emotion dysregulation. The fourth chapter presents a study on the relation between vicarious trauma and eating disorder risk. Results find vicarious trauma to be significantly and directly linked to eating disorder risk, as well as significant indirect effects through low self-esteem and emotion dysregulation. The fifth chapter focuses on the bisexual participants in the Italian context, examining the relation between internalized binegativity and binge eating symptoms. Results show how the relation between the two is significantly mediated by an indirect effect through shame. Dissertation Abstract Finally, the sixth chapter focuses on the possible role of structural stigma, drawing comparisons between Italian and British participants, examining their respective national contexts. Results show Italian participants having a higher level of distress related to heterosexist experiences compared to British participants, as well as lower self-esteem and higher body shame. However, the study has important limitations regarding sample size and composition. The findings of this dissertation show how minority stress is reliably linked to body image concerns and disordered eating, and that its impact on intrapsychic characteristics may explain the disparities in health levels of LGBTQ+ people found in the literature. A number of methodological limitations necessitate caution in generalization of its results, as more studies are needed. Clinical practice may benefit from considering the impact of minority stress on intrapsychic characteristics such as self-esteem, emotion dysregulation and shame. Reducing minority stress, and working toward creating a social, organizational and institutional context of respect and acceptance towards LGBTQ+ people, as well as promoting LGBTQ+ civil rights, may in turn improve their physical and mental health.