Rumination mediates the associations between sexual minority stressors and disordered eating, particularly for men

  • Shirley B. WangEmail author
  • Ashley Borders
Original Article



Sexual minority individuals experience unique minority stressors leading to negative clinical outcomes, including disordered eating. The psychological mediation framework posits that stress related to discrimination, internalized homonegativity, and concealment makes sexual minority individuals more vulnerable to maladaptive coping processes, such as rumination, known to predict disordered eating. The current study examined the influence of sexual minority stressors and rumination on disordered eating, and whether these associations differed between sexual minority men and women. We hypothesized that perceived discrimination, internalized homonegativity, and concealment would be positively associated with disordered eating, and that rumination about sexual minority stigma would mediate these associations.


One-hundred and sixteen individuals who identified as sexual minorities completed a survey study assessing perceived discrimination, internalized homonegativity, concealment, rumination about sexual minority stigma, and disordered eating.


Discrimination and concealment uniquely predicted disordered eating in both men and women. However, rumination emerged as a significant mediator for concealment and (marginally) for discrimination for men only. Internalized homonegativity was not uniquely associated with rumination or disordered eating for men or women.


Sexual minority men who experience discrimination and conceal their sexual orientation may engage in more disordered eating because they dwell on sexual minority stigma. We propose other potential mechanisms that may be relevant for sexual minority women.


