PROJECT SUMMARY
Sexual minority adolescents (SMA) are disproportionately affected by mental health problems such as
depression and suicidality relative to their heterosexual peers. These disparities are greatest during
adolescence and persist into adulthood, and are generally attributed to the unique interpersonal stressors that
they face (e.g., sexual orientation-related rejection). Given that rejection is a robust risk factor for mental health
problems, especially during adolescence, it has historically been the focus of research on SM individuals'
mental health. However, in addition to experiences of rejection, expectations of rejection and the emotions that
accompany them also play important roles in mental health. The rejection sensitivity (RS) theory proposes that
early experiences of rejection can lead to a disposition to anxiously expect, readily perceive, and intensely
react to rejection, which can then compromise one's mental health. Despite evidence that RS is associated
with a range of mental health problems among SM adults, our understanding of its development and role in
SMA's mental health is limited in several important ways (e.g., nearly all prior studies have been cross-
sectional studies of adults, and there has been a lack of attention to different emotions that can accompany
expectations of rejection as well as underlying mechanisms and protective factors).
Given these gaps, the goals of the proposed R01 are to determine the role of sexual orientation-related
rejection in the development of different types of RS and their respective mental health consequences among
SMA, to identify the mechanisms through which RS influences mental health in this population, and to identify
protective factors in the development of RS. We will recruit a cohort of 500 SMA (ages 14-17) to participate in
a longitudinal and experience-sampling study using methods established in our team's prior work. Data will be
collected at four biannual assessments (baseline, 6-, 12-, 18-months) to determine the longitudinal relations
among sexual orientation-related rejection, RS (anxious and angry), and mental health (depression symptoms
and clinical elevations, suicidal ideation, and reactive aggression). In addition, participants will complete a 6-
week experience-sampling study (4 assessments per day, administered in two 3-week bursts) to examine
antecedents and consequences of RS as they occur in daily life. These data will be used to accomplish three
specific aims: (1) Determine the longitudinal and daily relations among sexual orientation-related rejection, RS
(anxious and angry), and mental health (depression, suicidal ideation, and reactive aggression); (2) Identify
mechanisms (social withdrawal, self- and other-blame in response to rejection, and sexual orientation
concealment) underlying the longitudinal and daily relations between RS and mental health problems; and (3)
Examine sexual orientation-related social support and acceptance as protective factors in the development of
RS. The proposed R01 will advance our understanding of the development of RS, its consequences, the
underlying mechanisms, and protective factors, which will inform interventions to improve SMA's mental health.