Sexual minority Discrimination Concealment Rumination Disordered eating 


Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Matthews-Ewald MR, Zullig KJ, Ward RM (2014) Sexual orientation and disordered eating behaviors among self-identified male and female college students. Eat Behav 15(3):441–444. doi: 10.1016/j.eatbeh.2014.05.002 CrossRefPubMedGoogle Scholar
  2. 2.
    Schneider JA, O’Leary A, Jenkins SR (1995) Gender, sexual orientation, and disordered eating. Psychol Health 10(2):113–128. doi: 10.1080/08870449508401942 CrossRefGoogle Scholar
  3. 3.
    Meyer IH (2003) Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychol Bull 129(5):674–697. doi: 10.1037/0033-2909.129.5.674 CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Wiseman MC, Moradi B (2010) Body image and eating disorder symptoms in sexual minority men: A test and extension of objectification theory. J Couns Psychol 57(2):154–166. doi: 10.1037/a0018937 CrossRefPubMedGoogle Scholar
  5. 5.
    Watson LB, Grotewiel M, Farrell M, Marshik J, Schneider M (2015) Experiences of sexual objectification, minority stress, and disordered eating among sexual minority women. Psychol Women Q 39(4):458–470. doi: 10.1177/0361684315575024 CrossRefGoogle Scholar
  6. 6.
    Frisell T, Lichtenstein P, Rahman Q, Långström N (2010) Psychiatric morbidity associated with same-sex sexual behaviour: Influence of minority stress and familial factors. Psychol Med 40(2):315–324. doi: 10.1017/S0033291709005996 CrossRefPubMedGoogle Scholar
  7. 7.
    Reilly A, Rudd NA (2006) Is internalized homonegativity related to body image? Fam Consum Sci Res J 35(1):58–73. doi: 10.1177/1077727X06289430 CrossRefGoogle Scholar
  8. 8.
    Mason TB, Lewis RJ (2015) Minority stress and binge eating among lesbian and bisexual women. J Homosex 62(7):971–992. doi: 10.1080/00918369.2015.1008285 CrossRefPubMedGoogle Scholar
  9. 9.
    Hatzenbuehler ML (2009) How does sexual minority stigma ‘get under the skin’? A psychological mediation framework. Psychol Bull 135(5):707–730. doi: 10.1037/a0016441 CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Mason TB, Lewis RJ (2016) Examining social support, rumination, and optimism in relation to binge eating among Caucasian and African–American college women. Eat Weight Disord. doi: 10.1007/s40519-016-0300-x CrossRefPubMedGoogle Scholar
  11. 11.
    Naumann E, Tuschen-Caffier B, Voderholzer U, Caffier D, Svaldi J (2015) Rumination but not distraction increases eating-related symptoms in anorexia and bulimia nervosa. J Abnorm Psychol 124(2):412–420. doi: 10.1037/abn0000046 CrossRefPubMedGoogle Scholar
  12. 12.
    Maraldo TM, Zhou W, Dowling J, Vander Wal JS (2016) Replication and extension of the dual pathway model of disordered eating: the role of fear of negative evaluation, suggestibility, rumination, and self-compassion. Eat Behav 23:187–194. doi: 10.1016/j.eatbeh.2016.10.008 CrossRefPubMedGoogle Scholar
  13. 13.
    Martin LL, Tesser A (1996) Some ruminative thoughts. In: Wyer RJ, Wyer RJ (eds) Ruminative thoughts. Lawrence Erlbaum Associates Inc, Hillsdale, pp 1–47Google Scholar
  14. 14.
    Hatzenbuehler ML, Nolen-Hoeksema S, Dovidio J (2009) How does stigma ‘get under the skin’? The mediating role of emotion regulation. Psychol Sci 20(10):1282–1289. doi: 10.1111/j.1467-9280.2009.02441.x CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Szymanski DM, Dunn TL, Ikizler AS (2014) Multiple minority stressors and psychological distress among sexual minority women: the roles of rumination and maladaptive coping. Psychol Sex Orientat Gend Divers 1(4):412–421. doi: 10.1037/sgd0000066 CrossRefGoogle Scholar
  16. 16.
    Herek GM (2009) Hate crimes and stigma-related experiences among sexual minority adults in the United States: Prevalence estimates from a national probability sample. J Interpers Violence 24(1):54–74. doi: 10.1177/0886260508316477 CrossRefPubMedGoogle Scholar
  17. 17.
    Feinstein BA, Goldfried MR, Davila J (2012) The relationship between experiences of discrimination and mental health among lesbians and gay men: An examination of internalized homonegativity and rejection sensitivity as potential mechanisms. J Consult Clin Psychol 80(5):917–927. doi: 10.1037/a0029425 CrossRefPubMedGoogle Scholar
  18. 18.
    Dewaele A, Van Houtte M, Vincke J (2014) Visibility and coping with minority stress: A gender-specific analysis among lesbians, gay men, and bisexuals in Flanders. Arch Sex Behav 43(8):1601–1614. doi: 10.1007/s10508-014-0380-5 CrossRefPubMedGoogle Scholar
  19. 19.
    Gordon KH, Holm-Denoma JM, Troop-Gordon W, Sand E (2012) Rumination and body dissatisfaction interact to predict concurrent binge eating. Body Image 9(3):352–357. doi: 10.1016/j.bodyim.2012.04.001 CrossRefPubMedGoogle Scholar
  20. 20.
    McLaughlin KA, Aldao A, Wisco BE, Hilt LM (2014) Rumination as a transdiagnostic factor underlying transitions between internalizing symptoms and aggressive behavior in early adolescents. J Abnorm Psychol 123(1):13–23. doi: 10.1037/a0035358 CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Nolen-Hoeksema S, Harrell ZA (2002) Rumination, depression, and alcohol use: tests of gender differences. J Cogn Psychother 16(4):391–403. doi: 10.1891/jcop.16.4.391.52526 CrossRefGoogle Scholar
  22. 22.
    Williams DR, Yu Y, Jackson JS, Anderson NB (1997) Racial differences in physical and mental health: socio-economic status, stress and discrimination. J Health Psychol 2(3):335–351. doi: 10.1177/135910539700200305 CrossRefPubMedGoogle Scholar
  23. 23.
    Krieger N, Smith K, Naishadham D, Hartman C, Barbeau EM (2005) Experiences of discrimination: validity and reliability of a self-report measure for population health research on racism and health. Soc Sci Med 61(7):1576–1596. doi: 10.1016/j.socscimed.2005.03.006 CrossRefPubMedGoogle Scholar
  24. 24.
    Mohr JJ, Kendra MS (2011) Revision and extension of a multidimensional measure of sexual minority identity: the Lesbian, Gay, and Bisexual Identity Scale. J Couns Psychol 58(2):234–245. doi: 10.1037/a0022858 CrossRefPubMedGoogle Scholar
  25. 25.
    Wade NG, Vogel DL, Liao KY, Goldman DB (2008) Measuring state-specific rumination: development of the Rumination About an Interpersonal Offense Scale. J Couns Psychol 55(3):419–426. doi: 10.1037/0022-0167.55.3.419 CrossRefGoogle Scholar
  26. 26.
    Sukhodolsky DG, Golub A, Cromwell EN (2001) Development and validation of the Anger Rumination Scale. Pers Individ Differ 31(5):689–700. doi: 10.1016/S0191-8869(00)00171-9 CrossRefGoogle Scholar
  27. 27.
    Garner DM, Olmsted MP, Bohr Y, Garfinkel PE (1982) The eating attitudes test: psychometric features and clinical correlates. Psychol Med 12(4):871–878. doi: 10.1017/S0033291700049163 CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Brewster ME, Velez BL, Esposito J, Wong S, Geiger E, Keum BT (2014) Moving beyond the binary with disordered eating research: a test and extension of objectification theory with bisexual women. J Couns Psychol 61(1):50–62. doi: 10.1037/a0034748s CrossRefPubMedGoogle Scholar
  29. 29.
    Muthén LK, Muthén BO (1998) Mplus user’s guide (1998–2012), 7th edn. Muthén & Muthén, Los Angeles, CAGoogle Scholar
  30. 30.
    Little R, Rubin D (1987) Statistical analysis with missing data. Wiley, New YorkGoogle Scholar
  31. 31.
    Preacher KJ, Hayes AF (2008) Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods 40:879–891. doi: 10.3758/BRM.40.3.879 CrossRefPubMedGoogle Scholar
  32. 32.
    Critcher CR, Ferguson MJ (2014) The cost of keeping it hidden: decomposing concealment reveals what makes it depleting. J Exp Psychol Gen 143(2):721–735. doi: 10.1037/a0033468 CrossRefPubMedGoogle Scholar
  33. 33.
    Heatherton TF, Baumeister RF (1991) Binge eating as escape from self-awareness. Psychol Bull 110:86–108CrossRefGoogle Scholar
  34. 34.
    Nolen-Hoeksema S, Wisco BE, Lyubomirsky S (2008) Rethinking rumination. Perspect Psychol Sci 3:400–424. doi: 10.1111/j.1745-6924.2008.00088 CrossRefPubMedGoogle Scholar
  35. 35.
    Kashubeck-West S, Mintz LB, Saunders KJ (2001) Assessment of eating disorders in women. Couns Psychol 29(5):662–694. doi: 10.1177/0011000001295003 CrossRefGoogle Scholar
  36. 36.
    Watkins E, Scott J, Wingrove J, Rimes K, Bathurst N, Steiner H, Malliaris Y (2007) Rumination-focused cognitive behaviour therapy for residual depression: a case series. Behav Res Ther 45(9):2144–2154. doi: 10.1016/j.brat.2006.09.018 CrossRefPubMedGoogle Scholar
  37. 37.
    Ramel W, Goldin PR, Carmona PE, McQuaid JR (2004) The effects of mindfulness meditation on cognitive processes and affect in patients with past depression. Cognit Ther Res 28:433–455. doi: 10.1023/B:COTR.0000045557.15923.96 CrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of PsychologyThe College of New JerseyEwingUSA

Personalised recommendations